目的總結干細胞對椎間盤退變的修復機制，綜述干細胞移植修復椎間盤退變的研究現狀。 方法查閱近年干細胞移植修復椎間盤退變的相關文獻，分析總結干細胞移植修復椎間盤退變的臨床療效、修復機制、影響修復效果的相關因素，以及面臨的主要問題。 結果臨床自體干細胞移植可修復椎間盤退變并有效緩解腰腿痛癥狀。干細胞在退變椎間盤內可向椎間盤軟骨細胞分化，促進細胞外基質以及營養因子合成，延緩椎間盤細胞凋亡，維持椎間盤免疫豁免狀態。干細胞的種類與數量、細胞移植的載體支架、干細胞移植前的預處理方法，以及移植椎間盤的退變程度等因素皆可影響干細胞移植的修復效果。減少移植干細胞的回漏、調控干細胞在椎間盤中的遷移分布、探明干細胞在退變椎間盤微環境下維持其干細胞特性的能力和規律是面臨的全新挑戰。 結論基于干細胞移植的生物學修復策略是早期扭轉椎間盤退變的可行方案。
引用本文： 王鋒,吳小濤,王運濤,鮑軍平. 干細胞移植修復椎間盤退變的研究現狀. 中國修復重建外科雜志, 2013, 27(5): 575-579. doi: 10.7507/1002-1892.20130127 復制
| 1. | Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J, 2008, 8(1): 8-20. |
| 2. | 王鋒, 王運濤, 吳小濤. 髓核細胞修復椎間盤退行性變的研究進展. 中國修復重建外科雜志, 2009, 23(7): 864-867. |
| 3. | Wang F, Wu XT, Zhuang SY, et al. Ex vivo observation of human nucleus pulposus chondrocytes isolated from degenerated intervertebral discs. Asian Spine J, 2011, 5(2): 73-81. |
| 4. | Sakai D, Mochida J, Yamamoto Y, et al. Transplantation of mesenchymal stem cells embedded in Atelocollagen gel to the intervertebral disc: a potential therapeutic model for disc degeneration. Biomaterials, 2003, 24(20): 3531-3541. |
| 5. | Wang YT, Wu XT, Wang F. Regeneration potential and mechanism of bone marrow mesenchymal stem cell transplantation for treating intervertebral disc degeneration. J Orthop Sci, 2010, 15(6): 707-719. |
| 6. | Haufe SM, Mork AR. Intradiscal injection of hematopoietic stem cells in an attempt to rejuvenate the intervertebral discs. Stem Cells Dev, 2006, 15(1): 136-137. |
| 7. | Yoshikawa T, Ueda Y, Miyazaki K, et al. Disc regeneration therapy using marrow mesenchymal cell transplantation: a report of two case studies. Spine (Phila Pa 1976), 2010, 35(11): E475-480. |
| 8. | Orozco L, Soler R, Morera C, et al. Intervertebral disc repair by autologous mesenchymal bone marrow cells: a pilot study. Transplantation, 2011, 92(7): 822-828. |
| 9. | Huang S, Tam V, Cheung KM, et al. Stem cell-based approaches for intervertebral disc regeneration. Curr Stem Cell Res Ther, 2011, 6(4): 317-326. |
| 10. | 嚴慧深, 吳小濤, 王運濤, 等. 骨髓間充質干細胞修復退變椎間盤中營養和分化效應的變化. 中華實驗外科雜志, 2009, 26(6): 704-706. |
| 11. | Wei A, Tao H, Chung SA, et al. The fate of transplanted xenogeneic bone marrow-derived stem cells in rat intervertebral discs. J Orthop Res, 2009, 27(3): 374-379. |
| 12. | Henriksson HB, Svanvik T, Jonsson M, et al. Transplantation of human mesenchymal stems cells into intervertebral discs in a xenogeneic porcine model. Spine (Phila Pa 1976), 2009, 34(2): 141-148. |
| 13. | Zhang Y, Drapeau S, Howard SA, et al. Transplantation of goat bone marrow stromal cells to the degenerating intervertebral disc in a goat disc injury model. Spine (Phila Pa 1976), 2011, 36(5): 372-377. |
| 14. | Serigano K, Sakai D, Hiyama A, et al. Effect of cell number on mesenchymal stem cell transplantation in a canine disc degeneration model. J Orthop Res, 2010, 28(10): 1267-1275. |
| 15. | Richardson SM, Walker RV, Parker S, et al. Intervertebral disc cell-mediated mesenchymal stem cell differentiation. Stem Cells, 2006, 24(3): 707-716. |
| 16. | Yang SH, Wu CC, Shih TT, et al. In vitro study on interaction between human nucleus pulposus cells and mesenchymal stem cells through paracrine stimulation. Spine (Phila Pa 1976), 2008, 33(18): 1951-1957. |
| 17. | Zhao CQ, Jiang LS, Dai LY. Programmed cell death in intervertebral disc degeneration. Apoptosis, 2006, 11(12): 2079-2088. |
| 18. | Hiyama A, Mochida J, Iwashina T, et al. Transplantation of mesenchymal stem cells in a canine disc degeneration model. J Orthop Res, 2008, 26(5): 589-600. |
| 19. | 樊守剛, 吳小濤, 王運濤, 等. 移植骨髓間充質干細胞對兔退變椎間盤髓核細胞凋亡的影響. 中華實驗外科雜志, 2010, 27(7): 979-982. |
