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Orthopedic researchers at Jefferson Medical College have for the first time found stem cells in the intervertebral discs

 

of the human spine, suggesting that such cells might someday be used to help repair

degenerating discs and remedy lower back and neck pain

Reporting November 1, 2007 in the journal Spine, a team led by Makarand
Risbud, Ph.D., and Irving Shapiro, Ph.D., at Jefferson Medical College of Thomas Jefferson University in Philadelphia, have
found stem cells in both degenerated adult human discs and in discs of animals
Many people suffer from lower back pain, and treatment ranges from painkillers such as
acetominophen to medical procedures, such as fusing vertebrae. The combined annual
costs for treatment of back pain and disc disease is approximately $100 billion a year
 and a major cause of lost work in the United States
 

According to Dr. Shapiro, as the discs in the spine degenerate, cells are lost and the
ability to produce water-binding molecules called proteoglycans is decreased. The
water absorbs forces on the spine, essentially serving as shock absorbers. Losing
proteoglycans can result in damage to the disc, and sometimes, pain
 

"It would be wonderful if we could get the cells in the intervertebral disc to regenerate
or increase the amount of proteoglycans that they synthesize," he says. "That way
we could regenerate the shock-absorbing capabilities of the spine
 

Dr. Risbud, an assistant professor of Orthopedic Surgery, and Dr. Shapiro, who is
professor of Orthopedic Surgery, both at Jefferson Medical College, and their co-workers
asked if it was possible to regenerate proteoglycans using adult stem cells. Federal
regulations prevent them from using embryonic stem cells

Dr. Risbud built the study around the observation that while the tissue that he could
isolate from the disc was no longer binding water, the tissue still might contain dormant
stem cells. He thought that while these cells were no longer functioning to repair the
damaged disc, under appropriate conditions, they could be activated
 

To explore that possibility, he isolated cells from discarded disc tissue that still had
the capacity to proliferate. Dr. Risbud notes that under certain conditions, the cells
could be encouraged to form bone. In other conditions, the cells would form cartilage
or even fat. The tests proved that these cells were indeed dormant disc stem cells. "If
we are able to stimulate the 'silent' cells in the patient, then it may be possible to repair
the ravages of degenerative disc disease without undergoing invasive surgical
procedures that may limit the motion of the spine," he says
 

According to Dr. Risbud, in earlier work, the researchers found that local conditions in
the disc can promote adult stem cells of the bone marrow to acquire characteristics of
disc cells. Within the disc, the local conditions are unique in that the oxygen levels are
low. These conditions cause the expression of many specialized molecules, including the
water-binding proteoglycans. Some of the researchers' current experiments focus on
the use of adult stem cells to repair the degenerate intervertebral disc
 

Shapiro notes that other researchers have taken bone marrow stem cells and have
made new bone, cartilage and fat tissue. "Our next step is to activate these disc stem
cells and get them to repopulate the disc and make proteoglycans and restore the water-binding

The scientists theorize that because the stem cells exist in the degenerate disk, there may
be molecules that are blocking stem cell activity. "Something is inhibiting the disc repair
process," says Dr. Shapiro. Drs. Shapiro and Risbud agree that "new studies are needed
to discover the nature of such inhibitory molecules" and to find ways to block their
activities, promoting natural healing.
 
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