Disc regeneration: A glimpse of the novel interventional approaches
Babak Ashrafnejad
Tehran Pain Clinic, Iran
: Analg Resusc: Curr Res
Abstract
The normal intervertebral disc clinically acts to support and dissipate loads while permitting multiaxial motions of the spine. Its demanding mechanical function is provided by a well-defined microstructural organization and biochemical composition. Intervertebral disc degeneration is a complex process that disrupts this well-defined organization and biochemical balance. One hallmark of intervertebral disc degeneration is the loss of proteoglycan and water in the Nucleous Palposous. Because of the central role of proteoglycans in the function of the intervertebral disc, restoration of normal proteoglycan production may be critical. Many different biological and interventional strategies have been developed, including the use of cells, scaffolds, and molecules. The molecules used to treat disc degeneration include anticatabolics such as anti IL-1, TNF agents and growth factors or its stimulants, which may influence the cell proliferation rate and phenotypic expression of the cells. Delivery of the molecules may include direct injection into the disc and also in vivo and ex vivo gene therapy using a viral vector. Autologous or allograft reinsertion, injection and transplantation of Nucleous Palposous cells, and stem cells therapy are methods of use of cells for disc regeneration. The purpose of a cellular scaffold is to provide an optimal environment for cellular migration and proliferation that allows maintaining the appropriate phenotype. Collagen is a physiological biomolecular scaffold and hyaluronan acts as an anchor for aggrecan retention by promoting proteoglycan aggregate formation.
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