Chronic low back pain is a common condition that can significantly reduce the quality of life. The degeneration of the intervertebral disc is one cause for low back pain, and there is no therapeutic intervention that effectively reverses this type of degeneration. Both non-surgical and surgical treatments that are currently used for chronic low back pain aim to help the symptoms associated with the condition but do not address the underlying cause. Recently, however, researchers have begun to explore the ways in which stem cells may be used to help regenerate the intervertebral disc to restore functioning and eliminate low back pain over the long-term. A review of the relevant literature was recently published in Translational Pediatrics.
The intervertebral disc does not have a large potential to regenerate itself, so it is a challenge to find the best cell sources to facilitate such regeneration. Adult mesenchymal stem cells, which are found most often in bone marrow and also in fat, or adipose, tissue are attractive candidates for this type of regeneration given their high capacity to proliferate and to differentiate into different types of cells. In addition, they can self-renew, are highly accessible, and unlike some other types of stem cells, there are no ethical issues associated with their retrieval.
Given the success of mesenchymal stem cell transplantation in preclinical studies of intervertebral disc degeneration, the use of these cells has progressed to clinical trials. Autologous bone marrow mesenchymal stem cells – meaning stem cells taken from the bone marrow of the patients themselves – have been reported in the treatment of disc degeneration in patients with leg and back pain. Reduced pain has been observed at one and two years after transplantation. Importantly, the clinical trials investigating the use of stem cells in intervertebral disc regeneration have provided evidence that the relevant procedures are not only effective but also clinically safe. Future research will help to clarify if and how these and other types of stem cells may be used to reverse intervertebral disc regeneration and the associated chronic low back pain.
Reference: Wei, A. et al. (2014). Mesenchymal stem cells: potential application in intervertebral disc regeneration. Translational Pediatrics, 3(2), 71-90.
The complex interplay between nutrition and health is still being researched by experts. In many cases, there are already established links between certain foods and undesirable health outcomes. For example, recent dietary guidelines recommend limiting added sugars to 10% of your daily calories or less, as they’re associated with an increased risk of heart disease. For individuals with chronic diseases, it’s perhaps even more important to consider the ways food can impact health.
For those with Multiple Sclerosis (MS),
optimizing your diet means not only filling your plate with healthy foods, but
also avoiding or limiting foods known to exacerbate symptoms. Research shows
that in particular, patients with MS have been able to improve their quality of
life by making specific tweaks
to their diet. Discover which foods
you should discuss with your doctor as a means of controlling your symptoms.
Fats
Saturated fats are commonly found in animal products,
including red meat. These foods aren’t entirely void of nutritious qualities –
after all, they can be rich sources of protein. Yet, their high concentration
of saturated fats presents issues, as they could raise “bad” cholesterol
levels. This is especially of concern for MS patients, who face a higher risk
for heart problems than people without MS.
Trans fats, too, are considered dangerous. Sometimes labeled
as “partially hydrogenated oils,” these fats are known to increase
inflammation, particularly within the blood vessels. This, too, increases the
risk of cardiovascular issues. Steer clear of packaged cookies, crackers, and dessert
items, or at the very least, be sure to enjoy them sparingly.
Sugar
We mentioned briefly above that added sugars are notorious
for their adverse health effects. Not only does excess
sugar lead to weight gain, but it also produces an inflammatory effect
which can intensify MS symptoms. Natural sugars, including those found in
fruits, don’t have the same effect, so feel free to snack on those instead.
Sodium
Added salt presents a number of issues for MS patients. In
general, higher sodium intake is associated with increased
disease activity in MS, and has been found to increase likelihood of
relapse and development of lesions. Sodium intake and blood pressure are also
related, and because high blood pressure can decrease life expectancy in MS
patients, added salt should be consumed at a minimum.
Dairy
Like meat, cow’s milk and other full-fat dairy products are high
in saturated fats. Besides the fat content, however, specific proteins in the
milk could cause trouble for people with MS. These agents could produce a
reaction in multiple sclerosis sufferers, but research shows
the link isn’t very strong. However, it may be worth replacing cow’s milk and
other full-fat dairy products with alternatives to see if it alleviates your
symptoms. Consider exploring options such as soy, almond, or even camel’s
milk.
Gluten
Gluten is primarily a concern for people with celiac
disease, which is characterized by an allergy to the protein found in rye,
wheat, and barley. Consuming gluten can cause intestinal damage in people with
the allergy. Because MS patients have a higher incidence
of celiac disease than the general population, it may be useful to closely
monitor your body’s reaction to consuming bread, cereal, pasta, and other foods
with gluten. While there is currently no evidence suggesting avoidance of
gluten can alleviate MS symptoms in patients who don’t have celiac disease, it never
hurts to bring up any food-related concerns you may have with your physician.
The human skeleton is made up of bone, cartilage, fat, nerves, blood vessels, and bone marrow. While the skeleton is usually strong and vibrant in youth, it changes considerably with age. Many people, especially women, experience demineralization of bone called osteoporosis. Most of us will suffer from painful, stiff, arthritic joints either from osteoarthritis or rheumatoid arthritis or both. While some of the diseases of bone and joints have specific treatments, none of them helps to restore bone and joints to their younger state. If one could reintroduce skeletal stem cells into the body, that could all change. Excitingly, researchers have recently isolated human skeletal stem cells from bone and other tissues.
