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Samanta A, Lufkin T, Kraus P. Intervertebral disc degeneration-Current therapeutic options and challenges. Front Public Health 2023; 11:1156749. [PMID: 37483952 PMCID: PMC10359191 DOI: 10.3389/fpubh.2023.1156749] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/12/2023] [Indexed: 07/25/2023] Open
Abstract
Degeneration of the intervertebral disc (IVD) is a normal part of aging. Due to the spine's declining function and the development of pain, it may affect one's physical health, mental health, and socioeconomic status. Most of the intervertebral disc degeneration (IVDD) therapies today focus on the symptoms of low back pain rather than the underlying etiology or mechanical function of the disc. The deteriorated disc is typically not restored by conservative or surgical therapies that largely focus on correcting symptoms and structural abnormalities. To enhance the clinical outcome and the quality of life of a patient, several therapeutic modalities have been created. In this review, we discuss genetic and environmental causes of IVDD and describe promising modern endogenous and exogenous therapeutic approaches including their applicability and relevance to the degeneration process.
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Affiliation(s)
| | | | - Petra Kraus
- Department of Biology, Clarkson University, Potsdam, NY, United States
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2
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Wöltje M, Künzelmann L, Belgücan B, Croft AS, Voumard B, Bracher S, Zysset P, Gantenbein B, Cherif C, Aibibu D. Textile Design of an Intervertebral Disc Replacement Device from Silk Yarn. Biomimetics (Basel) 2023; 8:biomimetics8020152. [PMID: 37092404 PMCID: PMC10123607 DOI: 10.3390/biomimetics8020152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/06/2023] [Accepted: 04/09/2023] [Indexed: 04/25/2023] Open
Abstract
Low back pain is often due to degeneration of the intervertebral discs (IVD). It is one of the most common age- and work-related problems in today's society. Current treatments are not able to efficiently restore the full function of the IVD. Therefore, the aim of the present work was to reconstruct the two parts of the intervertebral disc-the annulus fibrosus (AF) and the nucleus pulposus (NP)-in such a way that the natural structural features were mimicked by a textile design. Silk was selected as the biomaterial for realization of a textile IVD because of its cytocompatibility, biodegradability, high strength, stiffness, and toughness, both in tension and compression. Therefore, an embroidered structure made of silk yarn was developed that reproduces the alternating fiber structure of +30° and -30° fiber orientation found in the AF and mimics its lamellar structure. The developed embroidered ribbons showed a tensile strength that corresponded to that of the natural AF. Fiber additive manufacturing with 1 mm silk staple fibers was used to replicate the fiber network of the NP and generate an open porous textile 3D structure that may serve as a reinforcement structure for the gel-like NP.
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Affiliation(s)
- Michael Wöltje
- Institute of Textile Machinery and High-Performance Material Technology, Technische Universität Dresden, 01602 Dresden, Germany
| | - Liesa Künzelmann
- Institute of Textile Machinery and High-Performance Material Technology, Technische Universität Dresden, 01602 Dresden, Germany
| | - Basak Belgücan
- Institute of Textile Machinery and High-Performance Material Technology, Technische Universität Dresden, 01602 Dresden, Germany
| | - Andreas S Croft
- Tissue Engineering for Orthopaedic and Mechanobiology, Bone and Joint Program, Department for BioMedical Research (DBMR), Medical Faculty, University of Bern, 3008 Bern, Switzerland
| | - Benjamin Voumard
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland
| | - Stefan Bracher
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland
| | - Philippe Zysset
- ARTORG Center for Biomedical Engineering Research, University of Bern, 3008 Bern, Switzerland
| | - Benjamin Gantenbein
- Tissue Engineering for Orthopaedic and Mechanobiology, Bone and Joint Program, Department for BioMedical Research (DBMR), Medical Faculty, University of Bern, 3008 Bern, Switzerland
- Department of Orthopedic Surgery and Traumatology, Inselspital, University of Bern, 3010 Bern, Switzerland
| | - Chokri Cherif
- Institute of Textile Machinery and High-Performance Material Technology, Technische Universität Dresden, 01602 Dresden, Germany
| | - Dilbar Aibibu
- Institute of Textile Machinery and High-Performance Material Technology, Technische Universität Dresden, 01602 Dresden, Germany
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3
