METHOD FOR TREATING LOWER BACK PAIN
A method of treating lower back pain in a subject in need thereof, the method comprising administering to the subject a composition comprising mesenchymal lineage precursor or stem cells (MLPSCs), wherein the lower back pain is associated with an intervertebral disc that has a disc height that is not substantially reduced compared to that of an adjacent healthy disc in the subject.
1 . A method of treating lower back pain in a subject in need thereof, the method comprising administering to the subject a composition comprising mesenchymal lineage precursor or stem cells (MLPSCs), wherein the lower back pain is associated with an intervertebral disc that has a disc height that is not substantially reduced compared to that of an adjacent healthy disc in the subject.
2 . The method of claim 1 wherein the lower back pain is associated with an intervertebral disc that has a disc height loss of <30% compared to that of an adjacent healthy disc in the subject.
3 . The method of claim 1 wherein the lower back pain is non-radicular in origin.
4 . The method of claim 1 wherein the lower back pain is associated with an intervertebral disc herniation up to a 3 mm protrusion.
5 . The method of claim 1 wherein the lower back pain is associated with nerve ingrowth into an intervertebral disc.
6 . The method of claim 1 wherein the lower back pain is associated with inflammation in an intervertebral disc.
7 . The method of claim 5 wherein the nerve ingrowth or inflammation is in the intervertebral disc space, or the nucleus pulposus, or the annulus fibrosis of the intervertebral disc.
8 . The method of claim 1 wherein the MLPSCs release TGFβ1 when cultured in an amount of at least about 2800 pg/10 6 cells, or at least about at 2810 pg/10 6 cells, or at least about 2820 pg/10 6 cells, or at least about 2830 pg/10 6 cells, or at least about 2840 pg/10 6 cells, or at least about 2850 pg/10 6 cells, or at least about 2860 pg/10 6 cells, or at least about 2870 pg/10 6 cells, or at least about 2880 pg/10 6 cells, or at least about 2890 pg/10 6 cells, or at least about 2900 pg/10 6 cells, or at least about 2910 pg/10 6 cells, or at least about 2920 pg/10 6 cells, or at least about 2930 pg/10 6 cell, or at least about 2940 pg/10 6 cells, or at least about 2950 pg/10 6 cells, or at least about 2960 pg/10 6 cells, or at least about 2970 pg/10 6 cells, or at least about 2980 pg/10 6 cells, or at least about 2990 pg/10 6 cells, or at least about 3000 pg/10 6 cells.
9 . The method of claim 1 wherein the MLPSCs release TGFβ1 when cultured in an amount of at least about an amount of at least about 400 pg/ml, or at least about 405 pg/ml, or at least about 410 pg/ml, or at least about 415 pg/ml, or at least about 420 pg/ml, or at least about 425 pg/ml, or at least about 430 pg/ml, or at least about 435 pg/ml, or at least about 440 pg/ml, or at least about 445 pg/ml, or at least about 450 pg/ml, or at least about 455 pg/ml, or at least about 460 pg/ml, or at least about 465 pg/ml, or at least about 470 pg/ml, or at least about 475 pg/, or at least about 480 pg/ml, or at least about 485 pg/ml, or at least about 490 pg/ml, or at least about 495 pg/ml, or at least about 500 pg/ml.
10 . The method of claim 8 wherein MLPSCs release TGFβ1 in an amount sufficient to enhance Sema3A expression in the annulus fibrosis of the intervertebral disc space.
11 . The method claim 1 , wherein the mesenchymal lineage precursor or stem cells are isolated by immunoselection.
12 . The method of claim 1 , wherein the immunoselected cells are culture expanded prior to administration.
13 . The method of claim 1 , wherein the mesenchymal lineage precursor or stem cells are culture expanded mesenchymal stem cells.
14 . The method according to claim 1 , wherein the composition is administered to the subject at a dose of between about 1×10 6 cells to about 20×10 6 cells.
15 . The method according to claim 1 , wherein the composition is administered to the subject at a dose of about 6×10 6 cells.
16 . The method according to claim 1 , wherein the composition is administered to the subject at a dose of about 18×10 6 cells.
17 . The method according to claim 1 , wherein the composition is administered as a single dose.
18 . The method according to claim 1 , wherein the composition is administered into the nucleus pulposus or the annulus fibrosis of an intervertebral disc.
19 . The method according to claim 1 wherein administration of the MLSPCs results in at least a 50% reduction in pain as determined by the visual analog scale (VAS) for at least 1 month, or at least 6 months, or at least 12 months, or at least 18 months, or at least 24 months after administration.
20 . The method according claim 1 wherein administration of the MLSPCs results in a reduction of at least 15 points as determined by the Oswestry Disability Index (ODI) for at least 1 month, or at least 6 months, or at least 12 months, or at least 18 months, or at least 24 months after administration.