| 20. | 王鋒, 吳小濤, 王運濤, 等. 非接觸共培養條件下人BMSCs 對氧化應激環境中退變髓核細胞凋亡的保護研究. 中國修復重建外科雜志, 2010, 24(4): 391-398. |
| 21. | Gruber HE, Norton HJ, Hanley EN Jr. Anti-apoptotic effects of IGF-1 and PDGF on human intervertebral disc cells in vitro. Spine (Phila Pa 1976), 2000, 25(17): 2153-2157. |
| 22. | Wei A, Brisby H, Chung SA, et al. Bone morphogenetic protein-7 protects human intervertebral disc cells in vitro from apoptosis. Spine J, 2008, 8(3): 466-474. |
| 23. | Lwin T, Hazlehurst LA, Li Z, et al. Bone marrow stromal cells prevent apoptosis of lymphoma cells by upregulation of anti-apoptotic proteins associated with activation of NF-kappaB (RelB/p52) in non-Hodgkin’s lymphoma cells. Leukemia, 2007, 21(7): 1521-1531. |
| 24. | Park JB, Lee JK, Park EY, et al. Fas/FasL interaction of nucleus pulposus and cancer cells with the activation of caspases. Int Orthop, 2008, 32(6): 835-840. |
| 25. | Peng B, Hao J, Hou S, et al. Possible pathogenesis of painful intervertebral disc degeneration. Spine (Phila Pa 1976), 2006, 31(5): 560-566. |
| 26. | Kaneyama S, Nishida K, Takada T, et al. Fas ligand expression on human nucleus pulposus cells decreases with disc degeneration processes. J Orthop Sci, 2008, 13(2): 130-135. |
| 27. | Bertolo A, Thiede T, Aebli N, et al. Human mesenchymal stem cell co-culture modulates the immunological properties of human intervertebral disc tissue fragments in vitro. Eur Spine J, 2011, 20(4): 592-603. |
| 28. | Kuhn NZ, Tuan RS. Regulation of stemness and stem cell niche of mesenchymal stem cells: implications in tumorigenesis and metastasis. J Cell Physiol, 2010, 222(2): 268-277. |
| 29. | Ganey T, Hutton WC, Moseley T, et al. Intervertebral disc repair using adipose tissue-derived stem and regenerative cells: experiments in a canine model. Spine (Phila Pa 1976), 2009, 34(21): 2297-2304. |
| 30. | Vadalà G, Sobajima S, Lee JY, et al. In vitro interaction between muscle-derived stem cells and nucleus pulposus cells. Spine J, 2008, 8(5): 804-809. |
| 31. | Miyamoto T, Muneta T, Tabuchi T, et al. Intradiscal transplantation of synovial mesenchymal stem cells prevents intervertebral disc degeneration through suppression of matrix metalloproteinase-related genes in nucleus pulposus cells in rabbits. Arthritis Res Ther, 2010, 12(6): R206. |
| 32. | Murrell W, Sanford E, Anderberg L, et al. Olfactory stem cells can be induced to express chondrogenic phenotype in a rat intervertebral disc injury model. Spine J, 2009, 9(7): 585-594. |
| 33. | Ruan D, Zhang Y, Wang D, et al. Differentiation of human Wharton’s jelly cells toward nucleus pulposus-like cells after coculture with nucleus pulposus cells in vitro. Tissue Eng Part A, 2012, 18(1-2): 167-175. |
| 34. | Puetzer JL, Petitte JN, Loboa EG. Comparative review of growth factors for induction of three-dimensional in vitro chondrogenesis in human mesenchymal stem cells isolated from bone marrow and adipose tissue. Tissue Eng Part B Rev, 2010, 16(4): 435-444. |
| 35. | Liang C, Li H, Tao Y, et al. Responses of human adipose-derived mesenchymal stem cells to chemical microenvironment of the intervertebral disc. J Transl Med, 2012, 10: 49. |
| 36. | Vadalà G, Sowa G, Hubert M, et al. Mesenchymal stem cells injection in degenerated intervertebral disc: cell leakage may induce osteophyte formation. J Tissue Eng Regen Med, 2012, 6(5): 348-355. |
| 37. | Nerurkar NL, Elliott DM, Mauck RL. Mechanical design criteria for intervertebral disc tissue engineering. J Biomech, 2010, 43(6): 1017-1030. |
