title: Biological approaches to treating intervertebral disk degeneration: devising stem cell therapies.
abstract: Intervertebral disk (IVD) degeneration is a common, chronic, and complex degeneration process that frequently leads to back pain and disability, resulting in a major public health issue. In this review we describe biological therapies under preclinical or clinical development with an emphasis on stem cell-based multimodal approaches that target prevention and treatment of IVD degeneration. Systematical review of the basic science and clinical literature was performed to summarize the current status of devising biological approaches to treating IVD degeneration. Since the exact mechanisms underlying IVD degeneration have not yet been fully elucidated and conservative managements appear to be mostly ineffective, current surgical treatment focuses on removal of the pathological disk tissues combined with spinal fusion. The treatment options, however, often produce insufficient efficacy and even serious complications. Therefore, there have been growing demands and endeavors for developing novel regenerative biology-guided strategies for repairing the IVD via delivery of exogenous growth factors, introduction of therapeutic genes, and transplantation of stem cells, or combinatorial therapies. Overall, the data suggest that when applied under a recovery neurobiology principle, multimodal regimens comprising ex vivo engineered stem cell-based disks hold a high potential promise for efficacious clinical translations.
authors.affiliation: Department of Neurosurgery, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Inbo
authors.initials: I
authors.lastname: Han
authors.forename: Alexander E
authors.initials: AE
authors.lastname: Ropper
authors.forename: Deniz
authors.initials: D
authors.lastname: Konya
authors.forename: Serdar
authors.initials: S
authors.lastname: Kabatas
authors.forename: Zafer
authors.initials: Z
authors.lastname: Toktas
authors.forename: Zaid
authors.initials: Z
authors.lastname: Aljuboori
authors.forename: Xiang
authors.initials: X
authors.lastname: Zeng
authors.forename: John H
authors.initials: JH
authors.lastname: Chi
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
authors.forename: Yang D
authors.initials: YD
authors.lastname: Teng
mesh_terms: D060846:Cell Engineering; D015316:Genetic Therapy; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery / Q000628:therapy*; D013123:Spinal Fusion / Q000009:adverse effects; D033581:Stem Cell Transplantation