1. Efficacy of administered mesenchymal stem cells in the initiation and co‐ordination of repair processes by resident disc cells in an ovine (Ovis aries) large destabilizing lesion model of experimental disc degeneration
- Author
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Margaret M. Smith, Elizabeth Clarke, James Melrose, R. J W Bell, Andrew J. Dart, CM Dart, Cindy C. Shu, and Christopher B. Little
- Subjects
0301 basic medicine ,musculoskeletal diseases ,medicine.medical_specialty ,Pathology ,H&E stain ,Glycosaminoglycan ,Lesion ,03 medical and health sciences ,Hydroxyproline ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,Orthopedics and Sports Medicine ,Research Articles ,mesenchymal stem cells ,intervertebral disc degeneration ,business.industry ,Neutral zone ,Mesenchymal stem cell ,Intervertebral disc ,intervertebral disc repair ,musculoskeletal system ,030104 developmental biology ,medicine.anatomical_structure ,chemistry ,Histopathology ,intervertebral disc ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Research Article - Abstract
Background Forty percent of low back pain cases are due to intervertebral disc degeneration (IVDD), with mesenchymal stem cells (MSCs) a reported treatment. We utilized an ovine IVDD model and intradiscal heterologous MSCs to determine therapeutic efficacy at different stages of IVDD. Methodology Three nonoperated control (NOC) sheep were used for MSC isolation. In 36 sheep, 6 × 20 mm annular lesions were made at three spinal levels using customized blades/scalpel handles, and IVDD was allowed to develop for 4 weeks in the Early (EA) and late Acute (LA) groups, or 12 weeks in the chronic (EST) group. Lesion IVDs received injections of 10 × 106 MSCs or PBS, and after 8 (EA), 22 (LA) or 14 (EST) weeks recuperation the sheep were sacrificed. Longitudinal lateral radiographs were used to determine disc heights. IVD glycosaminoglycan (GAG) and hydroxyproline contents were quantified using established methods. An Instron materials testing machine and customized jigs analyzed IVD (range of motion, neutral zone [NZ] and stiffness) in flexion/extension, lateral bending and axial rotation. qRTPCR gene profiles of key anabolic and catabolic matrix molecules were undertaken. Toluidine blue and hematoxylin and eosin stained IVD sections were histopathologically scoring by two blinded observers. Results IVDD significantly reduced disc heights. MSC treatment restored 95% to 100% of disc height, maximally improved NZ and stiffness in flexion/extension and lateral bending in the EST group, restoring GAG levels. With IVDD qRTPCR demonstrated elevated catabolic gene expression (MMP2/3/9/13, ADAMTS4/5) in the PBS IVDs and expession normalization in MSC-treated IVDs. Histopathology degeneracy scores were close to levels of NOC IVDs in MSC IVDs but IVDD developed in PBS injected IVDs. Discussion Administered MSCs produced recovery in degenerate IVDs, restored disc height, composition, biomechanical properties, down regulated MMPs and fibrosis, strongly supporting the efficacy of MSCs for disc repair.
- Published
- 2018