Stem cell therapy for intervertebral disc degeneration: Clinical progress with exosomes and gene vectors

Table 1 Comparison of stem cell types

Stem cell source	Harvesting method	Differentiation potential	Anti-inflammatory action	Applicable scenarios	Prospects for IVDD repair application
BMSCs	Bone marrow extraction, complex procedure	Multipotent differentiation potential, can differentiate into NPCs and AF cells	Secretes TGF-β, IGF-1, VEGF; regulates ECM metabolism, reduces NP cell apoptosis and inflammation	Suitable for severe disc damage	Demonstrates repair potential in in vivo and in vitro studies and early clinical research; long-term efficacy still requires validation
ADSCs	Fat extraction, relatively simple	Multipotent differentiation ability, promotes ECM production	Secretes anti-inflammatory factors, helps reduce NP cell apoptosis and inflammation	Minimally invasive treatment, suitable for wide application	Shows promising results in preclinical studies; combining with materials like hydrogels can enhance therapeutic effects
UC-MSCs	Extraction from umbilical cord tissue, easy to obtain	Multipotent differentiation potential, high proliferative capacity	Secretes TGF-β, VEGF, IL-10; exhibits significant anti-inflammatory and anti-apoptotic effects	Suitable for allogeneic transplantation and large-scale treatment, low immunogenicity	Shows good results in preclinical studies; can be further optimized with gene editing and exosome technologies
ProNPs	Extraction from the disc, relatively complex	Differentiates into mature NP cells	Promotes NP tissue regeneration through paracrine effects	Suitable for NP regeneration, high potential	Promotes ECM production by activating specific signaling pathways, high future application potential

BMSCs: Bone marrow-derived mesenchymal stem cells; ADSCs: Adipose-derived mesenchymal stem cells; UC-MSCs: Umbilical cord-derived mesenchymal stem cells; ProNPs: Nucleus pulposus progenitor cells; NPCs: Nucleus pulposus cells; AF: Annulus fibrosus; ECM: Extracellular matrix; TGF: Transforming growth factor; IGF: Insulin-like growth factor; VEGF: Vascular endothelial growth factor; IL: Interleukin; NP: Nucleus pulposus; IVDD: Intervertebral disc degeneration.