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Cheng X, Zhang M, Xie W, Ma X, Yang X, Cai Y. Well-aligned three-dimensional silk fibroin protein scaffold for orientation regulation of cells. JOURNAL OF BIOMATERIALS SCIENCE. POLYMER EDITION 2023:1-17. [PMID: 36745185 DOI: 10.1080/09205063.2023.2177828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The similar characteristics of biomaterials to the extracellular matrix are essential for efficient tissue repair through dictating cell behaviors. But the scaffold fabrication with complex shapes and controlled alignment have proven to be a difficult task. Herein, a well-designed three-dimensional silk fibroin scaffold is fabricated through ice template technology. The effect of the silk fibroin protein concentration and the freezing temperature on the microstructure and mechanical properties of scaffolds are investigated systematically. Cells behavior mediated by the obtained silk fibroin scaffolds is detected. The results show that the protein concentration plays a vital role in microstructure and scaffold strength. A well-aligned scaffold can be obtained when silk fibroin solution is kept at 12 wt%, which holds the highest mechanical properties. The pore size can be further adjusted in the range of 5-80 µm by changing the freezing temperature from -60 to -196 °C. The well-oriented scaffold with the appropriate pore size of 10-20 µm has the best ability to guide cell alignment. The resulting scaffolds provide an excellent matrix to guide cells behaviors and have a potential application in tissue engineering.
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Affiliation(s)
- Xiuwen Cheng
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, National Engineering Lab for Textile Fiber Materials and Processing Technology, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China
| | - Minghao Zhang
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, National Engineering Lab for Textile Fiber Materials and Processing Technology, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China
| | - Wenjiao Xie
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, National Engineering Lab for Textile Fiber Materials and Processing Technology, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China
| | - Xiaoyu Ma
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, National Engineering Lab for Textile Fiber Materials and Processing Technology, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China
| | - Xiaogang Yang
- Academy of Science and Technology, Zhejiang Sci-Tech University, Hangzhou, China
| | - Yurong Cai
- The Key Laboratory of Advanced Textile Materials and Manufacturing Technology of Ministry of Education, National Engineering Lab for Textile Fiber Materials and Processing Technology, School of Materials Science and Engineering, Zhejiang Sci-Tech University, Hangzhou, China
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Conde-González A, Glinka M, Dutta D, Wallace R, Callanan A, Oreffo ROC, Bradley M. Rapid fabrication and screening of tailored functional 3D biomaterials: Validation in bone tissue repair - Part II. BIOMATERIALS ADVANCES 2023; 145:213250. [PMID: 36563509 DOI: 10.1016/j.bioadv.2022.213250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 11/24/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Regenerative medicine strategies place increasingly sophisticated demands on 3D biomaterials to promote tissue formation at sites where tissue would otherwise not form. Ideally, the discovery/fabrication of the 3D scaffolds needs to be high-throughput and uniform to ensure quick and in-depth analysis in order to pinpoint appropriate chemical and mechanical properties of a biomaterial. Herein we present a versatile technique to screen new potential biocompatible acrylate-based 3D scaffolds with the ultimate aim of application in tissue repair. As part of this process, we identified an acrylate-based 3D porous scaffold that promoted cell proliferation followed by accelerated tissue formation, pre-requisites for tissue repair. Scaffolds were fabricated by a facile freeze-casting and an in-situ photo-polymerization route, embracing a high-throughput synthesis, screening and characterization protocol. The current studies demonstrate the dependence of cellular growth and vascularization on the porosity and intrinsic chemical nature of the scaffolds, with tuneable 3D scaffolds generated with large, interconnected pores suitable for cellular growth applied to skeletal reparation. Our studies showed increased cell proliferation, collagen and ALP expression, while chorioallantoic membrane assays indicated biocompatibility and demonstrated the angiogenic nature of the scaffolds. VEGRF2 expression in vivo observed throughout the 3D scaffolds in the absence of growth factor supplementation demonstrates a potential for angiogenesis. This novel platform provides an innovative approach to 3D scanning of synthetic biomaterials for tissue regeneration.
