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      Low-dose mesenchymal stem cell therapy for discogenic pain: safety and efficacy results from a 1-year feasibility study

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          Abstract

          Aim:

          To evaluate safety and efficacy of low dose autologous adipose-derived mesenchymal stem cells (ADMSCs) for treatment of disc degeneration resulting in low back pain (LBP).

          Methods:

          Nine participants with chronic LBP originating from single-level lumbar disc disease underwent intradiscal injection of 10 million ADMSCs with optional repetition after 6 months.

          Results:

          No unexpected or serious adverse events were recorded. Seven (78%) of participants reported reductions in pain 12 months after treatment. Five (56%) reported increased work capacity. Three (33%) reduced analgesic medication. Improvements in EQ-5D and Oswestry disability index results were observed. MRI demonstrated no further disc degeneration and improvements to annular fissures and disc protrusions.

          Conclusion:

          This study provides initial evidence of safety and efficacy of ADMSCs for discogenic LBP.

          Plain language summary

          This feasibility study sought to evaluate the safety and efficacy of low dose autologous adipose-derived mesenchymal stem cells (ADMSCs) for treatment of disc degeneration resulting in low back pain (LBP) in 9 participants. No unexpected or serious adverse events were recorded. Seven (78%) of participants reported reductions in pain 12 months after treatment. Five (56%) reported increased work capacity. Three reduced analgesic medication. Quality of life improvements were also observed. Conclusion: This study provides initial evidence of safety and efficacy of ADMSCs for discogenic LBP.

          Most cited references80

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          Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement.

          The considerable therapeutic potential of human multipotent mesenchymal stromal cells (MSC) has generated markedly increasing interest in a wide variety of biomedical disciplines. However, investigators report studies of MSC using different methods of isolation and expansion, and different approaches to characterizing the cells. Thus it is increasingly difficult to compare and contrast study outcomes, which hinders progress in the field. To begin to address this issue, the Mesenchymal and Tissue Stem Cell Committee of the International Society for Cellular Therapy proposes minimal criteria to define human MSC. First, MSC must be plastic-adherent when maintained in standard culture conditions. Second, MSC must express CD105, CD73 and CD90, and lack expression of CD45, CD34, CD14 or CD11b, CD79alpha or CD19 and HLA-DR surface molecules. Third, MSC must differentiate to osteoblasts, adipocytes and chondroblasts in vitro. While these criteria will probably require modification as new knowledge unfolds, we believe this minimal set of standard criteria will foster a more uniform characterization of MSC and facilitate the exchange of data among investigators.
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            Multilineage potential of adult human mesenchymal stem cells.

            Human mesenchymal stem cells are thought to be multipotent cells, which are present in adult marrow, that can replicate as undifferentiated cells and that have the potential to differentiate to lineages of mesenchymal tissues, including bone, cartilage, fat, tendon, muscle, and marrow stroma. Cells that have the characteristics of human mesenchymal stem cells were isolated from marrow aspirates of volunteer donors. These cells displayed a stable phenotype and remained as a monolayer in vitro. These adult stem cells could be induced to differentiate exclusively into the adipocytic, chondrocytic, or osteocytic lineages. Individual stem cells were identified that, when expanded to colonies, retained their multilineage potential.
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              EuroQol: the current state of play.

              R. Brooks (1996)
              The EuroQol Group first met in 1987 to test the feasibility of jointly developing a standardised non-disease-specific instrument for describing and valuing health-related quality of life. From the outset the Group has been multi-country, multi-centre, and multi-disciplinary. The EuroQol instrument is intended to complement other forms of quality of life measures, and it has been purposefully developed to generate a cardinal index of health, thus giving it considerable potential for use in economic evaluation. Considerable effort has been invested by the Group in the development and valuation aspects of health status measurement. Earlier work was reported upon in 1990; this paper is a second 'corporate' effort detailing subsequent developments. The concepts underlying the EuroQol framework are explored with particular reference to the generic nature of the instrument. The valuation task is reviewed and some evidence on the methodological requirements for measurement is presented. A number of special issues of considerable interest and concern to the Group are discussed: the modelling of data, the duration of health states and the problems surrounding the state 'dead'. An outline of some of the applications of the EuroQol instrument is presented and a brief commentary on the Group's ongoing programme of work concludes the paper.
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                Author and article information

                Journal
                Future Sci OA
                Future Sci OA
                FSOA
                Future Science OA
                Future Science Ltd (London, UK )
                2056-5623
                21 April 2022
                March 2022
                21 April 2022
                : 8
                : 5
                : FSO794
                Affiliations
                [1 ]Melbourne Stem Cell Centre, Box Hill, Victoria, 3128, Australia
                [2 ]Magellan Stem Cells, Victoria, Australia
                [3 ]Metro Pain Group, Clayton, Victoria, 3168, Australia
                [4 ]Monash Clinical Research, Clayton, Victoria, 3168, Australia
                [5 ]School of Dentistry & Medical Sciences, Charles Sturt University, Wagga Wagga, NSW, 2650, Australia
                [6 ]The Hudson Institute, Clayton, Victoria, 3168, Australia
                [7 ]Capital Radiology, Clayton, Victoria, 3168, Australia
                Author notes
                [* ]Author for correspondence: Tel.: +61 3 9595 6184; research@ 123456monashcr.com.au
                Author information
                https://orcid.org/0000-0001-6701-4368
                Article
                10.2144/fsoa-2021-0155
                9136638
                35662742
                1a8f1b56-3872-4007-a946-fe6f6111bdf3
                © 2022 The Authors

                This work is licensed under the Creative Commons Attribution 4.0 License

                History
                : 05 December 2021
                : 22 March 2022
                : 21 April 2022
                Page count
                Pages: 18
                Categories
                Research Article

                chronic pain,disc degeneration,discogenic low back pain,feasibility study,mesenchymal stem cells

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