![]() ![]() It is composed of a highly viscous nucleus pulposus surrounded by a thick fibrocartilage outer ring, annulus fibrosus, and sandwiched by cartilage endplates below and above (Fig. The intervertebral disc is a complex cartilage structure whose function is to resist biomechanical loading during spinal movement. In this comment, we will discuss the key issues mentioned above in disc cell therapy. In addition, there are still other considerable challenges in the entire translational spectrum of cell therapy, including the lack of guidelines for disease classification and patient stratification, as well as a marked lack of understanding of the characteristics of neural distribution, cell fate, and long-term prospects for disc regeneration in the context of cell therapy. This situation establishes an adverse microenvironment for resident cells and delivered exogenous cells, which limits the effect of cell therapy 4, 5. However, due to its distinctive structure and function, disc presents unique characteristics: largely avascular, hypoxia, low pH, high osmotic pressure and high mechanical load 4, 6, 7. For this reason, regenerative medicine, the repair of degenerate discs by intradiscal injection of exogenous cells, is emerging as a promising approach 4. So far, neither conservative treatment nor surgical treatment can prevent or at least slow down the degenerative process 4, 5. Although the specific cause of low back pain is rarely determined, lumbar intervertebral disc degeneration is considered to be the main cause of low back pain 3. Low back pain is a very common symptom in people all over the world, which is now the leading cause of disability worldwide 1, 2.
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