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Affiliation(s)
| | - Michael Glinka
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Deepanjalee Dutta
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh EH9 3FJ, UK
| | - Robert Wallace
- Orthopaedics and Trauma, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Anthony Callanan
- School of Engineering, Institute for Bioengineering, University of Edinburgh, Edinburgh EH9 3DW, UK
| | - Richard O C Oreffo
- Bone and Joint Research Group, Centre for Human Development, Stem Cells and Regeneration, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK.
| | - Mark Bradley
- EaStCHEM School of Chemistry, University of Edinburgh, Edinburgh EH9 3FJ, UK.
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Lin M, Hu Y, An H, Guo T, Gao Y, Peng K, Zhao M, Zhang X, Zhou H. Silk fibroin-based biomaterials for disc tissue engineering. Biomater Sci 2023; 11:749-776. [PMID: 36537344 DOI: 10.1039/d2bm01343f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Low back pain is the major cause of disability worldwide, and intervertebral disc degeneration (IVDD) is one of the most important causes of low back pain. Currently, there is no method to treat IVDD that can reverse or regenerate intervertebral disc (IVD) tissue, but the recent development of disc tissue engineering (DTE) offers a new means of addressing these disadvantages. Among numerous biomaterials for tissue engineering, silk fibroin (SF) is widely used due to its easy availability and excellent physical/chemical properties. SF is usually used in combination with other materials to construct biological scaffolds or bioactive substance delivery systems, or it can be used alone. The present article first briefly outlines the anatomical and physiological features of IVD, the associated etiology and current treatment modalities of IVDD, and the current status of DTE. Then, it highlights the characteristics of SF biomaterials and their latest research advances in DTE and discusses the prospects and challenges in the application of SF in DTE, with a view to facilitating the clinical process of developing interventions related to IVD-derived low back pain caused by IVDD.
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Affiliation(s)
- Maoqiang Lin
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China. .,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou 730030, Gansu, China
| | - Yicun Hu
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China. .,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou 730030, Gansu, China
| | - Haiying An
- Department of Laboratory Medicine, Zhongnan Hospital, Wuhan University, Wuhan 430000, Hubei, China
| | - Taowen Guo
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China. .,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou 730030, Gansu, China
| | - Yanbing Gao
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China. .,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou 730030, Gansu, China
| | - Kaichen Peng
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China. .,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou 730030, Gansu, China
| | - Meiling Zhao
- Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou 730030, Gansu, China
| | - Xiaobo Zhang
- Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an 710000, Shaanxi, China.
| | - Haiyu Zhou
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China. .,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou 730030, Gansu, China
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6
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Croft AS, Spessot E, Bhattacharjee P, Yang Y, Motta A, Wöltje M, Gantenbein B. Biomedical applications of silk and its role for intervertebral disc repair. JOR Spine 2022; 5:e1225. [PMID: 36601376 PMCID: PMC9799090 DOI: 10.1002/jsp2.1225] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/10/2022] [Accepted: 09/10/2022] [Indexed: 12/30/2022] Open
Abstract
Intervertebral disc (IVD) degeneration (IDD) is the main contributor to chronic low back pain. To date, the present therapies mainly focus on treating the symptoms caused by IDD rather than addressing the problem itself. For this reason, researchers have searched for a suitable biomaterial to repair and/or regenerate the IVD. A promising candidate to fill this gap is silk, which has already been used as a biomaterial for many years. Therefore, this review aims first to elaborate on the different origins from which silk is harvested, the individual composition, and the characteristics of each silk type. Another goal is to enlighten why silk is so suitable as a biomaterial, discuss its functionalization, and how it could be used for tissue engineering purposes. The second part of this review aims to provide an overview of preclinical studies using silk-based biomaterials to repair the inner region of the IVD, the nucleus pulposus (NP), and the IVD's outer area, the annulus fibrosus (AF). Since the NP and the AF differ fundamentally in their structure, different therapeutic approaches are required. Consequently, silk-containing hydrogels have been used mainly to repair the NP, and silk-based scaffolds have been used for the AF. Although most preclinical studies have shown promising results in IVD-related repair and regeneration, their clinical transition is yet to come.
