Abstract
BACKGROUND CONTEXT Despite tremendous in vitro achievements, the clinical breakthrough towards intervertebral disc tissue engineering is still missing. The reasons for this are multiple: current protocols are based on the isolation of nucleus pulposus cells from herniated IVD tissue. The subsequent in vitro expansion is time and cost consuming and no consensus on the optimal scaffold material has been reached. Adipose tissue contains stem cells capable of differentiating towards the chondrocytic lineage and an extracellular matrix consisting of collagen and glycosaminoglycans. PURPOSE Aim of the presented study is to test the possibility of differentiating total adipose tissue towards tissue of a fibrocartilginous phenotype suitable for nucleus pulposus regeneration. STUDY DESIGN/SETTING Laboratory study. PATIENT SAMPLE Fat tissue biopsies from 10 patients harvested from surgical waste material were used with informed consent. OUTCOME MEASURES Histologic evaluation, durometry and quantification of collagen and glycosaminoglycan content. METHODS One half of the tissue was placed in standard cell culture medium while the other half was placed in a commercially available chondrogenic differentiation medium. Tissue samples were incubated at 37°C, 5% CO2 and 90% humidity for 3-6 weeks followed by histologic evaluation, durometry and quantification of collagen and glycosaminoglycan content. RESULTS Chondrogenic transdifferentiated fat tissue demonstrated a smooth surface remodelling and a significant increase in tissue density. Durometric rigidity increased from Shore 0.25 (control) to 5 (p CONCLUSIONS Total adipose tissue can be successfully differentiated towards tissue of a NPP phenotype and shows a potential to create a fully autologous, scaffold free nucleus pulposus transplant.
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