Abstract
Low back pain (LBP) is one of the most common musculoskeletal conditions, and intervertebral disc (IVD) degeneration is associated with most cases. Although many treatment options are available, they focus on the removal of symptoms rather than repair of the degenerate tissue. However, there is a growing interest in the potential of cell-based tissue engineering strategies for regeneration of the damaged IVD. To achieve this, investigators are now focusing on the use of mesenchymal stem cells (MSCs), which offer several advantages over more mature cell types. A number of problems must be overcome for MSC-based IVD regeneration to be successful, including determining a method for the differentiation of stem cells into nucleus pulposus-like cells. Although this is still a relatively new field, it offers huge potential for the clinical treatment of IVD degeneration and LBP in the future.
Similar content being viewed by others
References and Recommended Reading
Stewart WF, Ricci JA, Chee E, et al.: Lost productive time and cost due to common pain conditions in the US workforce. JAMA 2003, 290:2443–2454.
Walker BF: The prevalence of low back pain: a systematic review of the literature from 1966 to 1998. J Spinal Disord 2000, 13:205–217.
Papageorgiou AC, Croft PR, Ferry S, et al.: Estimating the prevalence of low back pain in the general population. Evidence from the South Manchester Back Pain Survey. Spine 1995, 20:1889–1894.
Jones GT, Johnson RE, Wiles NJ, et al.: Predicting persistent disabling low back pain in general practice: a prospective cohort study. Br J Gen Pract 2006, 56:334–341.
Harkness EF, Macfarlane GJ, Silman AJ, McBeth J: Is musculoskeletal pain more common now than 40 years ago?: Two population-based cross-sectional studies. Rheumatology (Oxford) 2005, 44:890–895.
Maniadakis N, Gray A: The economic burden of back pain in the UK. Pain 2000, 84:95–103.
Andersson GB: Epidemiological features of chronic low-back pain. Lancet 1999, 354:581–585.
Nelemans PJ, deBie RA, deVet HC, Sturmans F: Injection therapy for subacute and chronic benign low back pain. Spine 2001, 26:501–515.
Fritzell P, Hagg O, Wessberg P, Nordwall A: 2001 Volvo Award Winner in Clinical Studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine 2001, 26:2521–2532.
Fairbank J, Frost H, Wilson-MacDonald J, et al.: Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial. BMJ 2005, 330:1233.
Levin DA, Hale JJ, Bendo JA: Adjacent segment degeneration following spinal fusion for degenerative disc disease. Bull NYU Hosp Jt Dis 2007, 65:29–36.
Blumenthal S, McAfee PC, Guyer RD, et al.: A prospective, randomized, multicenter Food and Drug Administration investigational device exemptions study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: part I: evaluation of clinical outcomes. Spine 2005, 30:1565–1575.
Bertagnoli R, Yue JJ, Shah RV, et al.: The treatment of disabling single-level lumbar discogenic low back pain with total disc arthroplasty utilizing the Prodisc prosthesis: a prospective study with 2-year minimum follow-up. Spine 2005, 30:2230–2236.
Di Martino A, Vaccaro AR, Lee JY, et al.: Nucleus pulposus replacement: basic science and indications for clinical use. Spine 2005, 30:S16–S22.
Sive JI, Baird P, Jeziorsk M, et al.: Expression of chondrocyte markers by cells of normal and degenerate intervertebral discs. Mol Pathol 2002, 55:91–97.
Mwale F, Roughley P, Antoniou J: Distinction between the extracellular matrix of the nucleus pulposus and hyaline cartilage: a requisite for tissue engineering of intervertebral disc. Eur Cell Mater 2004, 8:58–63.
Zhao CQ, Jiang LS, Dai LY: Programmed cell death in intervertebral disc degeneration. Apoptosis 2006, 11:2079–2088.
Le Maitre CL, Freemont AJ, Hoyland JA: Accelerated cellular senescence in degenerate intervertebral discs: a possible role in the pathogenesis of intervertebral disc degeneration. Arthritis Res Ther 2007, 9:R45.
Le Maitre CL, Freemont AJ, Hoyland JA: Localization of degradative enzymes and their inhibitors in the degenerate human intervertebral disc. J Pathol 2004, 204:47–54.
Le Maitre CL, Hoyland JA, Freemont AJ: Interleukin-1 receptor antagonist delivered directly and by gene therapy inhibits matrix degradation in the intact degenerate human intervertebral disc: an in situ zymographic and gene therapy study. Arthritis Res Ther 2007, 9:R83.
Masuda K, Imai Y, Okuma M, et al.: Osteogenic protein-1 injection into a degenerated disc induces the restoration of disc height and structural changes in the rabbit anular puncture model. Spine 2006, 31:742–754.
Li X, Leo BM, Beck G, et al.: Collagen and proteoglycan abnormalities in the GDF-5-deficient mice and molecular changes when treating disk cells with recombinant growth factor. Spine 2004, 29:2229–2234.
