gms | German Medical Science

Fragestellung: Intervertebral disc prolapse or degenerative disc disease are not curable, as of yet. The experiment has been designed to test the doability of cell-based regenerative disc repair in a sheep model. In particular, feasability of the method, untoward side effects in the test animals, and the behaviour of disc cells from pre-damaged tissue in vitro has been examined.

Methodik: We present evidence for successful cell therapy in the sheep traumatic disc based on isolated and in vitro propagated cells harvested from severely pre-damaged discs. The hydrogel supports survival of disc cells, anchors the injected cells within the disc and prevents leakage of the cells through the injection canal.

Ergebnisse und Schlussfolgerung: The experiment presents pre-clinical evidence towards cell-based therapy of human intervertebral disc disease. Evidence was obtained that a spontaneous repair may occur, and that the administration of in vitro expanded disc cells from pre-damaged discs may improve healing.In the experiment, injection of disc cells took place in an in situ polymerizing hydrogel. The data indicate a profound regenerative capacity, even after massive damage, in sheep intervertebral discs. The regeneration occurs spontaneously and independent of external stimuli but may be improved and be more efficient after re-introduction of externally cultured intervertebral disc cells. This is even true if the cells are harvested, as done here, from pre-damaged tissue. The present observations question the present dogma of intervertebral discs to be non-renewable organs and also question the dogma of the nutritional bottleneck in discs. Even though the direct translation of such observations into the situation in humans is not advisable, the baseline biological evidence does allow cautious optimism beyond the currently propagated pessimism towards cell therapy based on autologous disc cells and the promotion of stem cell therapy. In particular, it seems to be obvious that both annulus and nucleus cells can be utilized, even in a random mixture, as happened here, to promote healing.