| 38. | 鮑軍平, 吳小濤, 王運濤, 等. 干細胞移植延緩椎間盤退變及磁共振示蹤研究. 東南大學學報: 醫學版, 2008, 27 (3): 166-170. |
| 39. | Sobajima S, Vadala G, Shimer A, et al. Feasibility of a stem cell therapy for intervertebral disc degeneration. Spine J, 2008, 8(6): 888-896. |
| 40. | Illien-Jünger S, Pattappa G, Peroglio M, et al. Homing of mesenchymal stem cells in induced degenerative intervertebral discs in a whole organ culture system. Spine (Phila Pa 1976), 2012, 37(22): 1865-1873. |
| 41. | 孟晨, 吳小濤. SDF-1/CXCR4信號軸在調節干細胞遷移及發育中的作用. 東南大學學報: 醫學版, 2011, 30(4): 625-629. |
| 42. | Feng G, Jin X, Hu J, et al. Effects of hypoxias and scaffold architecture on rabbit mesenchymal stem cell differentiation towards a nucleus pulposus-like phenotype. Biomaterials, 2011, 32(32): 8182-8189. |
| 43. | Markway BD, Tan GK, Brooke G, et al. Enhanced chondrogenic differentiation of human bone marrow-derived mesenchymal stem cells in low oxygen environment micropellet cultures. Cell Transplant, 2010, 19(1): 29-42. |
| 44. | Thorpe SD, Buckley CT, Vinardell T, et al. The response of bone marrow-derived mesenchymal stem cells to dynamic compression following TGF-beta3 induced chondrogenic differentiation. Ann Biomed Eng, 2010, 38(9): 2896-2909. |
| 45. | Sheikh H, Zakharian K, De La Torre RP, et al. In vivo intervertebral disc regeneration using stem cell-derived chondroprogenitors. J Neurosurg Spine, 2009, 10(3): 265-272. |
| 46. | Roberts S, Johnson WE. Analysis of aging and degeneration of the human intervertebral disc. Spine (Phila Pa 1976), 1999, 24(5): 500-501. |
| 47. | Acosta FL Jr, Metz L, Adkisson HD, et al. Porcine intervertebral disc repair using allogeneic juvenile articular chondrocytes or mesenchymal stem cells. Tissue Eng Part A, 2011, 17(23-24): 3045-3055. |
| 48. | Dominici M, Le Blanc K, Mueller I, et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy, 2006, 8(4): 315-317. |
| 49. | 邵建樹, 吳小濤, 王運濤, 等. 兔骨髓間充質干細胞與髓核細胞共培養后的營養效應和類髓核分化效應. 中國脊柱脊髓雜志, 2009, 19(5): 381-387. |
| 50. | Risbud MV, Guttapalli A, Tsai TT, et al. Evidence for skeletal progenitor cells in the degenerate human intervertebral disc. Spine (Phila Pa 1976), 32(23): 537-2544. |
| 51. | Henriksson H, Thornemo M, Karlsson C, et al. Identification of cell proliferation zones, progenitor cells and a potential stem cell niche in the intervertebral disc region: a study in four species. Spine (Phila Pa 1976), 2009, 34(21): 2278-2287. |
| 52. | Henriksson HB, Svala E, Skioldebrand E, et al. Support of concept that migrating progenitor cells from stem cell niches contribute to normal regeneration of the adult mammal intervertebral disc: a descriptive study in the New Zealand white rabbit. Spine (Phila Pa 1976), 2012, 37(9): 722-732. |
| 53. | Liu LT, Huang B, Li CQ, et al. Characteristics of stem cells derived from the degenerated human intervertebral disc cartilage endplate. PLoS One, 2011, 6(10): e26285. |
| 54. | Sakai D, Nakamura Y, Nakai T, et al. Exhaustion of nucleus pulposus progenitor cells with ageing and degeneration of the intervertebral disc. Nat Commun, 2012, 3: 1264. |
| 55. | Bendtsen M, Bünger CE, Zou X, et al. Autologous stem cell therapy maintains vertebral blood flow and contrast diffusion through the endplate in experimental intervertebral disc degeneration. Spine (Phila Pa 1976), 2011, 36(6): E373-E379. |
| 56. | Ho G, Leung VY, Cheung KM, et al. Effect of severity of intervertebral disc injury on mesenchymal stem cell-based regeneration. Connect Tissue Res, 2008, 49(1): 15-21. |
- 1. Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J, 2008, 8(1): 8-20.
