Stem cell therapy for intervertebral disc degeneration:Clinical progress with exosomes and gene vectors  

作　　者：Zhi-Peng Li Han Li Yu-Hua Ruan Peng Wang Meng-Ting Zhu Wei-Ping Fu Rui-Bo Wang Xiao-Dong Tang Qi Zhang Sen-Li Li He Yin Cheng-Jin Li Yi-Gong Tian Rui-Ning Han Yao-Bin Wang Chang-Jiang Zhang 

机构地区：[1]Second Department of Orthopedics,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China [2]Tianjian Advanced Biomedical Laboratory,Zhengzhou University,Zhengzhou 450001,Henan Province,China [3]Department of Orthopedics,Affiliated Dongyang Hospital of Wenzhou Medical University,Jinhua 322100,Zhejiang Province,China [4]Department of Neurology,Union Medical College Hospital of Fujian Medical University,Fuzhou 350001,Fujian Province,China [5]Third Department of Orthopedics,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China [6]Henan Key Laboratory for Helicobacter pylori and Digestive Tract Microecology,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China

出　　处：《World Journal of Stem Cells》2025年第4期20-35,共16页世界干细胞杂志(英文)

基　　金：Supported by Henan Province Key Research and Development Program,No.231111311000;Henan Provincial Science and Technology Research Project,No.232102310411;Henan Province Medical Science and Technology Key Project,No.LHGJ20220566 and No.LHGJ20240365;Henan Province Medical Education Research Project,No.WJLX2023079;and Zhengzhou Medical and Health Technology Innovation Guidance Program,No.2024YLZDJH022.

摘　　要：Intervertebral disc degeneration is a leading cause of lower back pain and is characterized by pathological processes such as nucleus pulposus cell apoptosis,extracellular matrix imbalance,and annulus fibrosus rupture.These pathological changes result in disc height loss and functional decline,potentially leading to disc herniation.This comprehensive review aimed to address the current challenges in intervertebral disc degeneration treatment by evaluating the regenerative potential of stem cell-based therapies,with a particular focus on emerging technologies such as exosomes and gene vector systems.Through mechanisms such as differentiation,paracrine effects,and immunomodulation,stem cells facilitate extracellular matrix repair and reduce nucleus pulposus cell apoptosis.Despite recent advancements,clinical applications are hindered by challenges such as hypoxic disc environments and immune rejection.By analyzing recent preclinical and clinical findings,this review provided insights into optimizing stem cell therapy to overcome these obstacles and highlighted future directions in the field.

关 键 词：EXOSOMES Extracellular matrix repair Gene vector system Hypoxic environment Intervertebral disc degeneration Mesenchymal stem cells Regenerative medicine Stem cell therapy 

分 类 号：R681.5[医药卫生—骨科学]