Yoon ST, Park JS, Kim KS, et al.: ISSLS prize winner: LMP-1 upregulates intervertebral disc cell production of proteoglycans and BMPs in vitro and in vivo. Spine 2004, 29:2603–2611.
Jones DG, Peterson L.: Autologous chondrocyte implantation. J Bone Joint Surg Am 2006, 88:2502–2520.
Meisel HJ, Siodla V, Ganey T, et al.: Clinical experience in cell-based therapeutics: disc chondrocyte transplantation A treatment for degenerated or damaged intervertebral disc. Biomol Eng 2007, 24:5–21.
Meisel HJ, Ganey T, Hutton WC, et al.: Clinical experience in cell-based therapeutics: intervention and outcome. Eur Spine J 2006, 15(Suppl 3):S397–S405.
Stockwell RA: The interrelationship of cell density and cartilage thickness in mammalian articular cartilage. J Anat 1971, 109:411–421.
Maroudas A, Stockwell RA, Nachemson A, Urban J: Factors involved in the nutrition of the human lumbar intervertebral disc: cellularity and diffusion of glucose in vitro. J Anat 1975, 120:113–130.
Jones E, McGonagle D: Human bone marrow mesenchymal stem cells in vivo. Rheumatology (Oxford) 2008, 47:126–131.
Urban JP, Smith S, Fairbank JC: Nutrition of the intervertebral disc. Spine 2004, 29:2700–2709.
Richardson SM, Walker RV, Parker S, et al.: Intervertebral disc cell-mediated mesenchymal stem cell differentiation. Stem Cells 2006, 24:707–716.
Horner HA, Roberts S, Bielby RC, et al.: Cells from different regions of the intervertebral disc: effect of culture system on matrix expression and cell phenotype. Spine 2002, 27:1018–1028.
Ma HL, Hung SC, Lin SY, et al.: Chondrogenesis of human mesenchymal stem cells encapsulated in alginate beads. J Biomed Mater Res A 2003, 64:273–281.
Richardson SM, Curran JM, Chen R, et al.: The differentiation of bone marrow mesenchymal stem cells into chondrocyte-like cells on poly-L-lactic acid (PLLA) scaffolds. Biomaterials 2006, 27:4069–4078.
Seguin CA, Grynpas MD, Pilliar RM, et al.: Tissue engineered nucleus pulposus tissue formed on a porous calcium polyphosphate substrate. Spine 2004, 29:1299–1306.
Alini M, Li W, Markovic P, et al.: The potential and limitations of a cell-seeded collagen/hyaluronan scaffold to engineer an intervertebral disc-like matrix. Spine 2003, 28:446–454.
Richardson SM, Hughes N, Hunt JA, et al.: Human mesenchymal stem cell differentiation to NP-like cells in chitosan-glycerophosphate hydrogels. Biomaterials 2008, 29:85–93.
Sakai D, Mochida J, Iwashina T, et al.: Regenerative effects of transplanting mesenchymal stem cells embedded in atelocollagen to the degenerated intervertebral disc. Biomaterials 2006, 27:335–345.
Risbud MV, Albert TJ, Guttapalli A, et al.: Differentiation of mesenchymal stem cells towards a nucleus pulposus-like phenotype in vitro: implications for cell-based transplantation therapy. Spine 2004, 29:2627–2632.
Longobardi L, O’Rear L, Aakula S, et al.: Effect of IGF-I in the chondrogenesis of bone marrow mesenchymal stem cells in the presence or absence of TGF-beta signaling. J Bone Miner Res 2006, 21:626–636.
Bai X, Xiao Z, Pan Y, et al.: Cartilage-derived morphogenetic protein-1 promotes the differentiation of mesenchymal stem cells into chondrocytes. Biochem Biophys Res Commun 2004, 325:453–460.
Mauck RL, Byers BA, Yuan X, Tuan RS: Regulation of cartilaginous ECM gene transcription by chondrocytes and MSCs in 3D culture in response to dynamic loading. Biomech Model Mechanobiol 2007, 6:113–125.
Rajpurohit R, Risbud MV, Ducheyne P, et al.: Phenotypic characteristics of the nucleus pulposus: expression of hypoxia inducing factor-1, glucose transporter-1 and MMP-2. Cell Tissue Res 2002, 308:401–407.
Lee CR, Sakai D, Nakai T, et al.: A phenotypic comparison of intervertebral disc and articular cartilage cells in the rat. Eur Spine J 2007, 16:2174–2185.
Le Maitre CL, Hoyland JA, Freemont AJ: Studies of human intervertebral disc cell function in a constrained in vitro tissue culture system. Spine 2004, 29:1187–1195.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Richardson, S.M., Hoyland, J.A. Stem cell regeneration of degenerated intervertebral discs: Current status. Current Science Inc 12, 83–88 (2008). https://doi.org/10.1007/s11916-008-0016-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11916-008-0016-3