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用于退行性椎间盘疾病的干细胞疗法:弥合临床前前景与临床潜力之间的差距。

Stem cell therapy for degenerative disc disease: Bridging the gap between preclinical promise and clinical potential.

作者信息

Munda Matic, Velnar Tomaz

机构信息

Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana, Slovenia; AMEU-AMC, Maribor, Slovenia.

出版信息

Biomol Biomed. 2024 Mar 11;24(2):210-218. doi: 10.17305/bb.2023.9518.

Abstract

Stem cell therapy has gained attention in the field of regenerative medicine due to its potential to restore damaged tissue. This article focuses on the application of stem cell therapy for treating spinal pathologies, particularly intervertebral disc degeneration. Disc degeneration is a major cause of low back pain and is characterized by changes in the matrix and inflammation. Animal studies have demonstrated that the implantation of mesenchymal stem cells (MSCs) yields promising results, including increased disc height, improved hydration, and reduced inflammation. However, the number of clinical trials remains limited, necessitating further research to optimize MSCs therapy. Although preclinical studies offer valuable insights, caution is needed when extrapolating these findings to clinical practice. Stem cell therapy still faces multiple challenges, such as the durability and survival of MSCs upon implantation, uncertain pathways to discogenic differentiation, and the adverse impact of a harsh microenvironment on cell survival. The avascular nature of the intervertebral disc and dynamic loading conditions also affect the adaptation of transplanted cells. Despite these obstacles, stem cell therapy holds promise as a potential treatment for disc degeneration, and ongoing research aims to fill the current gap in conclusive data.

摘要

干细胞疗法因其修复受损组织的潜力而在再生医学领域受到关注。本文重点探讨干细胞疗法在治疗脊柱疾病,特别是椎间盘退变方面的应用。椎间盘退变是下腰痛的主要原因,其特征是基质变化和炎症。动物研究表明,间充质干细胞(MSCs)的植入产生了令人鼓舞的结果,包括椎间盘高度增加、水合作用改善和炎症减轻。然而,临床试验的数量仍然有限,需要进一步研究以优化MSCs疗法。尽管临床前研究提供了有价值的见解,但将这些发现外推至临床实践时仍需谨慎。干细胞疗法仍然面临多重挑战,例如植入后MSCs的持久性和存活率、椎间盘源性分化的不确定途径以及恶劣微环境对细胞存活的不利影响。椎间盘的无血管性质和动态负荷条件也会影响移植细胞的适应性。尽管存在这些障碍,干细胞疗法有望成为治疗椎间盘退变的潜在方法,目前正在进行的研究旨在填补确凿数据方面的现有空白。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/814b/10950333/c5fa1d47b9a0/bb-2023-9518f1.jpg

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