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      Mesenchymal Stem Cell Homing Into Intervertebral Discs Enhances the Tie2-positive Progenitor Cell Population, Prevents Cell Death, and Induces a Proliferative Response

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          Abstract

          Supplemental Digital Content is available in the text

          Homing of mesenchymal stem cells (MSCs) from the endplate into the intervertebral disc (IVD) has been described as alternative intradiscal application route. Our findings indicate that the homed MSCs enhance the Tie2-positive disc progenitor cell population, prevent disc cell death, and induce a proliferative response in the IVD cells.

          Study Design.

          Experimental study with human mesenchymal stem cells (MSCs) and intervertebral disc (IVD) tissue samples.

          Objective.

          This study aimed to characterize the effect of MSC homing on the Tie2-positive IVD progenitor cell population, IVD cell survival, and proliferation.

          Summary of Background Data.

          Homing of human MSCs has been described as potential alternative to MSC injection, aiming to enhance the regenerative capacity of the IVD. IVD cells expressing Tie2 (also known as CD202b or Angiopoietin-1 receptor TEK tyrosine kinase) represent a progenitor cell population with discogenic differentiation potential. However, the fraction of Tie2-positive progenitor cells decreases with aging and degree of IVD degeneration, resulting in a potential loss of the IVD's regenerative capacity.

          Methods.

          Human MSCs, isolated from vertebral bone marrow aspirates, were labeled and seeded onto the endplate of bovine IVDs and human IVD tissue. Following MSC migration for 5 days, IVD cells were isolated by tissue digestion. The fractions of Tie2-positive, dead, apoptotic, and proliferative IVD cells were evaluated by flow cytometry and compared to untreated IVDs. For human IVDs, 3 groups were investigated: nondegenerated (organ donors), IVDs of patients suffering from spinal trauma, and degenerative IVD tissue samples.

          Results.

          MSC homing enhanced the fraction of Tie2-positive IVD cells in bovine and human IVD samples. Furthermore, a proliferative response and lower fraction of dead cells were observed after MSC homing in both bovine and human IVD tissues.

          Conclusion.

          Our findings indicate that MSC homing enhances the survival and regenerative capability of IVD cells, which may be mediated by intercellular communication. MSC homing could represent a potential treatment strategy to prevent the onset of the degenerative cascade in IVDs at risk such as IVDs adjacent to a fused segment or IVDs after herniation.

          Level of Evidence: N/A

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          Most cited references30

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          Bcl-2-regulated apoptosis: mechanism and therapeutic potential.

          Apoptosis is essential for tissue homeostasis, particularly in the hematopoietic compartment, where its impairment can elicit neoplastic or autoimmune diseases. Whether stressed cells live or die is largely determined by interplay between opposing members of the Bcl-2 protein family. Bcl-2 and its closest homologs promote cell survival, but two other factions promote apoptosis. The BH3-only proteins sense and relay stress signals, but commitment to apoptosis requires Bax or Bak. The BH3-only proteins appear to activate Bax and Bak indirectly, by engaging and neutralizing their pro-survival relatives, which otherwise constrain Bax and Bak from permeabilizing mitochondria. The Bcl-2 family may also regulate autophagy and mitochondrial fission/fusion. Its pro-survival members are attractive therapeutic targets in cancer and perhaps autoimmunity and viral infections.
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            Is Open Access

            Secreted trophic factors of mesenchymal stem cells support neurovascular and musculoskeletal therapies

            Adult mesenchymal stem cells (MSCs) represent a subject of intense experimental and biomedical interest. Recently, trophic activities of MSCs have become the topic of a number of revealing studies that span both basic and clinical fields. In this review, we focus on recent investigations that have elucidated trophic mechanisms and shed light on MSC clinical efficacy relevant to musculoskeletal applications. Innate differences due to MSC sourcing may play a role in the clinical utility of isolated MSCs. Pain management, osteochondral, nerve, or blood vessel support by MSCs derived from both autologous and allogeneic sources have been examined. Recent mechanistic insights into the trophic activities of these cells point to ultimate regulation by nitric oxide, nuclear factor-kB, and indoleamine, among other signaling pathways. Classic growth factors and cytokines—such as VEGF, CNTF, GDNF, TGF-β, interleukins (IL-1β, IL-6, and IL-8), and C-C ligands (CCL-2, CCL-5, and CCL-23)—serve as paracrine control molecules secreted or packaged into extracellular vesicles, or exosomes, by MSCs. Recent studies have also implicated signaling by microRNAs contained in MSC-derived exosomes. The response of target cells is further regulated by their microenvironment, involving the extracellular matrix, which may be modified by MSC-produced matrix metalloproteinases (MMPs) and tissue inhibitor of MMPs. Trophic activities of MSCs, either resident or introduced exogenously, are thus intricately controlled, and may be further fine-tuned via implant material modifications. MSCs are actively being investigated for the repair and regeneration of both osteochondral and other musculoskeletal tissues, such as tendon/ligament and meniscus. Future rational and effective MSC-based musculoskeletal therapies will benefit from better mechanistic understanding of MSC trophic activities, for example using analytical “-omics” profiling approaches.
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              Intervertebral disc regeneration: From cell therapy to the development of novel bioinspired endogenous repair strategies

              Low back pain (LBP), frequently associated with intervertebral disc (IVD) degeneration, is a major public health concern. LBP is currently managed by pharmacological treatments and, if unsuccessful, by invasive surgical procedures, which do not counteract the degenerative process. Considering that IVD cell depletion is critical in the degenerative process, the supplementation of IVD with reparative cells, associated or not with biomaterials, has been contemplated. Recently, the discovery of reparative stem/progenitor cells in the IVD has led to increased interest in the potential of endogenous repair strategies. Recruitment of these cells by specific signals might constitute an alternative strategy to cell transplantation. Here, we review the status of cell-based therapies for treating IVD degeneration and emphasize the current concept of endogenous repair as well as future perspectives. This review also highlights the challenges of the mobilization/differentiation of reparative progenitor cells through the delivery of biologics factors to stimulate IVD regeneration.
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                Author and article information

                Journal
                Spine (Phila Pa 1976)
                Spine
                BRS
                Spine
                Lippincott Williams & Wilkins
                0362-2436
                1528-1159
                1 December 2019
                22 July 2019
                : 44
                : 23
                : 1613-1622
                Affiliations
                []AO Research Institute Davos, Davos Platz, Switzerland
                []Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
                []Inselspital, University of Bern, Bern, Switzerland
                [§ ]Department of Surgery, Division of Orthopaedics, Faculty of Medicine, McGill University, Montreal, Canada
                []Tokai University School of Medicine, Isehara, Kanagawa, Japan.
                Author notes
                Address correspondence and reprint requests to Sibylle Grad, PhD, AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos Platz, Switzerland; E-mail: sibylle.grad@ 123456aofoundation.org
                Article
                SPINE158114 00002
                10.1097/BRS.0000000000003150
                6867676
                31730570
                291e1fe7-9bf4-40cb-93df-f9cf378453c3
                Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                : 6 November 2018
                : 25 May 2019
                : 3 June 2019
                Categories
                Basic Science
                Custom metadata
                TRUE

                organ culture,msc migration,msc homing,disc cell survival,disc cell proliferation,ivd regeneration,tie2,cd202,disc progenitor cells,human mesenchymal stem cells

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