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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.

Original publication

DOI

10.1038/nrrheum.2014.91

Type

Journal article

Journal

Nat Rev Rheumatol

Publication Date

09/2014

Volume

10

Pages

561 - 566

Keywords

Animals, Cell Physiological Phenomena, Humans, Intervertebral Disc, Intervertebral Disc Degeneration, Regeneration