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Affiliation(s)
- Andreas S. Croft
- Tissue Engineering for Orthopaedic & Mechanobiology, Bone & Joint Program, Department for BioMedical Research (DBMR), Medical FacultyUniversity of BernBernSwitzerland
| | - Eugenia Spessot
- Department of Industrial Engineering and BIOtech Research CenterUniversity of TrentoTrentoItaly
- European Institute of Excellence on Tissue Engineering and Regenerative Medicine UnitTrentoItaly
| | - Promita Bhattacharjee
- Department of Chemical SciencesSSPC the Science Foundation Ireland Research Centre for Pharmaceuticals, Bernal Institute, University of LimerickLimerickIreland
| | - Yuejiao Yang
- Department of Industrial Engineering and BIOtech Research CenterUniversity of TrentoTrentoItaly
- European Institute of Excellence on Tissue Engineering and Regenerative Medicine UnitTrentoItaly
- INSTM, Trento Research Unit, Interuniversity Consortium for Science and Technology of MaterialsTrentoItaly
| | - Antonella Motta
- Department of Industrial Engineering and BIOtech Research CenterUniversity of TrentoTrentoItaly
- European Institute of Excellence on Tissue Engineering and Regenerative Medicine UnitTrentoItaly
- INSTM, Trento Research Unit, Interuniversity Consortium for Science and Technology of MaterialsTrentoItaly
| | - Michael Wöltje
- Institute of Textile Machinery and High Performance Material TechnologyDresdenGermany
| | - Benjamin Gantenbein
- Tissue Engineering for Orthopaedic & Mechanobiology, Bone & Joint Program, Department for BioMedical Research (DBMR), Medical FacultyUniversity of BernBernSwitzerland
- Department of Orthopaedic Surgery & Traumatology, InselspitalBern University Hospital, Medical Faculty, University of BernBernSwitzerland
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Nadhif MH, Ghiffary MM, Irsyad M, Mazfufah NF, Nurhaliza F, Rahman SF, Rahyussalim AJ, Kurniawati T. Anatomically and Biomechanically Relevant Monolithic Total Disc Replacement Made of 3D-Printed Thermoplastic Polyurethane. Polymers (Basel) 2022; 14:4160. [PMID: 36236107 PMCID: PMC9571194 DOI: 10.3390/polym14194160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/17/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022] Open
Abstract
Various implant treatments, including total disc replacements, have been tried to treat lumbar intervertebral disc (IVD) degeneration, which is claimed to be the main contributor of lower back pain. The treatments, however, come with peripheral issues. This study proposes a novel approach that complies with the anatomical features of IVD, the so-called monolithic total disc replacement (MTDR). As the name suggests, the MTDR is a one-part device that consists of lattice and rigid structures to mimic the nucleus pulposus and annulus fibrosus, respectively. The MTDR can be made of two types of thermoplastic polyurethane (TPU 87A and TPU 95A) and fabricated using a 3D printing approach: fused filament fabrication. The MTDR design involves two configurations-the full lattice (FLC) and anatomy-based (ABC) configurations. The MTDR is evaluated in terms of its physical, mechanical, and cytotoxicity properties. The physical characterization includes the geometrical evaluations, wettability measurements, degradability tests, and swelling tests. The mechanical characterization comprises compressive tests of the materials, an analytical approach using the Voigt model of composite, and a finite element analysis. The cytotoxicity assays include the direct assay using hemocytometry and the indirect assay using a tetrazolium-based colorimetric (MTS) assay. The geometrical evaluation shows that the fabrication results are tolerable, and the two materials have good wettability and low degradation rates. The mechanical characterization shows that the ABC-MTDR has more similar mechanical properties to an IVD than the FLC-MTDR. The cytotoxicity assays prove that the materials are non-cytotoxic, allowing cells to grow on the surfaces of the materials.
