Bioengineered Intervertebral Discs are Implanted Successfully in Goats

Significant progress has been made in the tissue engineering of intervertebral discs in recent years. Researchers here report on an initial study in larger animals, demonstrating that the implanted intervertebral discs exhibit the correct behavior and otherwise hold up well for at least a few months. Degeneration of intervertebral discs is universal to at least some degree in older people, with a sizable portion of the population suffering pain and loss of function, and the consequences of disc injury at any stage of life can also be lasting and severe. Thus approaches that can meaningfully address this issue are most welcome, whether they involve engineered replacement discs, or act through forms of regenerative therapy that can spur existing tissues to restore themselves.

The soft tissues in the spinal column, the intervertebral discs, are essential for the motions of daily life, such as turning your head to tying your shoes. At any given time, however, about half the adult population in the United States is suffering from back or neck pain, for which treatment and care place a significant economic burden on society - an estimated $195 billion a year. While spinal disc degeneration is often associated with that pain, the underlying causes of disc degeneration remain less understood. Today's approaches, which include spinal fusion surgery and mechanical replacement devices, provide symptomatic relief, but they do not restore native disc structure, function, and range of motion, and they often have limited long-term efficacy. Thus, there is a need for new therapies.

Tissue engineering holds great promise. It involves combining the patients' or animals' own stem cells with biomaterial scaffolds in the lab to generate a composite structure that is then implanted into the spine to act as a replacement disc. For the last 15 years, a team has been developing a tissue engineered replacement disc, moving from in vitro basic science endeavors to small animal models to larger animal models with an eye towards human trials. Past studies from the team successfully demonstrated the integration of their engineered discs, known as disc-like angle ply structures (DAPS), in rat tails for five weeks. This latest research extended that time period in the rat model - up to 20 weeks - but with revamped engineered discs, known as endplate-modified DAPS, or eDAPS, to mimic the structure of the native spinal segment. The addition of the endplates helped to retain the composition of the engineered structure and promote its integration into the native tissue.

MRI, along with histological, mechanical, and biochemical analyses, showed that the eDAPS restored native disc structure, biology, and mechanical function in the rat model. Building off that success, the researchers then implanted the eDAPS into the cervical spine of goats. They chose the goat because its cervical spinal disc dimensions are similar to humans' and goats have the benefit of semi-upright stature. Researchers demonstrated successful total disc replacement in the goat cervical spine. After four weeks, matrix distribution was either retained or improved within the large-scale eDAPS. MRI results also suggest that disc composition at eight weeks was maintained or improved, and that the mechanical properties either matched or exceeded those of the native goat cervical disc.

Link: https://www.pennmedicine.org/news/news-releases/2018/november/treating-spinal-pain-with-replacement-discs-made-of-engineered-living-tissue-moves-closer-to-reality

Comments

I've been talking about this possibility as an example of a future rejuvenation therapy since 2005. I've also been talking about bio-engineered hair replacement about the same amount of time. As a balding man with no back problems, this is Murphy's law.

Posted by: Tom Schaefer at November 23rd, 2018 8:24 AM

@Tom, check out http://www.folliclethought.com. It's like this blog but only about hair loss research. Pretty neat!

Posted by: Morpheus at November 23rd, 2018 8:55 AM

Pretty sure anybody in his right mind would prefer baldness to bad back :)

Posted by: Märten at November 23rd, 2018 10:26 AM

Nice for goats ! It is a laboratory onstruct .

Of more relevance is that Mesoblast have a late phase 111 human trial - 404 pts - which uses stem cells to achieve the same end ie disc regeneration.
Should be reporting mid 2019. If licensed, it will change the landscape of DDD treatment.

Posted by: JLH at November 23rd, 2018 12:03 PM

I would try the MSC injections before even considering this, guessing this is for people that can not even stand. I am trying to mitigate my disc degeneration by supplemeting 10g/day of Dietary Collagen, and doing weighted hangs for a few minute a day. I should also do foam roller work but I am too lazy.

Posted by: JohnD at November 23rd, 2018 12:31 PM

It is good that various angles of attack are being employed in biotech generally and in particular in DDD. However, I do not think it is quite appreciated just how advanced stem cell science is. There are now hundreds of clinical trials and about 20-30 phase 111's. Circa 13 stem cell treatments already licensed though they have not yet critical mass.
28 RMAT trials in progress.
2019 should witness a transformation of the landscape.

Posted by: JLH at November 23rd, 2018 1:35 PM

Given that shrinkage of these discs is the primary reason why older people tend to shrink in height, I wonder if using stem cell tech like this to augment normal sized discs in healthy (but short) younger people might one day become a practical cosmetic operation for increasing height?

Posted by: The Transhumanist Runner at November 26th, 2018 6:41 AM

@Transhumanist Runner
There already exist a bone extender since the 70s. It works quite well for kids with legs that have different size. However, it is a torture.

Posted by: Cuberat at November 27th, 2018 5:42 AM

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