- 2. 王鋒, 王運濤, 吳小濤. 髓核細胞修復椎間盤退行性變的研究進展. 中國修復重建外科雜志, 2009, 23(7): 864-867.
- 3. Wang F, Wu XT, Zhuang SY, et al. Ex vivo observation of human nucleus pulposus chondrocytes isolated from degenerated intervertebral discs. Asian Spine J, 2011, 5(2): 73-81.
- 4. Sakai D, Mochida J, Yamamoto Y, et al. Transplantation of mesenchymal stem cells embedded in Atelocollagen gel to the intervertebral disc: a potential therapeutic model for disc degeneration. Biomaterials, 2003, 24(20): 3531-3541.
- 5. Wang YT, Wu XT, Wang F. Regeneration potential and mechanism of bone marrow mesenchymal stem cell transplantation for treating intervertebral disc degeneration. J Orthop Sci, 2010, 15(6): 707-719.
- 6. Haufe SM, Mork AR. Intradiscal injection of hematopoietic stem cells in an attempt to rejuvenate the intervertebral discs. Stem Cells Dev, 2006, 15(1): 136-137.
- 7. Yoshikawa T, Ueda Y, Miyazaki K, et al. Disc regeneration therapy using marrow mesenchymal cell transplantation: a report of two case studies. Spine (Phila Pa 1976), 2010, 35(11): E475-480.
- 8. Orozco L, Soler R, Morera C, et al. Intervertebral disc repair by autologous mesenchymal bone marrow cells: a pilot study. Transplantation, 2011, 92(7): 822-828.
- 9. Huang S, Tam V, Cheung KM, et al. Stem cell-based approaches for intervertebral disc regeneration. Curr Stem Cell Res Ther, 2011, 6(4): 317-326.
- 10. 嚴慧深, 吳小濤, 王運濤, 等. 骨髓間充質干細胞修復退變椎間盤中營養和分化效應的變化. 中華實驗外科雜志, 2009, 26(6): 704-706.
- 11. Wei A, Tao H, Chung SA, et al. The fate of transplanted xenogeneic bone marrow-derived stem cells in rat intervertebral discs. J Orthop Res, 2009, 27(3): 374-379.
- 12. Henriksson HB, Svanvik T, Jonsson M, et al. Transplantation of human mesenchymal stems cells into intervertebral discs in a xenogeneic porcine model. Spine (Phila Pa 1976), 2009, 34(2): 141-148.
- 13. Zhang Y, Drapeau S, Howard SA, et al. Transplantation of goat bone marrow stromal cells to the degenerating intervertebral disc in a goat disc injury model. Spine (Phila Pa 1976), 2011, 36(5): 372-377.
- 14. Serigano K, Sakai D, Hiyama A, et al. Effect of cell number on mesenchymal stem cell transplantation in a canine disc degeneration model. J Orthop Res, 2010, 28(10): 1267-1275.
- 15. Richardson SM, Walker RV, Parker S, et al. Intervertebral disc cell-mediated mesenchymal stem cell differentiation. Stem Cells, 2006, 24(3): 707-716.
- 16. Yang SH, Wu CC, Shih TT, et al. In vitro study on interaction between human nucleus pulposus cells and mesenchymal stem cells through paracrine stimulation. Spine (Phila Pa 1976), 2008, 33(18): 1951-1957.
- 17. Zhao CQ, Jiang LS, Dai LY. Programmed cell death in intervertebral disc degeneration. Apoptosis, 2006, 11(12): 2079-2088.
