Evaluation of Percutaneous Intradiscal Amniotic Suspension Allograft in a Rabbit Model of Intervertebral Disc Degeneration

Luo, T. David; Vines, Jeremy B.; Zabarsky, Zachary K; Mowry, Katie C.; Marquez-Lara, Alejandro; Jinnah, Alexander H.; Ma, Xue; Berwick, Benjamin W.; Willey, Jeffrey S.; Smith, Thomas L.; Li, Zhongyu; O’Gara, Tadhg

doi:10.1097/brs.0000000000002851

Cited by 5 publications

(2 citation statements)

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“…Other cell types were not further analyzed as only a limited number of studies utilized them. These included: fibroblast cells, 80 , 81 , 82 , 83 gynecological cells (menstrual blood derived stem cells and human amniotic cells), 84 , 85 hematopoietic stem cells, 77 hESC, 86 , 87 , 88 muscle derived stem cells, 89 olfactory stem cells, 90 and synovial derived mesenchymal stem cells. 91 , 92 Cellular therapies have been proposed either as cells alone or together with instructive biomaterials or growth factors to support regenerative properties.…”

Section: Proposed Cell Sources For Nucleus Pulposus Regenerationmentioning

confidence: 99%

Cell sources proposed for nucleus pulposus regeneration

et al. 2021

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Lower back pain (LBP) occurs in 80% of adults in their lifetime; resulting in LBP being one of the biggest causes of disability worldwide. Chronic LBP has been linked to the degeneration of the intervertebral disc (IVD). The current treatments for chronic back pain only provide alleviation of symptoms through pain relief, tissue removal, or spinal fusion; none of which target regenerating the degenerate IVD. As nucleus pulposus (NP) degeneration is thought to represent a key initiation site of IVD degeneration, cell therapy that specifically targets the restoration of the NP has been reviewed here. A literature search to quantitatively assess all cell types used in NP regeneration was undertaken. With key cell sources: NP cells; annulus fibrosus cells; notochordal cells; chondrocytes; bone marrow mesenchymal stromal cells; adiposederived stromal cells; and induced pluripotent stem cells extensively analyzed for their regenerative potential of the NP. This review highlights: accessibility; expansion capability in vitro; cell survival in an IVD environment; regenerative potential; and safety for these key potential cell sources. In conclusion, while several potential cell sources have been proposed, iPSC may provide the most promising regenerative potential.

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Section: Proposed Cell Sources For Nucleus Pulposus Regenerationmentioning

confidence: 99%

Cell sources proposed for nucleus pulposus regeneration

et al. 2021

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“…12 Luo et al have shown effective use of a single intradiscal injection of ASA in a rat annular puncture model to treat intervertebral disc degeneration by looking at maintenance of disc height on a radiograph, T-2 signal of the disc on magnetic resonance imaging and histologic sections after death. 13 In vitro studies from Flannery et al on an alternate lyophilized amnion-chorion and umbilical cord product (PTP-001) have shown that this product can cause a dose-dependent decrease in tumor necrosis factor and IL-1b in an inflammatory model and also shows anticatabolic effect through a dose-dependent decrease in MMP 13, a matrix metalloproteinase that degrades collagen. 14 These basic science studies show that proteins in these harvested and processed tissues are antiinflammatory, anticatabolic, and proanabolic and, therefore, seem to contain the "right stuff" to potentially treat chronic OA and tendinopathies in the future.…”

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confidence: 99%

Editorial Commentary: Amniotic Orthopaedic Biologics: There’s Hope If We Avoid Hype

Zaslav¹

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Amniotic products donated from mothers having live births have been in use for wound care and other medical uses for many years. Recent developments in regenerative sciences have suggested these products in solution or lyophilized forms may be useful for the treatment of inflammatory diseases such as chronic tendinopathies and osteoarthritis of joints. These products for these indications, however, are deemed human cells, tissues, or cellular or tissue-based products (otherwise known as HCTPs) in the "351" category, meaning that they need to have a biologic license to be marketed and sold in the United States, and to gain this license, one needs to go through the usual rigor of investigational new drug filing and phase 1, 2, and 3 trials to prove safety and efficacy. Although current clinical use of amniotic solution and lyophilized products is on hold through this study period, both basic science and clinical trial studies are building a convincing set of data that suggest broad possibilities for their uses in the future. To date, both animal and human studies have shown that a single injection of amniotic suspension allograft is safe, has not elicited any significant immune response, and has been shown to be effective in several prospective studies and at least one well-controlled randomized controlled human study for knee osteoarthritis when compared with both hyaluronic acid and placebo saline. Proteins in these harvested and processed tissue allografts are anti-inflammatory, anticatabolic, and proanabolic. Appropriate caution by the Food and Drug Administration in granting licenses for these indications should not dissuade basic scientists and physicians from pursuing further research into these interesting products.

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