SOURCE: AAOS

July 08, 2008 16:48 ET

A New Frontier in the Battle Against Disc Degeneration

Gene Therapy May Someday Help Painful Discs

ROSEMONT, IL--(Marketwire - July 8, 2008) - Many individuals experience back pain arising from discs that are no longer healthy. The condition is often referred to as painful disc degeneration, and it is a common problem. A review article published in the June 2008 issue of the Journal of the American Academy of Orthopaedic Surgeons discusses how gene therapy may one day potentially offer some relief to millions of individuals who experience back pain due to disc degeneration.

"Gene therapy involves taking a therapeutic gene and inserting it into the cells of a degenerating disc," said Mark Hubert, MD, lead author of the article. "This stimulates the cells to produce certain therapeutic proteins (such as growth factors and matrix proteins) that can help create an improved cushioning effect that is necessary in order to have a healthy disc." Dr. Hubert is part of a team of researchers headed by Dr. James Kang at the University of Pittsburgh School of Medicine. Dr. Hubert indicates that while this type of therapy is in an experimental stage and is several years away from being available to patients, the hope is that it will eventually be able to help slow down and possibly reverse the process of painful disc degeneration. If successful, it may help patients suffering with this disorder avoid surgery.

Current treatments for symptomatic disc degeneration can include but are not limited to:

--  Physical Therapy
--  Nonsteroidal anti-inflammatory drugs
--  Epidural Steroids
--  Surgery
    

These traditional treatments are meant to help patients whose disc degeneration is symptomatic and already well established. Dr. Hubert says that gene therapy would be implemented at the earliest stages of disc disease to prevent the progressive degeneration of the disc. "We would hopefully prevent the problems associated with disc degeneration by attacking it earlier," said Hubert.

Symptoms associated with painful disc degeneration may include:

--  Stiffness in lower back
--  Back pain when bending, twisting or carrying heavy objects
--  Weakness in the lower extremity, radiating pain to the buttocks and
    upper thighs
    

There is currently no way to reverse the process of disc degeneration. Dr. Hubert explains, "Once it starts it is usually going to continue." However, unlike arthritis of the knees or hips, most patients with disc degeneration have few symptoms. As individuals age, disc degeneration becomes more common, yet back pain from painful disc degeneration is less prevalent among individuals over 50 years of age.

Gene therapy may one day be able to alleviate the symptoms of painful disc degeneration. This therapy is currently being tested in research studies and investigators indicate that in some of the animals the disc disease has shown significant improvement with slowing of the degenerative process. However, human clinical trials are years away and currently safety issues are still being investigated. "With further research, gene therapy may one day be a powerful tool in the treatment of disc degeneration."

Disclosure: Dr. Mark Hubert and the co-authors of this article received no compensation for this review and do not own stock in a commercial company or institution related directly or indirectly to the subject of this article.

JAAOS

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