Cell-Based Therapeutics for Intervertebral Disc Degeneration

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About this Research Topic

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Background

Low back pain (LBP) is the leading cause of disability worldwide with enormous social and economic burden. One of the main causes of LBP is intervertebral disc degeneration (IDD). The causes of IDD are complicated, including genetic, nutritional, metabolic, and mechanical factors. Whilst the pathogenesis and pathology has been extensively studied, the treatment options are still limited. When the conservative therapies fail, surgical interventions have to be performed. However, none of these therapies are able to repair the damaged tissue and revive a functional disc. In recent decades, substantial progress has occurred in tissue engineering and stem cell therapies. Several cell types including mesenchymal stem cells, chondrocytes, and other progenitor cells have been investigated in studies, and clinical trials have commenced with cell-based therapies to treat degenerative diseases, providing new opportunities for IDD treatment.

Cells are a very useful tool for disease treatment. They build up and regulate the tissue environment through a variety of ways. Therefore, figuring out the strategies to use the proper cell type for IDD treatment, as well as the mechanism of cell-based therapeutics, is the goal of this topic. To achieve this goal, cell sources, recruiting strategies, and regulation mechanisms, need to be addressed.

Cells are one of the key factors for this treatment, and they can be recruited either from the tissue itself (resident stem cells or progenitors) or elsewhere (e.g. bone marrow or adipose tissue). However, cells from different sources have pros and cons, respectively. Therefore, studies on different cells for IDD treatment are needed.

Stem cells can remodel the tissue through regulating resident tissue cells by growth factors, cytokines, microRNAs, etc. Thus, they are not only concrete, but also engineers of the tissue. Finding out the mechanism of stem cell regulation on the tissue cells would further improve the disease treatment and tissue regeneration strategies.

According to the goal of this research topic, the specific themes are as follows.

• Endogenous cell recruitment. As IVD is a dense and avascular tissue, the endogenous cell recruitment is important but also challenging.

• Regulatory functions of cells. Stem cells can not only differentiate into mature tissue cells to build specific tissue directly, but also regulate other cells through a variety of ways. Therefore, the regulatory function of the cells could also be utilized for disease treatment.

• Cell subtype identification. Endogenous cells are critical for tissue function and repair evaluation. However, the understanding of tissue cells, as well as the resident stem cells or progenitors, is still limited.

• Cell delivery strategy. Innovative strategies for effective cell delivery in cell-based therapies to overcome cell loss are needed.

• In situ differentiation of cells and tissue remodeling during treatment. The progression and mechanisms of cell-based treatments should be investigated.

Keywords: Intervertebral Disc Degeneration, Cell-Based Therapeutics, Low back pain, Cell Delivery

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