Degenerative disc disease is one of the most common causes of low back pain and neck pain, but also one of the most misunderstood. In the ongoing effort to develop new treatments for this chronic condition, Mesoblast, an Australian biotech company, is testing a new stem cell treatment that seeks to alleviate the condition. Simply put, degenerative disc disease describes the symptoms of pain, and possibly radiating weakness or numbness, stemming from a degenerated disc in the spine.
While the definition sounds simple, many patients diagnosed with degenerative disc disease are left wondering exactly what this diagnosis means for them. Common questions often include:
• If I have this much pain in my thirties, how much worse will it become with age?
• Will the disease become a crippling condition? Will I end up in a wheelchair?
• Should I restrict my activities? Can I still play sports?
• Will the disease spread to other parts of the spine?
• Will the degenerated disc(s) cause any permanent damage?
A diagnosis of degenerative disc disease often sounds alarming to many patients because it sounds like a progressive, threatening disease. However, it’s not technically a “disease,” and it is not strictly “degenerative.”
For most people, the term degenerative understandably implies the symptoms will get worse with age. However, the term does not apply to the symptoms, but rather describes the process of the disc degenerating over time.
Mesoblast is currently enrolling patients in a Phase 3 study to see if a single injection of mesenchymal precursor cells, taken from the bone marrow of healthy donors, can relieve back pain and improve the mobility of patients suffering from the condition; degenerative disc disease occurs when the cushions between vertebrae wear down because of aging, genetics or injuries.
Mesenchymal stem cells, or MSCs, are multipotent stromal cells that can differentiate into a variety of cell types, including: osteoblasts (bone cells), chondrocytes (cartilage cells), myocytes (muscle cells) and adipocytes (fat cells).
The treatment consists of millions of MPCs that are injected directly into the damaged disc in an outpatient procedure. Previous studies have found that MPCs have anti-inflammatory effects, and help strengthen and improve the stability of damaged discs. The treatment is being developed for patients who have exhausted other options for their back pain.
“Patients with this level of degeneration often try multiple treatments for relief, including pain medication, massage, physical therapy, chiropractic adjustments and acupuncture,” explained lead investigator Dr. Kee Kim, a professor of neurological surgery and co-director of the University of California Davis Spine Center, in a published study of the procedure by the U.S. National Institutes of Health
“For some of them, nothing seems to help, and we end up operating to remove the degenerated disc and fuse the spine to eliminate motion that may cause increased pain,” Dr. Kim explained. “We want to know if a single dose of this investigational therapy can offer relief without the need for surgery.”
UC Davis is one of 28 sites in the United States and Australia involved in the study. Participants with degenerative disc disease in the lower back will receive injections of either MPCs, MPCs with a carrier material (hyaluronic acid) or a placebo.
Although the MPCs are collected from donors, tissue matching is not necessary.
Following treatment, researchers will evaluate participants six times over the course of a year. They also will be given the option to participate in an extension of the study to track their progress for three years after the initial injection.
Previous studies have found that MPCs have anti-inflammatory effects and help strengthen and improve the stability of damaged discs. Researchers caution, however, that the treatment may not be effective for everyone.
“Many patients with back pain will not benefit from this stem cell therapy and may still require surgery,” Kim said. “For some patients, it could offer improvement. For these patients, it is worth exploring this alternative.”