Stem cell transplants may help treat degenerative disc disease

The transplants can be effective in halting or reversing degenerative disc disease, researchers said.

Stem cell transplantation was found to be viable and effective for halting or reversing degenerative disc disease in the spine by helping maintain disc height, according to a study conducted at the Mayo Clinic, in Rochester, Minn., presented at the American Academy of Pain Medicine Annual Meeting.

Recent developments in stem cell research made it possible to assess the effect of this therapy on intervertebral disc (IVD) height. Intervertebral disc degenerative disease (DDD) is characterized by poor self-repair capacity secondary to the loss of IVD cells, according to a press release about the presentation from the American Academy of Pain Medicine.

“This landmark study draws the conclusion in pre-clinical animal studies that stem cell therapy for disc degenerative disease might be a potentially effective treatment for the very common condition that affects people’s quality of life and productivity,” Wenchun Qu, MD, PhD, the principal investigator, stated in the release.

Translational therapy

In animal trials that Qu and colleagues reviewed for their research, disc height (DH) increased and disc water content increased in the stem cell transplant group. The introduction of stem cells also improved appropriate gene expression, they noted in the release.

“These exciting developments place us in a position to prepare for translation of stem cell therapy for degenerative disc disease into clinical trials,” Qu told Spine Surgery Today.

The researchers performed a comprehensive literature search for original, randomized, controlled trials on animals that examined the association between IVD stem cell transplant and changes in DH. Six studies met their inclusion criteria. Due to differences between the studies, Qu and colleagues used random-effects models to pool estimates of effect, according to the release.

Five of the six studies used bone marrow mesenchymal stem cells (MSCs). One study used adipose-derived MSCs, Qu said in the interview. The MSCs were isolated and expanded, then transplanted into the IVDs using injection techniques with 1x10⁶ to 2x10⁶ cells injected per disc.

Increase in disc height

The researchers found an effect size of 23% increase in the DH index in the group that received the transplanted MSCs compared with the placebo group (95% CI; 19.7-23.5; P < 0.001). None of the studies that met the inclusion criteria showed a decrease in the DH index in the transplant group and the increases in the DH index were statistically significant in all the individual studies, based on the release.

Qu told Spine Surgery Today a similar number of cells were injected into each disc across the studies, however cell volume was not as consistently reported.

Histologic studies showed the transplanted MSCs were viable, Qu and colleagues stated in the study. The increase in DH was attributed to restoration of the nucleus pulposus structure and the increased amount of aggrecan in the transplant group.

Qu and colleagues wrote that findings of this meta-analysis indicate that cell therapy may arrest or reverse the IVD degenerative process.

The researchers noted in the release the next step in this regard was to determine the safety, feasibility and efficacy of IVD stem cell transplant for humans.

“This study draws conclusion on the current animal research that mesenchymal stem cell transplantation to the intervertebral disc effectively halts or reverses the degeneration process of the disc,” Qu told Spine Surgery Today. “Further studies on safety would be needed before human clinical trials maybe be conducted.” – by Robert Linnehan

Reference:

Dauffenbach J. Poster #216. Presented at: American Academy of Pain Medicine Annual Meeting; March 5-9, 2014; Phoenix.

For more information:

Wenchun Qu, MD, PhD, can be reached at 200 1st St. SW, Rochester, MN 55905; email: qu.wenchun@mayo.edu.
Disclosure: Qu has no relevant financial disclosures.