Regenerative therapy for the intervertebral disc

椎间盘相关性腰痛是工业化社会中最重要的骨科疾病之一，每年花费美国经济约500 - 1000亿美元，人均成本与加拿大经济相当。尽管椎间盘（IVD）疾病的经济负担，但患者的选择很少。药物疗法和物理疗法治疗症状而不治疗潜在的疾病，而手术干预有40%的失败率，并且在很大一部分患者中不实用。因此，需要新的治疗方法。 再生医学通过增强身体自身的再生能力，为减缓或逆转退行性疾病提供了相当大的希望。一般来说，再生医学系统使用细胞、材料和外源刺激的组合来将治疗包递送到组织。在这项提案中，我们将组建一个多学科团队，拥有干细胞，生物材料，外源性刺激和手术方法的专业知识，以研究使用间充质干细胞治疗IVD变性的潜力。而不是开发一个单一的可植入材料，我们将使用我们的多学科方法来开发一个完整的治疗系统的构建模块，包括细胞扩增和制备，生物材料开发，离体和体内模型，并在3个平行的，相互关联的特定目标的手术递送技术。

Intervertebral disc-related low back pain is one of the most significant orthopaedic disorders in industrialized society, costing the U.S. economy some $50-100 billion annually, with comparable per capita costs to the Canadian economy. Despite the economic burden of intervertebral disc (IVD) disease, few options are available to patients. Pharmacotherapies and physical therapy treat the symptoms without treating the underlying condition, while surgical intervention has a 40% failure rate and is not practical in a significant portion of patients. Therefore new therapies are required. Regenerative medicine holds considerable promise for slowing or reversing degenerative conditions by bolstering the body's own regenerative capacity. In general, regenerative medicine systems use a combination of cells, materials, and exogenous stimuli to deliver a therapeutic package to the tissue. In this proposal, we will assemble a multidisciplinary team with expertise in stem cells, biomaterials, exogenous stimuli, and surgical methods to investigate the potential of using mesenchymal stem cells to treat IVD degeneration. Rather than develop a single implantable material, we will use our multidisciplinary approach to develop the building blocks of a complete therapeutic system, including cell expansion and preparation, biomaterial development, ex vivo and in vivo models, and surgical delivery techniques in 3 parallel, interconnected Specific Aims.