Development of advanced regenerative approaches for disc degeneration - consideration of the degenerate niche


Le Maitre, Christine (Sheffield Hallam University)


"Low back pain is the leading cause of morbidity worldwide and yet most therapies fail to target the cause and are purely symptomatic or end stage surgical options. Intervertebral disc degeneration is associated with approximately 40% of low back pain cases and thus a target for potential regeneration. Intervertebral disc degeneration is a catabolic process caused by altered cell behaviour and tissue biomechanics, leading to a harsh environment for potential cell therapies. To generate a successful regeneration strategy for the intervertebral disc this harsh environment must be considered, and therapies assessed within conditions which mimic this degenerate niche.
The utilisation of cells alone for regenerative therapies are unlikely to be successful if the degenerative cascade and mechanical environment are not restored, hence the combination of cells with biomaterials offers advanced therapeutic approaches. Injectable biomaterials which can restore the mechanical properties of the disc, inhibit catabolic processes of disc degeneration whilst delivering a regenerative cell source hold the most promise to halt disc degeneration and enabling regeneration.
Here, the development of novel injectable hydrogel systems which show potential to deliver a three-pronged attack to regeneration of the disc will be discussed. The application of differential cell sources including mesenchymal stromal cells from adipose and bone marrow, notochordal cells and induced pluripotent stem cells will be discussed. Importantly model systems which can recapitulate the degenerate disc environment as testing platforms for potential regenerative approaches for the disc will be introduced."


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