Regenerative medicine has long been an unattainable dream, but with the technological advances and the audacious intellect of several scientists, this great branch of medicine opens the way to the future, developing cures and treatments against great diseases that until now have limited us with death. But this medical science does not work alone, since it joins with others such as advanced cell therapy, genetic engineering, and tissue engineering, which are the main fields that, based on the body’s own self-healing, can lead to compliance with the goals proposed by this branch of current medicine.
How does this treatment work?
Cell therapy uses stem cells, embryos or specialized cells to be able to develop new tissues to replace diseased or damaged tissues, such as in bone marrow transplantation, which by replacing the diseased cells of a patient with leukemia with others of a healthy donor, offers the opportune treatment to cure the disease, therefore the opportunity to have a better lifestyle and prolong the patient’s existence.
But cell therapy has not been limited to working with hematopoietic cells, but from IPS cells (induced pluripotent stem cells) have been able to convert these cells into neurons, cardiomyocytes, bones, cartilage etc. There have been several laboratory studies which have opened the possibility of curing several diseases such as hemophilia or Fanconi anemia, and also check the ability of these cells to generate mini organs such as the liver, brain, and kidneys, offering a future promising to procreate organs ready to be transplanted.
Articular cartilage and The Spinal Disc is a tissue that supports weight and friction and is composed of an extracellular matrix, mainly collagen-2, proteoglycans, aggrecans, and chondrocytes. The subchondral or endplate bone is its only vascular support. Its low cellularity and avascularity expose it to a limited capacity for regeneration and restoration. Defects in the cartilage can be chondral or partial thickness when confined to articular cartilage, or osteochondral or full thickness when the defect is deep enough to affect the subchondral bone. Nucleus pulposus of disc cells has a similar structure.
Generally, while there is no repair in chondral defects, an attempt is made in the osteochondral defects due to the subchondral blood supply, resulting in a suboptimal tissue formed by the stem and progenitor cells migrating from the bone marrow. Small lesions of full-thickness are repaired with hyaline cartilage, but large lesions are usually repaired by fibrocartilage formations. Currently, multiple treatments are used for cartilage injuries. These include microfracture, arthroscopic lavage and debridement, autologous or allogeneic osteochondral transplantation, and implantation of autologous chondrocytes, among others.
Spinal Disc also show a loss of proteoglycans and disruption of collagen matrix similar to articular cartilage.
Mesenchymal Stem cells derived from adipose (fat) tissue are recognized as a viable option to potentially repair cartilage or spinal discs.
Clinical investigators have reported on the efficacy and safety of stem cell therapies in cartilage repair for osteoarthritis and focal chondral lesions. Several clinical trials have presented the results in cellular therapies. Although they show significant heterogeneity in the used cellular therapies, the common denominator is that the vast majority of them demonstrated positive results, with minimal postoperative adverse effects. Similar technologies are now being investigated for the repair of degenerate spinal discs. This technology under clinical investigation but offers hope to millions who suffer from articular cartilage or spinal disc degeneration.
Specialist in Minimally Invasive Spinal Surgery and Medical Director of The Spine Unit
Specialist in Spinal Surgery and previously worked as a consultant in Norway
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