In this article we will focus on the impact of stem cells on intervertebral disc degeneration. Intervertebral disc degeneration is the progressive degeneration and reduction of the disc gel material.
In the February 2018 issue of the Spine Journal, scientists did an experimental study in rats with inflammation of the intervertebral disc. What they wanted to see was how mesenchymal stem cells impacted the inflammation causing the discogenic pain.
The scientists focused on inflammatory cytokines (immune system cells that are calling for inflammation at the site of injury) produced by macrophages (immune cell or white blood cell that moves to the injured site to be able to signal for inflammation) or disc cells. These cells play an important role in painful progressive degeneration of degenerative disc disease. Mesenchymal stem cells have shown to have immunosuppressive and anti-inflammatory properties. Mesenchymal stem cells express a variety of chemokines and cytokines receptors having tropism (changing their surrounding environment to reaction) to inflammation sites.1 The stem cells acted in an anti-inflammatory capacity
In supportive research, doctors in Italy also found regenerative properties in stem cells. Their paper published in the World journal of stem cells suggested that research is showing proof of disc matrix reconstitution, increased cell viability and tissue regeneration in several experimental settings.2 The stem cells acted in regenerative capacity.
What the two studies above have in common is revealed by a fascinating study by university researchers in Portugal. The researchers found that when stem cells were injected into the spine, the stem cells created a change in the disc environment from degeneration towards repair and disc regeneration by signal initiation (sending messages).
In basic terms the stems cells arrived, told the immune system where they were, the immune and stem cells met at the site of disc damage and began the repair. As the study states: ” (this) highlights the complex interplay between stromal (stem) cells and cells of the immune system in achieving successful intervertebral disc tissue regeneration.”3 The stem cells acted in an anti-inflammatory and regenerative capacity sparked by cellular communication.
Emory University Researchers say stem cells may be the non-surgical answer to degenerative disc disease
A single injection of stem cells into degenerative discs reduced low back pain for at least 12 months according to results of a 100-patient clinical trial that included researchers at the Emory Orthopaedics & Spine Center at Emory University.
On average researchers found a pain reduction greater than 50 percent at 12 months. Additionally, there was less need for pain medication, improvement in function, and less need for further surgical and non-surgical spine interventions. These results were found in patients with moderate to severe discogenic low back pain.4
In supportive research military researchers at Third Military Medical University in China found injection of mesenchymal stem cells significantly reduces lumbar pain.5 Doctors writing in the medical journal Stem Cells published evidence of safety and feasibility in the nonsurgical treatment of degenerative disc disease with bone marrow stem cells and discogenic pain. 6
If you have back pain . . .
1 Miguélez-Rivera L, Pérez-Castrillo S, González-Fernández ML, Prieto-Fernández JG, López-González ME, García-Cosamalón J, Villar-Suárez V. Immunomodulation of mesenchymal stem cells in discogenic pain. The Spine Journal. 2018 Feb 1;18(2):330-42.
2 Vadalà G, Russo F, Ambrosio L, Papalia R, Denaro V. Mesenchymal stem cells for intervertebral disc regeneration.
J Biol Regul Homeost Agents. 2016 Oct-Dec;30(4 Suppl 1):173-179
3 Cunha C, Almeida CR, Almeida MI, Silva AM, Molinos M, Lamas S, Pereira CL, Teixeira GQ, Monteiro AT, Santos SG, Gonçalves RM, Barbosa MA. Systemic Delivery of Bone Marrow Mesenchymal Stem Cells for In Situ Intervertebral Disc Regeneration. Stem Cells Transl Med. 2016 Oct 11. pii: sctm.2016-0033.
4 Clinical trial shows stem cell injections reduce low back pain http://news.emory.edu/stories/2014/02/clinical_trial_stem_cell_injection/campus.html
5 Feng C, Liu H, Yang Y, Huang B, Zhou Y. Growth and Differentiation Factor-5 Contributes to the Structural and Functional Maintenance of the Intervertebral Disc.Cell Physiol Biochem. 2015 Jan 2;35(1):1-16.
6 Pettine KA, Murphy MB, Suzuki RK, Sand TT. Percutaneous injection of autologous bone marrow concentrate cells significantly reduces lumbar discogenic pain through 12 months. Stem Cells. 2015 Jan;33(1):146-56. doi: 10.1002/stem.1845.