- 18. Hiyama A, Mochida J, Iwashina T, et al. Transplantation of mesenchymal stem cells in a canine disc degeneration model. J Orthop Res, 2008, 26(5): 589-600.
- 19. 樊守剛, 吳小濤, 王運濤, 等. 移植骨髓間充質干細胞對兔退變椎間盤髓核細胞凋亡的影響. 中華實驗外科雜志, 2010, 27(7): 979-982.
- 20. 王鋒, 吳小濤, 王運濤, 等. 非接觸共培養條件下人BMSCs 對氧化應激環境中退變髓核細胞凋亡的保護研究. 中國修復重建外科雜志, 2010, 24(4): 391-398.
- 21. Gruber HE, Norton HJ, Hanley EN Jr. Anti-apoptotic effects of IGF-1 and PDGF on human intervertebral disc cells in vitro. Spine (Phila Pa 1976), 2000, 25(17): 2153-2157.
- 22. Wei A, Brisby H, Chung SA, et al. Bone morphogenetic protein-7 protects human intervertebral disc cells in vitro from apoptosis. Spine J, 2008, 8(3): 466-474.
- 23. Lwin T, Hazlehurst LA, Li Z, et al. Bone marrow stromal cells prevent apoptosis of lymphoma cells by upregulation of anti-apoptotic proteins associated with activation of NF-kappaB (RelB/p52) in non-Hodgkin’s lymphoma cells. Leukemia, 2007, 21(7): 1521-1531.
- 24. Park JB, Lee JK, Park EY, et al. Fas/FasL interaction of nucleus pulposus and cancer cells with the activation of caspases. Int Orthop, 2008, 32(6): 835-840.
- 25. Peng B, Hao J, Hou S, et al. Possible pathogenesis of painful intervertebral disc degeneration. Spine (Phila Pa 1976), 2006, 31(5): 560-566.
- 26. Kaneyama S, Nishida K, Takada T, et al. Fas ligand expression on human nucleus pulposus cells decreases with disc degeneration processes. J Orthop Sci, 2008, 13(2): 130-135.
- 27. Bertolo A, Thiede T, Aebli N, et al. Human mesenchymal stem cell co-culture modulates the immunological properties of human intervertebral disc tissue fragments in vitro. Eur Spine J, 2011, 20(4): 592-603.
- 28. Kuhn NZ, Tuan RS. Regulation of stemness and stem cell niche of mesenchymal stem cells: implications in tumorigenesis and metastasis. J Cell Physiol, 2010, 222(2): 268-277.
- 29. Ganey T, Hutton WC, Moseley T, et al. Intervertebral disc repair using adipose tissue-derived stem and regenerative cells: experiments in a canine model. Spine (Phila Pa 1976), 2009, 34(21): 2297-2304.
- 30. Vadalà G, Sobajima S, Lee JY, et al. In vitro interaction between muscle-derived stem cells and nucleus pulposus cells. Spine J, 2008, 8(5): 804-809.
- 31. Miyamoto T, Muneta T, Tabuchi T, et al. Intradiscal transplantation of synovial mesenchymal stem cells prevents intervertebral disc degeneration through suppression of matrix metalloproteinase-related genes in nucleus pulposus cells in rabbits. Arthritis Res Ther, 2010, 12(6): R206.
- 32. Murrell W, Sanford E, Anderberg L, et al. Olfactory stem cells can be induced to express chondrogenic phenotype in a rat intervertebral disc injury model. Spine J, 2009, 9(7): 585-594.
- 33. Ruan D, Zhang Y, Wang D, et al. Differentiation of human Wharton’s jelly cells toward nucleus pulposus-like cells after coculture with nucleus pulposus cells in vitro. Tissue Eng Part A, 2012, 18(1-2): 167-175.
- 34. Puetzer JL, Petitte JN, Loboa EG. Comparative review of growth factors for induction of three-dimensional in vitro chondrogenesis in human mesenchymal stem cells isolated from bone marrow and adipose tissue. Tissue Eng Part B Rev, 2010, 16(4): 435-444.
- 35. Liang C, Li H, Tao Y, et al. Responses of human adipose-derived mesenchymal stem cells to chemical microenvironment of the intervertebral disc. J Transl Med, 2012, 10: 49.
- 36. Vadalà G, Sowa G, Hubert M, et al. Mesenchymal stem cells injection in degenerated intervertebral disc: cell leakage may induce osteophyte formation. J Tissue Eng Regen Med, 2012, 6(5): 348-355.
