Concerns about cell therapy for intervertebral disc degeneration

Abstract

Low back pain is a very common symptom in people all over the world, which is now the leading cause of disability worldwide 1 , 2 . Although the specific cause of low back pain is rarely determined, lumbar intervertebral disc degeneration is considered to be the main cause of low back pain 3 . So far, neither conservative treatment nor surgical treatment can prevent or at least slow down the degenerative process 4 , 5 . For this reason, regenerative medicine, the repair of degenerate discs by intradiscal injection of exogenous cells, is emerging as a promising approach 4 . However, due to its distinctive structure and function, disc presents unique characteristics: largely avascular, hypoxia, low pH, high osmotic pressure and high mechanical load 4 , 6 , 7 . This situation establishes an adverse microenvironment for resident cells and delivered exogenous cells, which limits the effect of cell therapy 4 , 5 . In addition, there are still other considerable challenges in the entire translational spectrum of cell therapy, including the lack of guidelines for disease classification and patient stratification, as well as a marked lack of understanding of the characteristics of neural distribution, cell fate, and long-term prospects for disc regeneration in the context of cell therapy. In this comment, we will discuss the key issues mentioned above in disc cell therapy.

Topics & Concepts