Bone marrow mesenchymal stem cells combined with ultra-puriﬁed alginate gel as a regenerative therapeutic strategy after discectomy for degenerated intervertebral discs

EBioMedicine, 2020 · DOI: 10.1016/j.ebiom.2020.102698 · Published: January 1, 2020

Orthopedics Regenerative Medicine & Stem Cells

Simple Explanation

This study investigates a new way to treat degenerated spinal discs after surgery. The approach involves using stem cells combined with a special gel. The gel, made of ultra-puriﬁed alginate (UPAL), acts as a support for bone marrow-derived mesenchymal stem cells (BMSCs). The combination aims to help the disc regenerate after discectomy. The researchers found that the stem cells combined with the gel were more effective than the gel alone in promoting disc regeneration in rabbits with degenerated discs.

Study Duration

12 weeks

Participants

48 rabbits

Evidence Level

Not specified

Key Findings

1
Co-culturing nucleus pulposus cells (NPCs) and bone marrow-derived mesenchymal stem cells (BMSCs) in UPAL gel significantly increased the expression of NPC markers, growth factors, and extracellular matrix genes compared to monocultures.
2
In vivo, the combination of BMSCs and UPAL gel demonstrated a more potent effect in inducing IVD regeneration compared to UPAL gel alone following discectomy in rabbits with degenerated IVDs.
3
Similar IVD regeneration was observed using human BMSCs, suggesting the potential for translation to human clinical applications.

Research Summary

The study aimed to investigate the regenerative effects of transplanting bone marrow-derived mesenchymal stem cells (BMSCs) embedded in ultra-puriﬁed alginate (UPAL) gel on degenerated intervertebral discs (IVDs) following discectomy. In vitro experiments showed that co-culturing nucleus pulposus cells (NPCs) and BMSCs in UPAL gel promoted BMSC differentiation into NPCs and increased the production of growth factors and extracellular matrix. In vivo experiments in rabbits demonstrated that the combination of BMSCs and UPAL gel exerted a more potent effect in inducing IVD regeneration compared to UPAL gel alone, with similar results observed using human BMSCs.

Practical Implications

Clinical Translation

The findings support the future evaluation of this approach in a clinical setting, especially in older populations with limited self-repair capabilities.

Therapeutic Potential

BMSCs combined with UPAL gel show promise as a regenerative strategy following discectomy for degenerated IVDs.

Understanding Cell Interactions

The study highlights the interplay between BMSCs and existing NPCs in achieving IVD regeneration, providing insights into cell-based regenerative therapies.

Study Limitations

1
The animal models of IVD degeneration implemented in the present study were generated using rabbit IVDs and therefore do not strictly imitate the surgical procedure of discectomy executed clinically.
2
Radiographic assays were not conducted to precisely measure IVD height.
3
Only a single BMSC concentration was utilised.

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