Intervertebral Disc Engineering through Exploiting Mesenchymal Stem Cells: Progress and Perspective

Intervertebral disc degeneration is a common spinal disorder and may manifest with low back pain or sciatica. The degeneration is characterized by the loss of extracellular matrix integrity and dehydration in the nucleus pulposus. This compromises the viscoelastic property and compressive strength of the disc and therefore the capacity to withstand axial load, eventually causing the disc to collapse or leading to disc bulging or herniation due to abnormal strains on the surrounding annulus. Mesenchymal stem/stromal cells (MSCs) are attractive cell sources for engineering or repair of the disc tissues with respect to their ease of availability and capacity to expand in vitro. Moreover, recent investigations have proposed a potential of MSCs to differentiate into disc-like cells. This review discusses the approaches and concerns for engineering intervertebral disc through manipulating MSCs, with a highlight on the relevance of disc progenitor discovery. Ultimately, stem cell-based engineering of intervertebral disc may facilitate the preservation of motion segment function and address degenerative disc disease in future without spinal fusion.