Potential and limitations of intervertebral disc endogenous repair

Abstract

Intervertebral disc (IVD) disorders, especially degenerative disc disease, reduce the quality of life, and are short of effective therapy. A new direction for treatment of chronic tissue and organ diseases is to promote regeneration by harnessing endogenous repair mechanisms. In this review, we discuss the potential of endogenous repair in the IVD, the recent findings on endogenous IVD progenitor cells, and stem cell niches involved in IVD endogenous repair. We also highlight the factors which may restrict IVD self-healing. Ultimately, advanced therapeutic attempts to boost endogenous repair in the IVD are discussed, including bioactive factor delivery, gene therapy, activation of endogenous IVD progenitor cells and chemokine mediated stem cell homing.