Combination of ultra-puriﬁed stem cells with an in situ-forming bioresorbable gel enhances intervertebral disc regeneration

eBioMedicine, 2022 · DOI: https://doi.org/10.1016/j.ebiom.2022.103845 · Published: February 1, 2022

Regenerative Medicine Surgery Orthopedics

Simple Explanation

Lumbar intervertebral disc (IVD) herniations cause significant disability. Current surgical treatments like discectomy, while relieving symptoms, can cause further disc degeneration due to the IVD's limited self-repair ability. This study explores using ultra-purified, GMP-compliant human bone marrow mesenchymal stem cells (RECs) combined with a bioresorbable gel to regenerate IVDs after discectomy. The study found that RECs combined with the gel enhanced IVD regeneration in sheep with severe IVD degeneration, demonstrating translational potential for treating herniations in degenerative human IVDs.

Study Duration

24 weeks

Participants

14 sheep (56 IVDs)

Evidence Level

Not specified

Key Findings

1
Co-culturing RECs and nucleus pulposus cells (NPCs) in the gel significantly increased gene expression of NPC markers, growth factors, and extracellular matrix compared to monocultures.
2
The combination of RECs and the gel enhanced IVD regeneration after discectomy in a sheep model with severe IVD degeneration over 24 weeks.
3
The implantation of RECs encapsulated in the UPAL gel did not induce tumorigenesis.

Research Summary

This study investigates the therapeutic efficacy of combining ultra-purified human bone marrow mesenchymal stem cells (RECs) and a bioresorbable gel for IVD regeneration after discectomy in a sheep model. The findings demonstrate that co-culturing RECs and nucleus pulposus cells (NPCs) in the gel significantly increased the expression of NPC markers, growth factors, and extracellular matrix. The study concludes that the combination of RECs with an in situ-forming gel shows translational potential for treating herniations in degenerative human IVDs.

Practical Implications

Clinical Translation Potential

The study suggests a potential new treatment approach for intervertebral disc herniations using a combination of stem cells and a bioresorbable gel.

Improved IVD Regeneration

The combination therapy enhances IVD regeneration more effectively than the gel alone, offering a potential solution for preventing further disc degeneration after discectomy.

Safe Therapeutic Strategy

The study indicates that the use of ultra-purified stem cells in combination with the gel does not result in neoplastic changes, supporting its safety as a therapeutic intervention.

Study Limitations

1
Characterization of the hydrogel with Young's modulus based on results of the simple compression test is insufﬁcient
2
the surgical procedure of discectomy was not strictly replicated in clinical settings.
3
a detailed evaluation of AF regeneration was not performed.

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