Anatomy

Internal medicine

Pathology

Cell

Mesenchymal stem cell

Progenitor cell

Population

Biology

Progenitor

Endogeny

Stromal cell

Regeneration (biology)

Intervertebral disc

Stem cell

Cell biology

Genetics

Homeostasis

Medicine

Environmental health

Nature Reviews Rheumatology

Intervertebral disc (IVD) degeneration is associated with low back pain. In IVDs, a high mechanical load, high osmotic pressure and hypoxic conditions create a hostile microenvironment for resident cells. How IVD homeostasis and function are maintained under stress remains to be understood; however, several research groups have reported isolating native endogenous progenitor-like or otherwise proliferative cells from the IVD. The isolation of such cells implies that the IVD might contain a quiescent progenitor-like population that could be activated for IVD repair and regeneration. Increased understanding of endogenous disc progenitor cells will improve our knowledge of IVD homeostasis and, when combined with tissue engineering techniques, might hold promise for future therapeutic applications. In this Review, the characteristics of progenitor cells in different IVD compartments are discussed, as well as the potency of different cell populations within the IVD. The stem cell characteristics of these cells are also compared with those of mesenchymal stromal cells. On the basis of existing evidence, whether and how IVD degeneration and the hostile microenvironment might affect endogenous progenitor cell function are considered, and ways to channel the potential of these cells for IVD repair are suggested. Intervertebral disc degeneration is a leading cause of low back pain. Endogenous progenitor cells are still being fully characterized but hold promise for future regeneration strategies.

IVD progenitor cells: a new horizon for understanding disc homeostasis and repair