الفهرس | Only 14 pages are availabe for public view |
Abstract Transplantation of MSCs to humans has been effective for tissues such as cartilage and myocardium. Although MSCs are easily procured by bone marrow aspiration and hold significant potential to repopulate the degenerated NP, it is unclear whether endplate permeability in degenerated discs is sufficient to support increases in cell density and metabolism (because poor nutrition may have led to the degeneration in the first place). Furthermore, low pH, oxidative stresses, and inflammatory mediators present within the degenerated IVD may alter the behavioral and synthetic properties of transplanted MSCs. Thus, research focused on revealing the relationship between vertebral endplate permeability, disc nutrition, and disc cell health is central to understanding the feasibility of MSC regeneration of the IVD. Last, the biomechanical properties of the degenerated IVD, including distribution of mechanical loads and hydrostatic pressures, might alter the properties of transplanted MSCs or prevent them from fully differentiating into functional, disc-like cells. Moreover, the properties of the carrier medium may be altered in the biomechanical environment of the degenerated IVD. Current research is focused on determining whether MSCs can be made to maintain a disc-like phenotype under such conditions. The results of these investigations will serve as guides for tissue engineering approaches to disc repair and will help establish whether disc repair strategies in humans will ultimately be limited by inherent nutritional deficiencies and alterations in biomechanical properties caused by pathological conditions in the endplate. |