Dataset Information

Cell Therapy for Treatment of Intervertebral Disc Degeneration: A Systematic Review.

ABSTRACT:

Study design

Systematic review.

Objective

To review, critically appraise, and synthesize evidence on use of cell therapy for intervertebral disc repair.

Methods

A systematic search of PubMed/MEDLINE was conducted for literature published through October 31, 2018 and EMBASE and ClinicalTrials.gov databases through April 13, 2018 comparing allogenic or autologous cell therapy for intervertebral disc (IVD) repair in the lumbar or cervical spine. In the absence of comparative studies, case series of ?10 patients were considered.

Results

From 1039 potentially relevant citations, 8 studies across 10 publications on IVD cell therapies in the lumbar spine met the inclusion criteria. All studies were small and primarily case series. For allogenic cell sources, no difference in function or pain between mesenchymal cell treatment and sham were reported in 1 small randomized controlled trial; 1 small case series reported improved function and pain relative to baseline but it was unclear if the change was clinically significant. Similarly for autologous cell sources, limited data across case series suggest pain and function may be improved relative to baseline; whether the changes were clinically significant was not clear. Safety data was sparse and poorly reported. The need for subsequent surgery was reported in 3 case-series studies ranging from 6% to 80%.

Conclusions

The overall strength of evidence for efficacy and safety of cell therapy for lumbar IVD repair was very low primarily due to substantial risk of bias, small sample sizes and lack of a comparator intervention. Methodologically sound studies comparing cell therapies to other treatments are needed.

SUBMITTER: Meisel HJ

PROVIDER: S-EPMC6512192 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Cell Therapy for Treatment of Intervertebral Disc Degeneration: A Systematic Review.

Meisel Hans-Joerg HJ Agarwal Neha N Hsieh Patrick C PC Skelly Andrea A Park Jong-Beom JB Brodke Darrel D Wang Jeffrey C JC Yoon S Tim ST Buser Zorica Z

Global spine journal 20190508 1 Suppl

<h4>Study design</h4>Systematic review.<h4>Objective</h4>To review, critically appraise, and synthesize evidence on use of cell therapy for intervertebral disc repair.<h4>Methods</h4>A systematic search of PubMed/MEDLINE was conducted for literature published through October 31, 2018 and EMBASE and ClinicalTrials.gov databases through April 13, 2018 comparing allogenic or autologous cell therapy for intervertebral disc (IVD) repair in the lumbar or cervical spine. In the absence of comparative s ...[more]

PMID: 31157145

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Project description:As a controllable biological process, regulated cell death (RCD) extensively participates in cellular homeostasis, organismal development, and the pathogenesis of diseases. This review addresses the research gaps by synthesising the findings on the complexity of RCD modes and their role in disc degeneration, and summarises the preclinical strategies to alleviate disc degeneration and promote disc repair by regulating RCD.BackgroundIntervertebral disc degeneration (IDD) is the major source of chronic low back pain. As a controllable biological process, regulated cell death (RCD) extensively participates in the pathogenesis of IDD. Nevertheless, the initiation and progression of RCD remain unclear, and more importantly, the interaction between different RCD modes during IDD and therapy is far from well understood.MethodsLiterature search was performed using "regulated cell death AND intervertebral disc degeneration" in PubMed, Embase, and Web of Science. Meanwhile, relevant findings have been reviewed and quoted.ResultsIn this review, we discuss the inducing factors of IDD, various modes of RCD in intervertebral disc, the interactions between different RCD modes, as well as the obstacles to achieve disc regeneration. Meanwhile, the research gaps and perspective in studies that targeting RCD are also presented.ConclusionIncreasing evidence demonstrated the presence of different RCD modes in intervertebral disc during the progression of IDD. RCD in the resident disc cells is probably induced by the multiple factors such as abnormal mechanical loading, nutritional imbalance, inflammation microenvironment, circadian rhythm changes, withdraw of hormones, and other biomechanical factors. A better understanding of the fundamental mechanisms and the interactions between different RCD modes might contribute to the rescuing of disc degeneration and development of promising therapeutics.Translational potential statementThe Translational potential of this article. This review aims to demonstrate a better understanding of the fundamental mechanisms governing RCD, which might contribute to the rescuing of disc degeneration and to the development of promising therapeutics in a clinical setting.

Dataset Information

Cell Therapy for Treatment of Intervertebral Disc Degeneration: A Systematic Review.

Study design

Objective

Methods

Results

Conclusions

Publications

Cell Therapy for Treatment of Intervertebral Disc Degeneration: A Systematic Review.

Similar Datasets

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