Studies have shown that stem cells have a wide range of sources, low immunogenicity and good differentiation potential, and they have significant advantages as target cells for intervertebral disc degeneration gene intervention. It can differentiate into nucleus pulposus cells and express proteoglycan and type ii collagen. No matter autogenous or allogeneic, or even xenogenic stem cell transplantation, it can survive and proliferate in the degenerative disc for a long time, promote the secretion of intervertebral disc cell matrix, so as to alleviate the process of intervertebral disc degeneration. It has been proved to be a very promising method to intervene intervertebral disc degeneration.
The age of onset of disc degeneration is 20 to 70 years
The intervertebral disc is composed of the outer annulus fibrosus and the inner nucleus pulpae. Intervertebral disc degeneration, intervertebral disc degeneration, idd) is a chronic disc structure and function failure process, main show is matrix continuity of nucleus pulposus is missing, it is often secondary to end plate fracture, fiber ring radial crack, disc herniation, etc., cause spinal segmental instability with low back pain and nerve pain and other symptoms of radiation.
Eighty percent of adults will experience temporary incapacity due to low back pain during their lifetime, and twenty percent of adults begin degeneration of the nucleus pulposus around age 20. In recent years, intervertebral disc degeneration and its incidence of low back pain have been increasing year by year. About 40% of adults under 30 years old and 90% of adults over 50 years old have idd, and about 10% and 60% of men aged 50 and 70 have severe idd, which brings heavy burden to the social economy.
Three advantages of stem cell therapy in effective intervention of idd
Currently, conservative drug intervention and surgical intervention are the methods for intervertebral disc degeneration, but they can only temporarily alleviate or relieve the pain symptoms, and can not fundamentally restore the function of intervertebral disc, and there is a risk of aggravating the disease. Tissue engineering technology based on stem cells brings new hope for the regeneration and repair of degenerated intervertebral discs, because stem cells have many advantages in idd intervention :(1) easy access, less damage to the body, and can be cultured in large quantities in vitro; (2) low immunogenicity; (3) strong directional differentiation ability. Therefore, it is an ideal seed cell for cell transplantation intervention idd.
Animal studies have shown that stem cell therapy can effectively slow down the idd process
For the first time, crevensten et al. injected fluorescent-labeled allogeneic stem cells into the rat tail disc. After 28 days of injection, the number of stem cells returned to the original number, with a survival rate of 100% and no immune response, indicating that allogeneic stem cells could survive and proliferate in the rat disc without causing an immune response. Researchers then looked at the effects of allogeneic stem cells on idd in rabbits, dogs and pigs, and got similar results.
Compression strength (a) and elastic modulus (b) of lumbar disc in experimental animals
Jeong et al. transplanted the body stem cells into the mouse tail idd model and found that the stem cells could survive for at least 2 weeks, and the expression of proteoglycan and type ii collagen increased after 6 weeks, the height of the intervertebral disc and signal strength were significantly improved, and the inner annulus fibrosus structure was repaired, and no immune response was found.
He staining of intervertebral discs in each group 16 weeks after surgery
These studies have shown that both autologous and allogeneic, or even xenogenic stem cell transplantation, can survive and proliferate in the degenerative disc for a long time, promote the secretion of intervertebral disc cell matrix and effectively alleviate the idd process.
Human trials have shown that stem cell therapy interventions for idd are safe and effective
Currently, yoshikawa and others are the first to use autologous stem cell transplantation for human intervertebral disc intervention. Before surgery, two idd patients were taken from the body iliac bone marrow, which was cultured into stem cells with autologous serum culture medium. During the operation, the patient was decompressed through the lamina fenestration, and then transdermal transplantation of collagen sponge containing stem cells into the degenerated intervertebral disc. The pain in the patient's lower back and legs was significantly relieved after the operation. Imaging findings 2 years later showed that the vacuum phenomenon in the nucleus pulposus disappeared, the signal was enhanced, and no obvious adverse reactions were found.
Intervertebral disc degeneration intervention process
Recently, orozco et al. systematically observed the efficacy and safety of direct injection of autologous stem cells into the nucleus pulposus for lumbar idd(complete annulus fibrosus) with chronic lumbago and leg pain. During the 1-year follow-up, 9 cases of lumbago and leg pain were rapidly relieved, while only 1 case was invalid. Both pain score and oswestry disability index were significantly improved, with no obvious adverse reactions. This further confirms the efficacy and safety of idd intervention with autologous stem cell transplantation.
Japan this year pioneered the first cell therapy for disc degeneration
In May 2019, tokai university in Japan officially launched the country's first clinical trial of repairing and regenerative lumbar spine intervention. Now the research team has announced to the media that they have conducted cell intervention in the first group of patients with disc degeneration.
The study has been registered on clinicaltrials.gov and is expected to complete all clinicaltrials by 2021. It is now in phase I /ii.
In conclusion, as a high-tech clinical intervention program, stem cell therapy has aroused a global research upsurge, and its application in intervertebral disc degenerative diseases has an immeasurable future. What do you think about that? Welcome to forward and message!