Intervertebral Disc Repair by Allogeneic Mesenchymal Bone Marrow Cells: A Randomized Controlled Trial
| Autor: | Israel Sanchez-Lite, Miguel Ángel Martín-Ferrero, Javier García-Sancho, José M. Moraleda, Rubén Hernández-Ramajo, Francisco Ardura, David C. Noriega, Ana Sánchez, Mercedes Alberca, Borja Toribio, Verónica García |
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| Přispěvatelé: | Instituto de Salud Carlos III, Ministerio de Economía y Competitividad (España), Junta de Castilla y León |
| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Bone Marrow Cells Pilot Projects Lumbar vertebrae Disease Degeneration (medical) Intervertebral Disc Degeneration Mesenchymal Stem Cell Transplantation law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Prospective Studies Transplantation Lumbar Vertebrae business.industry Mesenchymal stem cell Intervertebral disc Mesenchymal Stem Cells Magnetic Resonance Imaging Surgery Clinical trial 030104 developmental biology medicine.anatomical_structure Treatment Outcome Quality of Life Feasibility Studies Female Bone marrow business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| ISSN: | 1534-6080 |
| Popis: | et al. [Background]: Degenerative disc disease often causes severe low-back pain, a public health problem with huge economic and life quality impact. Chronic cases often require surgery, which may lead to biomechanical problems and accelerated degeneration of the adjacent segments. Autologous mesenchymal stromal cells (MSC) treatments have shown feasibility, safety and strong indications of clinical efficacy. We present here a randomized, controlled trial using allogeneic MSC, which are logistically more convenient than autologous cells. [Methods]: We randomized 24 patients with chronic back pain diagnosed with lumbar disk degeneration and unresponsive to conservative treatments into 2 groups. The test group received allogeneic bone marrow MSCs by intradiscal injection of 25 × 10 cells per segment under local anesthesia. The control group received a sham infiltration of paravertebral musculature with the anesthetic. Clinical outcomes were followed up for 1 year and included evaluation of pain, disability, and quality of life. Disc quality was followed up by magnetic resonance imaging. [Results]: Feasibility and safety were confirmed and indications of clinical efficacy were identified. MSC-treated patients displayed a quick and significant improvement in algofunctional indices versus the controls. This improvement seemed restricted to a group of responders that included 40% of the cohort. Degeneration, quantified by Pfirrmann grading, improved in the MSC-treated patients and worsened in the controls. [Conclusions]: Allogeneic MSC therapy may be a valid alternative for the treatment of degenerative disc disease that is more logistically convenient than the autologous MSC treatment. The intervention is simple, does not require surgery, provides pain relief, and significantly improves disc quality. Financial support from the Red de Terapia Celular (RD12/0019/0036, RD12/0019/0001 and RD16/0011/0003), Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, and the Centro en Red de Medicina Regenerativa de Castilla y León is gratefully acknowledged. |
| Databáze: | OpenAIRE |
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