At first glance, this breakthrough may not seem so surprising. One might wonder: didn’t we already have stem cells that form bone and cartilage? The answer is yes, but with an important caveat. Before researchers recently isolated human skeletal stem cells, the only stem cells that could be used to produce bone and cartilage were rather unpredictable. In addition to bone and cartilage, the mesenchymal stem cells that have been long used to form these tissues could also produce fat, muscle, fiberglass, blood vessel cells, and other tissues. In other words, the stem cells were broadly multipotent and, by extension, could not easily be used for a specific purpose, like mending bone or repairing an arthritic joint. That is why the recent discovery of these particular skeletal stem cells is so important.
The researchers isolated skeletal stem cells from various human tissues, mainly bone. They then used the skeletal stem cells to regrow bone and/or cartilage. Not only did the stem cells produce bone and cartilage in the first animal they tested, but they could retrieve stem cells from that animal and then cause bone to regrow in a second animal. This means that the skeletal stem cells have the capability of reproducing themselves.
The same researchers also discovered that when a skeleton is injured, such as in a bone fracture, the number of skeletal stem cells in that area increases dramatically. This makes sense since these cells are used to repair and regrow bone. It is also a promising result because it suggests that stem cells could be used to accelerate bone and joint healing in humans.
Scientists not directly involved in this research heralded this finding as “an extremely important advance.” However, they also acknowledge that more work needs to be done before skeletal stem cells can be routinely used in patients with orthopedic conditions. Nevertheless, these results are an exciting development in the field of stem cell research and orthopedics.
Xiaodong Pang and colleagues have demonstrated the successful use of human umbilical cord tissue-derived mesenchymal stem cells in the treatment of chronic discogenic low back pain. The study, published in Pain Physician, is the first study to addressing the potential of this particular treatment option for chronic discogenic low back pain.
Chronic discogenic low back pain is the leading cause of chronic low back pain, which leads to a significant amount of disability. This type of back pain does not currently have any highly successful treatment options. Generally, the pain is managed conservatively, and if all else fails, surgical fusion is undertaken. Neither of these options addresses the underlying cause of chronic discogenic low back pain and instead simply address the symptoms, offering ways to try to reverse those symptoms.
In this initial study conducted by Pang and colleagues, the researchers aimed to establish that human umbilical cord tissue-derived mesenchymal stem cells could be both feasibly and safely used in humans to treat chronic discogenic low back pain. The study, conducted at a spine center in China, focused on two patients with chronic discogenic low back pain. Both patients underwent the transplantation of the stem cells, and their back pain symptoms and lumbar function were assessed both immediately after the transplants and again two years later.
The researchers found that both the pain and the function associated with the patients’ back conditions improved immediately after the stem cell transplants. In addition to demonstrating that this particular transplant procedure was feasible, the researchers also showed that it was safe, as neither patient suffered side effects.
There are a number of reasons for which human umbilical cord tissue-derived mesenchymal stem cells may provide the benefits that these researchers observed. For instance, unlike other stem cell types, these cells have the ability to differentiate into a number of different types of cells. The results of other studies suggest that these stem cells may help with this lower back condition by altering cell activity such that less inflammation occurs.
Going forward, researchers will need to replicate the findings of this study to show that the positive effects of human umbilical cord tissue-derived mesenchymal stem cells in chronic discogenic low back pain extends to the general patient population. Further, as the mechanism by which these cells may improve the condition is not clear, research that helps to elucidate the way these cells confer their benefits will also help in the development of relevant therapeutic interventions.
To learn more about stem cell treatments click here.
A specific type of stem cell called mesenchymal stem cells has shown significant promise for therapeutics against a host of diseases, and now scientists have found that they can improve the therapeutic impact of these stem cells through something called hypoxia preconditioning. They have published their findings in a journal called Cell Death and Disease.
Previous research has found that, though helpful for therapies, the effectiveness of mesenchymal stem cells is often limited by certain physiological conditions. For instance, DNA damage, cell death, and harm to tissue often persist because reactive oxygen species are produced in response to disease or injury. Insufficient nutrient levels can also minimize the therapeutic potential of mesenchymal stem cells. Studies performed to overcome these limitations by genetically modifying mesenchymal stem cells have demonstrated that this particular approach comes with its own difficulties, including toxicity and unwanted side effects.
Certain injuries lead to a shortage of blood supply to some tissue areas. When this occurs, the oxygen levels in those tissues can become severely limited in what is known as hypoxia. Hypoxia can lead to cell death and can also make it harder for stem cells to differentiate if they are applied for therapy. However, research has shown that preconditioning cells to lower oxygen level conditions can enable them to later withstand more severe hypoxia. Based on these observations, a team of scientists, led by Sang Hun Lee, hypothesized that preconditioning mesenchymal stem cells may help them survive and proliferate once they are transplanted into injured tissue.
To test their idea, the scientists preconditioned mesenchymal stem cells from people’s fat tissue to low oxygen levels and then transplanted the cells into mice whose blood supply had been cut off to certain tissues. When they compared the impact of transplanting these preconditioned cells to transplanting cells that were not preconditioned, they found that the preconditioned cells survived and proliferated at higher rates and that they were more effective in helping the mice recover functionally. These results add to the breadth of research that suggests that stem cells may have an array of therapeutic applications and that any limitations that arise may be able to be addressed by combining stem cell transplantation with other strategies.
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