Wednesday, August 28, 2013

Injection of jelly that can ease back pain - and fix a slipped disc

  • Gel substance containing protein and supplanting cells injected in discs
  • Protein laminin acts as a glue while cells repair the slipped disc
By Roger Dobson

A type of jelly injected into the spine could help ease back pain caused by a slipped disc. The gel-like substance contains cells that repair the damaged disc.

Slipped discs are usually the result of wear and tear, although they can also be caused by injury, for instance by lifting something awkwardly.

The disc — these circles of jelly-like material act as cushions between the bones of the spine — then bulges or splits, pressing on the delicate nerves in the back and triggering severe pain.

Are you jelly? The gel-like substance is injected into the back and strengthens the area with protein and cells which replace those in the core of the slipped disc
 Are you jelly? The gel-like substance is injected into the back and strengthens the area with protein and cells which replace those in the core of the slipped disc

Recently, scientists have suggested that the problem may occur because the cells in the centre of the disc — which are crucial for its strength and flexibility — become weakened.

A healthy disc has a strong core, called a nucleus pulposus, which holds water and allows it to absorb stresses and strains.

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Causing pain: A slipped disc can occur through wear and tear as a result of a physically demanding occupation or injury when the back is overstrained
The cells in this central part are held in place by laminin, a type of ‘sticky’ protein that acts as biological glue.

Studies suggest that laminin decreases as we get older, which means the cells in the core start to spread to other areas of the disc. The spongy core becomes weaker and more brittle, and the disc is more likely to ‘slip’.

Previous laboratory research on animals and humans has shown that re-implanting cells into the core of the disc can help repair damage.
But until now the problem has been that once the cells are injected, they quickly move away from the injection site because there is nothing to hold them in place.

Now, scientists at Duke University in the U.S. have developed a gel that contains the laminin ‘glue’ as well as cells to replace those in the core of the disc.

Results from animal studies show that after one injection, the gel solution began to solidify after five minutes and was completely set at 20 minutes.
More than 14 days after injection, the cells were still in place and the disc had become strengthened.

The treatment, which would be injected into a disc by a surgeon under general anaesthetic, is due to enter human trials within the next couple of years.

Commenting on the trial, Jane Tadman, of Arthritis Research UK, said: ‘This new injectable gel is certainly a less invasive procedure than common surgical treatments, which include removing the bulging portion of disc or fusing the spinal bones together.’

She added: ‘It remains to be seen whether it is an improvement on current treatments — we will only know this once it has been tested in people.

‘Our scientists are also involved in laboratory work to see if adult stem cells may be a source of cells for regenerating the intervertebral disc in the future.’

Meanwhile, scientists in the U.S. say that injecting bone marrow into the discs of the back may ease pain. In a study of 22 patients with a slipped disc, doctors took some of their bone marrow — the jelly-like substance at the centre of bones — and then injected it back into the discs in their spine.

Most patients showed improvement two years later.

The bone marrow is a rich source of stem cells — these have the ability to turn into a number of different cells in the body, and the team believe they may help repair cells in the damaged discs.

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