title: Intervertebral disc regeneration: from the degenerative cascade to molecular therapy and tissue engineering.
abstract: Low back pain is one of the major health problems in industrialized countries, as a leading source of disability in the working population. Intervertebral disc degeneration has been identified as its main cause, being a progressive process mainly characterized by alteration of extracellular matrix composition and water content. Many factors are involved in the degenerative cascade, such as anabolism/catabolism imbalance, reduction of nutrition supply and progressive cell loss. Currently available treatments are symptomatic, and surgical procedures consisting of disc removal are often necessary. Recent advances in our understanding of intervertebral disc biology led to an increased interest in the development of novel biological treatments aimed at disc regeneration. Growth factors, gene therapy, stem cell transplantation and biomaterials-based tissue engineering might support intervertebral disc regeneration by overcoming the limitation of the self-renewal mechanism. The aim of this paper is to overview the literature discussing the current status of our knowledge from the degenerative cascade of the intervertebral disc to the latest molecular, cell-based therapies and tissue-engineering strategies for disc regeneration.
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Vadalà
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Russo
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Di Martino
authors.affiliation: Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D055959:Intervertebral Disc Degeneration / Q000503:physiopathology* / Q000628:therapy*; D058990:Molecular Targeted Therapy; D012038:Regeneration; D023822:Tissue Engineering / Q000379:methods*
keywords: disc degeneration; gene therapy; growth factors; intervertebral disc; stem cells; tissue engineering