- 37. Nerurkar NL, Elliott DM, Mauck RL. Mechanical design criteria for intervertebral disc tissue engineering. J Biomech, 2010, 43(6): 1017-1030.
- 38. 鮑軍平, 吳小濤, 王運濤, 等. 干細胞移植延緩椎間盤退變及磁共振示蹤研究. 東南大學學報: 醫學版, 2008, 27 (3): 166-170.
- 39. Sobajima S, Vadala G, Shimer A, et al. Feasibility of a stem cell therapy for intervertebral disc degeneration. Spine J, 2008, 8(6): 888-896.
- 40. Illien-Jünger S, Pattappa G, Peroglio M, et al. Homing of mesenchymal stem cells in induced degenerative intervertebral discs in a whole organ culture system. Spine (Phila Pa 1976), 2012, 37(22): 1865-1873.
- 41. 孟晨, 吳小濤. SDF-1/CXCR4信號軸在調節干細胞遷移及發育中的作用. 東南大學學報: 醫學版, 2011, 30(4): 625-629.
- 42. Feng G, Jin X, Hu J, et al. Effects of hypoxias and scaffold architecture on rabbit mesenchymal stem cell differentiation towards a nucleus pulposus-like phenotype. Biomaterials, 2011, 32(32): 8182-8189.
- 43. Markway BD, Tan GK, Brooke G, et al. Enhanced chondrogenic differentiation of human bone marrow-derived mesenchymal stem cells in low oxygen environment micropellet cultures. Cell Transplant, 2010, 19(1): 29-42.
- 44. Thorpe SD, Buckley CT, Vinardell T, et al. The response of bone marrow-derived mesenchymal stem cells to dynamic compression following TGF-beta3 induced chondrogenic differentiation. Ann Biomed Eng, 2010, 38(9): 2896-2909.
- 45. Sheikh H, Zakharian K, De La Torre RP, et al. In vivo intervertebral disc regeneration using stem cell-derived chondroprogenitors. J Neurosurg Spine, 2009, 10(3): 265-272.
- 46. Roberts S, Johnson WE. Analysis of aging and degeneration of the human intervertebral disc. Spine (Phila Pa 1976), 1999, 24(5): 500-501.
- 47. Acosta FL Jr, Metz L, Adkisson HD, et al. Porcine intervertebral disc repair using allogeneic juvenile articular chondrocytes or mesenchymal stem cells. Tissue Eng Part A, 2011, 17(23-24): 3045-3055.
- 48. Dominici M, Le Blanc K, Mueller I, et al. Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy, 2006, 8(4): 315-317.
- 49. 邵建樹, 吳小濤, 王運濤, 等. 兔骨髓間充質干細胞與髓核細胞共培養后的營養效應和類髓核分化效應. 中國脊柱脊髓雜志, 2009, 19(5): 381-387.
- 50. Risbud MV, Guttapalli A, Tsai TT, et al. Evidence for skeletal progenitor cells in the degenerate human intervertebral disc. Spine (Phila Pa 1976), 32(23): 537-2544.
- 51. Henriksson H, Thornemo M, Karlsson C, et al. Identification of cell proliferation zones, progenitor cells and a potential stem cell niche in the intervertebral disc region: a study in four species. Spine (Phila Pa 1976), 2009, 34(21): 2278-2287.
- 52. Henriksson HB, Svala E, Skioldebrand E, et al. Support of concept that migrating progenitor cells from stem cell niches contribute to normal regeneration of the adult mammal intervertebral disc: a descriptive study in the New Zealand white rabbit. Spine (Phila Pa 1976), 2012, 37(9): 722-732.
- 53. Liu LT, Huang B, Li CQ, et al. Characteristics of stem cells derived from the degenerated human intervertebral disc cartilage endplate. PLoS One, 2011, 6(10): e26285.
- 54. Sakai D, Nakamura Y, Nakai T, et al. Exhaustion of nucleus pulposus progenitor cells with ageing and degeneration of the intervertebral disc. Nat Commun, 2012, 3: 1264.
- 55. Bendtsen M, Bünger CE, Zou X, et al. Autologous stem cell therapy maintains vertebral blood flow and contrast diffusion through the endplate in experimental intervertebral disc degeneration. Spine (Phila Pa 1976), 2011, 36(6): E373-E379.
- 56. Ho G, Leung VY, Cheung KM, et al. Effect of severity of intervertebral disc injury on mesenchymal stem cell-based regeneration. Connect Tissue Res, 2008, 49(1): 15-21.