1. Introduction
low back pain, chronic discogenic low back pain, chronic discogenic LBP, disability, hypertrophy, discogenic, LBP
DEGENERATION, INFLAMMATION, DEGENERATIVE, HYPERTROPHY, LEAKAGE, OSTEOPHYTE
These authors contributed equally to this work.Functionally enhanced mesenchymal stromal cells participate in the repair of intervertebral disc. This study aimed to assess the safety and tolerability of intradiscal administration of matrilin-3-primed adipose-derived stromal cell (ASC) spheroids with hyaluronic acid (HA) in patients with chronic discogenic low back pain (LBP). In this single-arm, open-label phase I clinical trial, eight patients with chronic discogenic LBP were observed over 6 months. Each patient underwent a one-time intradiscal injection of 1 mL of 6.0 × 10Chronic discogenic low back pain (LBP), resulting from intervertebral disc (IVD) degeneration, is a leading cause of disability with significant socio-economic consequences and remains a challenging condition to address [Although clinical success is promising, the effectiveness of stem cell regenerative therapy is still not well-defined. Furthermore, the attainment of optimal therapeutic effects is complex due to the detrimental conditions associated with IVD degeneration, which include inflammation, acidity, and low oxygen levels. Consequently, contemporary research aims to enhance the inherent capabilities of MSCs. Various methods have been developed to increase the therapeutic potential of these cells [In our previous studies aimed at enhancing the functionality of ASCs through protein priming, we identified matrilin-3 as a significant enhancer of ASCs’ therapeutic efficacy in cartilage regeneration. This was demonstrated in both in vitro and in vivo experiments, where matrilin-3 also showed its potential to counteract hypertrophy [MSC transplantation in degenerative IVDs may lead to unwanted osteophyte formation as a consequence of cell leakage. To minimize this risk, it has been proposed to combine MSCs with cell carriers such as HA during transplantation, which could potentially decrease the likelihood of osteophyte formation [