Profile and Department: Assistant Professor, University of Toronto
Chronic spinal pain is strongly associated with degenerative disc disease (DDD), a disorder that is responsible for the highest years lost to disability of all illnesses world-wide. For many years DDD was considered to be simply a product of ageing. However lessons learned from the canine species has taught us that there is much more to DDD than simply ageing. A subspecies of canine (non-chondrodystrophic canines) or ‘mongrel’ dogs retain populations of their primordial cells ‘notochordal cells’-cells that build the centre (nucleus pulposus) ‘NP’ of the IVD and are protected from developing DDD. On the other hand, chondrodystrophic dogs (such as dachshunds, poodles, Tzitzus and others) lose their notochordal cells early in life as do humans and are particularly vulnerable to developing DDD. This remarkable, naturally occurring resistance or susceptibility to DDD has been the focus of Our lab’s work for many years. We have studied the cellular and molecular biology of the notochordal cell within the context of its influence upon susceptibility to DDD and have identified the essential molecules secreted by these remarkable cells that protect the IVD from degenerative change. Furthermore, we have exploited the use of these molecules in a single injectable agent that can, in two pre-clinical animal models (small and large animal models) mediate the progression of DDD and can even induce a regenerative effect. We are currently working towards a human clinical trial of a novel, molecular therapy to treat DDD using a single injection into the degenerative disc. Additionally, the intervertebral disc contains a population of stem cells that likely contribute to the homeostatic regulation of the IVD that becomes disturbed with the progression of DDD. We are actively exploring the interplay between notochordal cell-secreted factors, resident IVD nucleus pulposus (NP) and stem cells within the disc in health, degeneration and resistance to degeneration. Harnessing the regenerative potential of notochordal cell-secreted factors, stem cells will greatly aid the development of improved molecular and cellular therapies address this globally important contributor to pain, disability and tremendous burden upon the healthcare system.