Sakai Daisuke, Mochida Joji, Yamamoto Yukihiro, Nomura Takeshi, Okuma Masahiko, Nishimura Kazuhiro, Nakai Tomoko, Ando Kiyoshi, Hotta Tomomitsu
Department of Orthopaedic Surgery, Functional Reconstruction, Tokai University School of Medicine, Bohseidai, Isehara, Kanagawa 259-1193, Japan.
Biomaterials. 2003 Sep;24(20):3531-41. doi: 10.1016/s0142-9612(03)00222-9.
Intervertebral disc degeneration is considered to be one of the major causes of low back pain. Despite this irreversible phenomenon, attempts to decelerate disc degeneration using various techniques have been reported. However, to date there has been no proven technique effective for broad clinical application. Based on previous studies, we hypothesize that maintenance of proteoglycan content in the disc is achieved by avoiding the depletion of nucleus pulposus and preserving the structure of the annulus is a primary factor in decelerating disc degeneration. One novel approach to solve the dilemma of intervertebral disc degeneration is found at the stem cell level. Mesenchymal stem cells (MSCs) are known to possess the ability to differentiate into various kinds of cells from mesenchymal origin. Although the majority of cells that contribute to disc formation are known to obtain chondrocyte-like phenotypes, no reported study has emphasized the correlation with mesenchymal stem cells. To evaluate the possible potential of MSCs in disc cell research and treatment of degenerative disc disease, autologous MSCs embedded in Atelocollagen gel were transplanted into the discs of rabbits which had undergone a procedure proven to induce degeneration. The results suggest that MSC transplantation is effective in decelerating disc degeneration in experimental models and provided new hopes for treatment of degenerative disc disease in humans. Atelocollagen gel served as an important carrier of MSCs in transplantation, permitting proliferation, matrix synthesis and differentiation of MSCs. This study strengthens the viable efficacy of practical application of MSCs in treatment of intervertebral disc disease.
椎间盘退变被认为是下腰痛的主要原因之一。尽管存在这种不可逆的现象，但已有报道尝试使用各种技术来减缓椎间盘退变。然而，迄今为止，尚无被证实对广泛临床应用有效的技术。基于先前的研究，我们推测，通过避免髓核耗竭来维持椎间盘内蛋白聚糖含量以及保持纤维环结构是减缓椎间盘退变的主要因素。在干细胞层面发现了一种解决椎间盘退变难题的新方法。间充质干细胞（MSCs）已知具有分化为各种间充质来源细胞的能力。虽然已知大多数参与椎间盘形成的细胞会获得软骨样表型，但尚无报道强调其与间充质干细胞的相关性。为了评估间充质干细胞在椎间盘细胞研究和退行性椎间盘疾病治疗中的潜在可能性，将包埋于去细胞胶原蛋白凝胶中的自体间充质干细胞移植到经过已证实可诱导退变的手术处理的兔椎间盘内。结果表明，间充质干细胞移植在实验模型中可有效减缓椎间盘退变，并为人类退行性椎间盘疾病的治疗带来了新希望。去细胞胶原蛋白凝胶在移植过程中作为间充质干细胞的重要载体，可使间充质干细胞增殖、合成基质并分化。本研究强化了间充质干细胞在治疗椎间盘疾病实际应用中的可行性疗效。
