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腰椎间盘退变的治疗前景:基于细胞疗法的价值主张、椎间盘源性细胞的免疫调节特性及相关临床评估策略

Perspectives on the Treatment of Lumbar Disc Degeneration: The Value Proposition for a Cell-Based Therapy, Immunomodulatory Properties of Discogenic Cells and the Associated Clinical Evaluation Strategy.

作者信息

Silverman Lara Ionescu, Heaton Will, Farhang Niloofar, Saxon Lindsey Hart, Dulatova Galina, Rodriguez-Granrose Daniel, Flanagan Flagg, Foley Kevin T

机构信息

DiscGenics Inc., Salt Lake City, UT, United States.

Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States.

出版信息

Front Surg. 2020 Dec 16;7:554382. doi: 10.3389/fsurg.2020.554382. eCollection 2020.

Abstract

Low back pain (LBP) is a serious medical condition that affects a large percentage of the population worldwide. One cause of LBP is disc degeneration (DD), which is characterized by progressive breakdown of the disc and an inflamed disc environment. Current treatment options for patients with symptomatic DD are limited and are often unsuccessful, so many patients turn to prescription opioids for pain management in a time when opioid usage, addiction, and drug-related deaths are at an all-time high. In this paper, we discuss the etiology of lumbar DD and currently available treatments, as well as the potential for cell therapy to offer a biologic, non-opioid alternative to patients suffering from the condition. Finally, we present an overview of an investigational cell therapy called IDCT (Injectable Discogenic Cell Therapy), which is currently under evaluation in multiple double-blind clinical trials overseen by major regulatory agencies. The active ingredient in IDCT is a novel allogeneic cell population known as Discogenic Cells. These cells, which are derived from intervertebral disc tissue, have been shown to possess both regenerative and immunomodulatory properties. Cell therapies have unique properties that may ultimately lead to decreased pain and improved function, as well as curb the numbers of patients pursuing opioids. Their efficacy is best assessed in rigorous double-blinded and placebo-controlled clinical studies.

摘要

下背痛(LBP)是一种严重的医疗状况,影响着全球很大一部分人口。下背痛的一个原因是椎间盘退变(DD),其特征是椎间盘逐渐分解以及椎间盘环境发炎。目前,有症状的椎间盘退变患者的治疗选择有限,而且往往不成功,因此在阿片类药物使用、成瘾和药物相关死亡人数创历史新高的时期,许多患者转向使用处方阿片类药物来控制疼痛。在本文中,我们讨论了腰椎间盘退变的病因和目前可用的治疗方法,以及细胞疗法为患有这种疾病的患者提供生物性、非阿片类替代疗法的潜力。最后,我们概述了一种名为IDCT(可注射椎间盘源性细胞疗法)的研究性细胞疗法,目前该疗法正在由主要监管机构监督的多项双盲临床试验中进行评估。IDCT的活性成分是一种名为椎间盘源性细胞的新型同种异体细胞群体。这些细胞源自椎间盘组织,已被证明具有再生和免疫调节特性。细胞疗法具有独特的特性,最终可能会减轻疼痛、改善功能,并减少使用阿片类药物的患者数量。其疗效最好在严格的双盲和安慰剂对照临床研究中进行评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff1a/7772215/605825348fb9/fsurg-07-554382-g0001.jpg

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