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Affiliation(s)
- Muhammad Hanif Nadhif
- Medical Physiology and Biophysics Department, Faculty of Medicine, Universitas Indonesia, Kampus UI Salemba, Jakarta 10430, Indonesia
- Medical Technology Cluster, Indonesian Medical Education and Research Institute, Kampus UI Salemba, Jakarta 10430, Indonesia
| | - Muhammad Maulana Ghiffary
- Medical Technology Cluster, Indonesian Medical Education and Research Institute, Kampus UI Salemba, Jakarta 10430, Indonesia
| | - Muhammad Irsyad
- Medical Technology Cluster, Indonesian Medical Education and Research Institute, Kampus UI Salemba, Jakarta 10430, Indonesia
- Mechanical Engineering Department, Faculty of Engineering, Universitas Indonesia, Kampus UI Depok, Depok 16424, Indonesia
| | - Nuzli Fahdia Mazfufah
- Stem Cells and Tissue Engineering Cluster, Indonesian Medical Education and Research Institute, Kampus UI Salemba, Jakarta 10430, Indonesia
| | - Fakhira Nurhaliza
- Medical Technology Cluster, Indonesian Medical Education and Research Institute, Kampus UI Salemba, Jakarta 10430, Indonesia
- Biomedical Engineering Program, Electrical Engineering Department, Faculty of Engineering, Universitas Indonesia, Kampus UI Depok, Depok 16424, Indonesia
| | - Siti Fauziyah Rahman
- Biomedical Engineering Program, Electrical Engineering Department, Faculty of Engineering, Universitas Indonesia, Kampus UI Depok, Depok 16424, Indonesia
| | - Ahmad Jabir Rahyussalim
- Stem Cells and Tissue Engineering Cluster, Indonesian Medical Education and Research Institute, Kampus UI Salemba, Jakarta 10430, Indonesia
- Orthopedics and Traumatology Department, Faculty of Medicine/Ciptomangunkusumo Central Hospital, Jakarta 10430, Indonesia
- Integrated Service Unit of Stem Cell Medical Technology, Cipto Mangunkusumo Central Hospital, Jakarta 10430, Indonesia
| | - Tri Kurniawati
- Stem Cells and Tissue Engineering Cluster, Indonesian Medical Education and Research Institute, Kampus UI Salemba, Jakarta 10430, Indonesia
- Integrated Service Unit of Stem Cell Medical Technology, Cipto Mangunkusumo Central Hospital, Jakarta 10430, Indonesia
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Kirnaz S, Singh S, Capadona C, Lintz M, Goldberg JL, McGrath LB, Medary B, Sommer F, Bonassar LJ, Härtl R. Innovative Biological Treatment Methods for Degenerative Disc Disease. World Neurosurg 2021; 157:282-299. [PMID: 34929786 DOI: 10.1016/j.wneu.2021.09.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 10/19/2022]
Abstract
Low back pain is the leading cause of work absences and years lived with disability, and it is often associated with degenerative disc disease. In recent years, biological treatment approaches such as the use of growth factors, cell injections, annulus fibrosus (AF) repair, nucleus pulposus replacement, and tissue-engineered discs have been explored as means for preventing or reversing degenerative disc disease. Both animal and clinical studies have shown promising results for cell-based therapy on the grounds of its regenerative potential. Clinical data also indicate that stem cell injection is safe when appropriately performed, albeit its long-term safety and efficacy are yet to be explored. Numerous challenges also remain to be overcome, such as isolating, differentiating, and preconditioning the disc cells, as well as managing the nutrient-deficient and oxygen-deficient micromilieu of the intervertebral disc (IVD). AF repair methods including devices used in clinical trials have shown success in decreasing reherniation rates and improving overall clinical outcomes. In addition, recent studies that combined AF repair and nucleus pulposus replacement have shown improved biomechanical stability in IVDs after the combined treatment. Tissue-engineered IVDs for total disc replacement are still being developed, and future studies are necessary to overcome the challenges in their delivery, efficacy, and safety.
