title: Intervertebral disc regeneration: do nutrients lead the way?
abstract: Strategies for the biological repair of intervertebral discs derive from the premise that disc degeneration results from impaired cellular activity and, therefore, that these structures can be induced to regenerate by implanting active cells or providing factors that restore normal cellular activity. In vitro and animal studies using this approach have had some success, but whether this success can be reproduced in degenerate human lumbar discs is unknown. Successful repair requires that the disc cells remain viable and active; they therefore need an adequate supply of nutrients. However, as the disc degenerates, the nutrient supply decreases, thereby limiting cell activity and viability. Current biologic approaches might place additional demands on an already precarious nutrient supply. Here, we discuss whether the loss of nutrients associated with disc degeneration limits the effectiveness of biologic approaches, and indicate that this neglected problem requires investigation if clinical application of such therapies is to succeed.
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, 5/F Professor Block, Queen Mary Hospital, Pokfulam, Hong Kong.
authors.forename: Yong-Can
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Department of Physiology, Anatomy and Genetics, University of Oxford, Le Gros Clark Building, South Parks Road, Oxford OX1 3QX, UK.
authors.forename: Jill P G
authors.initials: JP
authors.lastname: Urban
authors.affiliation: Department of Orthopaedics and Traumatology, The University of Hong Kong, 5/F Professor Block, Queen Mary Hospital, Pokfulam, Hong Kong.
authors.forename: Keith D K
authors.initials: KD
authors.lastname: Luk
mesh_terms: D000818:Animals; D002468:Cell Physiological Phenomena; D006801:Humans; D007403:Intervertebral Disc / Q000166:cytology / Q000502:physiology*; D055959:Intervertebral Disc Degeneration / Q000503:physiopathology / Q000628:therapy*; D012038:Regeneration