Cell-based strategies for IVD repair: clinical progress and translational obstacles
Top Cited Papers
- 1 February 2021
- journal article
- review article
- Published by Springer Science and Business Media LLC in Nature Reviews Rheumatology
- Vol. 17 (3), 158-175
- https://doi.org/10.1038/s41584-020-00568-w
Abstract
Intervertebral disc (IVD) degeneration is a major cause of low back pain, a prevalent and chronic condition that has a striking effect on quality of life. Currently, no approved pharmacological interventions or therapies are available that prevent the progressive destruction of the IVD; however, regenerative strategies are emerging that aim to modify the disease. Progress has been made in defining promising new treatments for disc disease, but considerable challenges remain along the entire translational spectrum, from understanding disease mechanism to useful interpretation of clinical trials, which make it difficult to achieve a unified understanding. These challenges include: an incomplete appreciation of the mechanisms of disc degeneration; a lack of standardized approaches in preclinical testing; in the context of cell therapy, a distinct lack of cohesion regarding the cell types being tested, the tissue source, expansion conditions and dose; the absence of guidelines regarding disease classification and patient stratification for clinical trial inclusion; and an incomplete understanding of the mechanisms underpinning therapeutic responses to cell delivery. This Review discusses current approaches to disc regeneration, with a particular focus on cell-based therapeutic strategies, including ongoing challenges, and attempts to provide a framework to interpret current data and guide future investigational studies.Keywords
This publication has 174 references indexed in Scilit:
- Exhaustion of nucleus pulposus progenitor cells with ageing and degeneration of the intervertebral discNature Communications, 2012
- GDF5 single-nucleotide polymorphism rs143383 is associated with lumbar disc degeneration in Northern European womenArthritis & Rheumatism, 2010
- Toward an understanding of the role of notochordal cells in the adult intervertebral disc: From discord to accordDevelopmental Dynamics, 2010
- Methods to monitor distribution and metabolic activity of mesenchymal stem cells following in vivo injection into nucleotomized porcine intervertebral discsEuropean Spine Journal, 2009
- Cell transplantation in lumbar spine disc degeneration diseaseEuropean Spine Journal, 2008
- A systematic review of low back pain cost of illness studies in the United States and internationallyThe Spine Journal, 2008
- Clinical experience in cell-based therapeutics: intervention and outcomeEuropean Spine Journal, 2006
- Senescence in human intervertebral discsEuropean Spine Journal, 2006
- Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statementCytotherapy, 2006
- Disc Pressure MeasurementsSpine, 1981