Tissue Engineering for Orthopaedics & Mechanobiology (TOM), The Department for BioMedical Research (DBMR) of the Faculty of Medicine of the University of Bern, University of Bern, CH-3008 Bern, Switzerland.
Department of Orthopaedics, Emory University School of Medicine, VAMC, 1670 Clairmont Rd, Decatur, GA 30033, USA.
Int J Mol Sci. 2021 Mar 29;22(7):3519. doi: 10.3390/ijms22073519.
Chronic low back pain (LBP) remains a challenging condition to treat, and especially to cure. If conservative treatment approaches fail, the current "gold standard" for intervertebral disc degeneration (IDD)-provoked back pain is spinal fusion. However, due to its invasive and destructive nature, the focus of orthopedic research related to the intervertebral disc (IVD) has shifted more towards cell-based therapeutic approaches. They aim to reduce or even reverse the degenerative cascade by mimicking the human body's physiological healing system. The implementation of progenitor and/or stem cells and, in particular, the delivery of mesenchymal stromal cells (MSCs) has revealed significant potential to cure the degenerated/injured IVD. Over the past decade, many research groups have invested efforts to find ways to utilize these cells as efficiently and sustainably as possible. This narrative literature review presents a summary of achievements made with the application of MSCs for the regeneration of the IVD in recent years, including their preclinical and clinical applications. Moreover, this review presents state-of-the-art strategies on how the homing capabilities of MSCs can be utilized to repair damaged or degenerated IVDs, as well as their current limitations and future perspectives.
慢性下腰痛（LBP）仍然是一种具有挑战性的治疗疾病，尤其是治愈。如果保守治疗方法失败，目前治疗椎间盘退变（IDD）引起的腰痛的“金标准”是脊柱融合术。然而，由于其具有侵袭性和破坏性，与椎间盘（IVD）相关的骨科研究的重点更多地转向了基于细胞的治疗方法。它们旨在通过模拟人体的生理愈合系统来减少甚至逆转退行性级联反应。祖细胞和/或干细胞的应用，特别是间充质基质细胞（MSC）的输送，已经显示出了治愈退化/受伤的 IVD 的巨大潜力。在过去的十年中，许多研究小组已经努力寻找尽可能高效和可持续地利用这些细胞的方法。本综述性文献总结了近年来应用 MSC 促进 IVD 再生的研究进展，包括其临床前和临床应用。此外，本综述还介绍了如何利用 MSC 的归巢能力修复受损或退化的 IVD 的最新策略，以及它们目前的局限性和未来的展望。
