Global Spine J 2016; 06(08): 771-779
DOI: 10.1055/s-0036-1582391
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Cell Therapy with Human Dermal Fibroblasts Enhances Intervertebral Disk Repair and Decreases Inflammation in the Rabbit Model

Ana Chee
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, United States
Peng Shi
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, United States
Thomas Cha
Department of Orthopaedics, Massachusetts General Hospital, Yawkey Center for Outpatient Care, Boston, Massachusetts, United States
Ting-Hsien Kao
Department of Neurosurgery, Lin Shin Hospital, Taichung, Taiwan, Republic of China
Shu-Hua Yang
Department of Orthopedics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China
Jun Zhu
Department of Orthopedics, First People's Hospital of Huaihua and University of South China, Huaihua, Hunan, People's Republic of China
Ding Chen
Department of Orthopedic Surgery, Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
Yejia Zhang
Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, United States
Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
Howard S. An
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, United States
› Author Affiliations
Further Information

Publication History

18 November 2015

22 February 2016

Publication Date:
13 April 2016 (eFirst)


Study Design Pilot study using the rabbit model.

Objective Low back pain is often associated with disk degeneration. Cell therapy for degenerating disks may promote tissue regeneration and repair. Human dermal fibroblasts, obtained from the patient's skin tissue or donated tissue, may be a promising cell therapy option for degenerating disks. The objective of these studies is to determine the effects of intradiscal transplantation of neonatal human dermal fibroblasts (nHDFs) on intervertebral disk (IVD) degeneration by measuring disk height, magnetic resonance imaging (MRI) signal intensity, gene expression, and collagen immunostaining.

Methods New Zealand white rabbits (n = 16) received an annular puncture to induce disk degeneration and were treated with nHDFs or saline 4 weeks later. At 2 and 8 weeks post-treatment, X-ray and MRI images were obtained. IVDs were isolated and examined for changes in collagen staining and gene expression.

Results In the nHDF-treated group, there was a 10% increase in the disk height index after 8 weeks of treatment (p ≤ 0.05), and there was no significant difference in the saline-treated group. When compared with the saline-treated disks, disks treated with nHDFs showed reduced expression of inflammatory markers, a higher ratio of collagen type II over collagen type I gene expression, and more intense immunohistochemical staining for both collagen types I and II.

Conclusions Human dermal fibroblast introduction into the disk reduced inflammation and promoted tissue rich in both type I and type II collagens. The results of this study suggest that nHDFs would be a feasible cell therapy option for disk degeneration.