A recent study published in Advanced Science finds that mucin gel derived from cows can help heal and alleviate pain in disc herniation patients post-surgical correction. 

According to Hongji Yan, a researcher at Uppsala University, Sweden and Karolinska Institute, Solna, Sweden, this technique can improve the quality of life for patients suffering from back pain due to herniated discs. 

What is intervertebral disc herniation?

The intervertebral disc (IVD) is a structure between the spinal vertebrae. It comprises a gel-like center called Nucleus pulposus, surrounded by a fibrous called Annulus fibrosus. This IVD can herniate in some people, leading to compression of spinal nerves, causing pain and disability. This spinal condition often requires the removal of the part of IVD that is herniated and the decompression of the affected spinal nerves. 

Current treatment and limitations:

Normally, the nucleus pulposus (NP) is an immune-privileged structure, meaning it is protected from the body’s immune cells better than other tissues. This could be because of the lack of blood vessels.

However, the treatment for disc herniation involves techniques like microdiscetomy, where the herniated disc is removed. This leads to exposure of the remaining NP after surgery to the immune cells of the body. These immune cells may recognize the NP as a foreign body and elicit an immune response to it. This can lead to inflammatory damage to the NP cells, causing further degradation. It can present as increased pain after surgery or a recurrence of disc herniation.

At present, conservative techniques are used post-disc herniation surgery. It includes using anti-inflammatory drugs and corticosteroid drugs to mitigate the pain, swelling, and inflammation. Physical therapy is used to promote the recovery of tissues and functions. 

Yet these techniques fail to address the root cause of the structural issues and the recurrence of herniation. There is potential re-herniation in 5-25% of discectomy cases. 

Most research focuses on the regeneration of the disc back to its normal state rather than correcting the underlying pathology and preventing further damage.

New study: Mucin gel as solution

Researchers in this study explored the use of mucin gels derived from cows to protect the exposed NP post-discectomy surgery, which is the root cause of the disability. 

They developed a synthetic mucin gel from the mucin derived from cows. They injected the mucin into a rat at the surgical site post-disc herniation surgery. This mucin gel protected the remnant nucleus pulposus from immune cell attack. This response is due to the mucin gel’s immunosuppressive property. Researchers compared the mucin gel’s activity against traditional gels like the alginate gel. The alginate gel failed to provide the same level of protection as the mucin gel. 

The study showed that mucin gels are better at protecting the nucleus pulposus and recurrence of herniation. This was due to factors like its structural integrity and preservation of the disc height similar to that of a healthy intervertebral disc. 

Though further research is needed in the human model, which has a diverse mechanical loading of the spine different from rats, this finding is promising. It has huge potential to alleviate post-surgical pain and disability faced by disc herniation patients. 

"This approach could have a major impact on surgical procedures, as a simple injection of mucin gels at the surgical site could improve patient outcomes, reduce the risk of long-term complications, and increase the overall success rate of disc surgery," Hongji Yan concludes.

Reference:

1. Wang, Huan, Song Chen, Zhao Liu, Qingchen Meng, Rita Sobreiro‐Almeida, Ling Liu, Håvard Jostein Haugen, et al. “Preserving the Immune‐Privileged Niche of the Nucleus Pulposus: Safeguarding Intervertebral Discs from Degeneration after Discectomy with Synthetic Mucin Hydrogel Injection.” Advanced Science, August 29, 2024. https://doi.org/10.1002/advs.202404496.

(Rehash/Dr. Shanjitha J Hussain/MSM)