Degenerative Disc Disease (DDD)
Degenerative disc disease (DDD) is characterized by degeneration of the intervertebral discs of the spine. There are varying degrees of severity, but progressed disease can will result in compression of the spinal cord and/or compression on the accessory nerves leaving the spinal cord. This can cause debilitating pain in the area of the compression as well as pain radiating down the nerve tracts (down the leg/arm/hip/etc). This degeneration can also cause arthritis, bone spur formation, inflammation, and ligament damage.
The cause of DDD is thought to be a loss of soluble proteins within the fluid portion of the disc (nucleus propulsus). This changes the oncotic pressure and allows for disc narrowing
Conventional treatment for DDD includes physical therapy, strength training, analgesics (pain killers), massage, and surgery.
Stem cell research for DDD is focused on trying to repair tears and weakness within the intervertebral discs and thus increase disc height. Alternatively, stem cells may be able to increase oxygen and nutrient delivery to the discs thus increasing the fluid within the disc.
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The most current research regarding stem cells and DDD is given below:
Human Umbilical Cord Blood–Derived Mesenchymal Stem Cells in the Cultured Rabbit Intervertebral Disc
D. Greg Anderson, MD, Dessislava Markova, PhD, Howard S. An, MD, Ana Chee, PhD, Motomi Enomoto-Iwamoto, DDS, PhD, Vladimir Markov, MD, Biagio Saitta, PhD, Peng Shi, DDS, PhD, Chander Gupta, BS, and Yejia Zhang, MD, PhD
Abstract: Back pain associated with symptomatic disc degeneration is a common clinical condition. Intervertebral disc (IVD) cell apoptosis and senescence increase with aging and degeneration. Repopulating the IVD with cells that could produce and maintain extracellular matrix would be an alternative therapy to surgery. The objective of this study was to determine the potential of human umbilical cord blood–derived mesenchymal stem cells (hUCB-MSCs) as a novel cell source for disc repair. In this study, we intended to confirm the potential for hUCB-MSCs to differentiate and display a chondrocyte-like phenotype after culturing in micromass and after injection into the rabbit IVD explant culture. We also wanted to confirm hUCB-MSC survival after transplantation into the IVD explant culture.
Novel therapeutic strategies for degenerative disc disease: Review of cell biology and intervertebral disc cell therapy
Joseph Fernandez-Moure, Caitlyn A Moore, Keemberly Kim, Azim Karim, Kevin Smith, Zonia Barbosa, Jeffrey Van Eps, Pranela Rameshwar, and Bradley Weiner
Abstract: Intervertebral disc degeneration is a disease of the discs connecting adjoining vertebrae in which structural damage leads to loss of disc integrity. Degeneration of the disc can be a normal process of ageing, but can also be precipitated by other factors. Literature has made substantial progress in understanding the biological basis of intervertebral disc, which is reviewed here. Current medical and surgical management strategies have shortcomings that do not lend promise to be effective solutions in the coming years. With advances in understanding the cell biology and characteristics of the intervertebral disc at the molecular and cellular level that have been made, alternative strategies for addressing disc pathology can be discovered. A brief overview of the anatomic, cellular, and molecular structure of the intervertebral disc is provided as well as cellular and molecular pathophysiology surrounding intervertebral disc degeneration. Potential therapeutic strategies involving stem cell, protein, and genetic therapy for intervertebral disc degeneration are further discussed.