title: Ex vivo observation of human intervertebral disc tissue and cells isolated from degenerated intervertebral discs.
abstract: OBJECTIVE
  Disc degeneration, and associated low back pain, are a primary cause of disability. Disc degeneration is characterized by dysfunctional cells and loss of proteoglycans: since intervertebral tissue has a limited capacity to regenerate, this process is at present considered irreversible. Recently, cell therapy has been suggested to provide more successful treatment of IVD degeneration. To understand the potential of cells to restore IVD structure/function, tissue samples from degenerated IVD versus healthy discs have been compared.
  
  
  METHODS
  Discal tissue from 27 patients (40.17 ± 11 years) undergoing surgery for degenerative disc disease (DDD), DDD + herniation and congenital scoliosis, as controls, was investigated. Cells and matrix in the nucleus pulposus (NP) and annulus fibrosus (AF) were characterized by histology. AF- and NP-derived cells were isolated, expanded and characterized for senescence and gene expression. Three-dimensional NP pellets were cultured and stained for glycosaminoglycan formation.
  
  
  RESULTS
  Phenotypical markers of degeneration, such as cell clusters, chondrons, and collagen disorganization were seen in the degenerate samples. In severe degeneration, granulation tissue and peripheral vascularization were observed. No correlation was found between the Pfirrmann clinical score and the extent of degeneration.
  
  
  CONCLUSIONS
  The tissue disorganization in degenerate discs and the paucity of cells out of cluster/chondron association, make the IVD-derived cells an unreliable option for disc regeneration.
authors.affiliation: Laboratory for Orthopaedic Pathophysiology and Regenerative Medicine, Istituto Ortopedico Rizzoli, via di Barbiano 1/10, 40136 Bologna, Italy. gabriela.ciapetti@ior.it
authors.forename: Gabriela
authors.initials: G
authors.lastname: Ciapetti
authors.forename: Donatella
authors.initials: D
authors.lastname: Granchi
authors.forename: Valentina
authors.initials: V
authors.lastname: Devescovi
authors.forename: Elisa
authors.initials: E
authors.lastname: Leonardi
authors.forename: Tiziana
authors.initials: T
authors.lastname: Greggi
authors.forename: Mario
authors.initials: M
authors.lastname: Di Silvestre
authors.forename: Nicola
authors.initials: N
authors.lastname: Baldini
mesh_terms: D000328:Adult; D002478:Cells, Cultured; D005260:Female; D006025:Glycosaminoglycans / Q000378:metabolism; D006801:Humans; D007403:Intervertebral Disc / Q000378:metabolism* / Q000473:pathology*; D055959:Intervertebral Disc Degeneration / Q000378:metabolism* / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000378:metabolism / Q000473:pathology; D017116:Low Back Pain / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011509:Proteoglycans / Q000378:metabolism; D012038:Regeneration; D012600:Scoliosis / Q000151:congenital / Q000378:metabolism / Q000473:pathology
chemical_list: D006025:Glycosaminoglycans; D011509:Proteoglycans