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Affiliation(s)
- Sertac Kirnaz
- Department of Neurological Surgery, Weill Cornell Medicine Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA
| | - Sunidhi Singh
- Department of Neurological Surgery, Weill Cornell Medicine Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA
| | - Charisse Capadona
- Department of Neurological Surgery, Weill Cornell Medicine Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA
| | - Marianne Lintz
- Department of Neurological Surgery, Weill Cornell Medicine Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA
| | - Jacob L Goldberg
- Department of Neurological Surgery, Weill Cornell Medicine Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA
| | - Lynn B McGrath
- Department of Neurological Surgery, Weill Cornell Medicine Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA
| | - Branden Medary
- Department of Neurological Surgery, Weill Cornell Medicine Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA
| | - Fabian Sommer
- Department of Neurological Surgery, Weill Cornell Medicine Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA
| | - Lawrence J Bonassar
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, USA; Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York, USA
| | - Roger Härtl
- Department of Neurological Surgery, Weill Cornell Medicine Brain and Spine Center, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA.
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Peredo AP, Gullbrand SE, Smith HE, Mauck RL. Putting the Pieces in Place: Mobilizing Cellular Players to Improve Annulus Fibrosus Repair. TISSUE ENGINEERING. PART B, REVIEWS 2021; 27:295-312. [PMID: 32907498 PMCID: PMC10799291 DOI: 10.1089/ten.teb.2020.0196] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The intervertebral disc (IVD) is an integral load-bearing tissue that derives its function from its composite structure and extracellular matrix composition. IVD herniations involve the failure of the annulus fibrosus (AF) and the extrusion of the nucleus pulposus beyond the disc boundary. Disc herniations can impinge the neural elements and cause debilitating pain and loss of function, posing a significant burden on individual patients and society as a whole. Patients with persistent symptoms may require surgery; however, surgical intervention fails to repair the ruptured AF and is associated with the risk for reherniation and further disc degeneration. Given the limitations of AF endogenous repair, many attempts have been made toward the development of effective repair approaches that reestablish IVD function. These methods, however, fail to recapitulate the composition and organization of the native AF, ultimately resulting in inferior tissue mechanics and function over time and high rates of reherniation. Harnessing the cellular function of cells (endogenous or exogenous) at the repair site through the provision of cell-instructive cues could enhance AF tissue regeneration and, ultimately, improve healing outcomes. In this study, we review the diverse approaches that have been developed for AF repair and emphasize the potential for mobilizing the appropriate cellular players at the site of injury to improve AF healing. Impact statement Conventional treatments for intervertebral disc herniation fail to repair the annulus fibrosus (AF), increasing the risk for recurrent herniation. The lack of repair devices in the market has spurred the development of regenerative approaches, yet most of these rely on a scarce endogenous cell population to repair large injuries, resulting in inadequate regeneration. This review identifies current and developing strategies for AF repair and highlights the potential for harnessing cellular function to improve AF regeneration. Ideal cell sources, differentiation strategies, and delivery methods are discussed to guide the design of repair systems that leverage specialized cells to achieve superior outcomes.
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Affiliation(s)
- Ana P. Peredo
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Sarah E. Gullbrand
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Harvey E. Smith
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Robert L. Mauck
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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10
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Peng Y, Qing X, Shu H, Tian S, Yang W, Chen S, Lin H, Lv X, Zhao L, Chen X, Pu F, Huang D, Cao X, Shao Z, Yp, Zs, Xc, Yp, Yp, Xq, Hs, St, Wy, Yp, Xq, Hs, St, Hl, Xl, Lz, Xc, Fp, Sc, Yp, Xq, Hs, St, Yp, Xq, Wy, Hl, Xl, Lz, Xc, Fp, Sc, Hdh, Wy, Hl, Xl, Lz, Xc, Fp, Sc, Hdh, Zs, Xc. Proper animal experimental designs for preclinical research of biomaterials for intervertebral disc regeneration. BIOMATERIALS TRANSLATIONAL 2021; 2:91-142. [PMID: 35836965 PMCID: PMC9255780 DOI: 10.12336/biomatertransl.2021.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/09/2021] [Indexed: 01/17/2023]
Abstract
Low back pain is a vital musculoskeletal disease that impairs life quality, leads to disability and imposes heavy economic burden on the society, while it is greatly attributed to intervertebral disc degeneration (IDD). However, the existing treatments, such as medicines, chiropractic adjustments and surgery, cannot achieve ideal disc regeneration. Therefore, advanced bioactive therapies are implemented, including stem cells delivery, bioreagents administration, and implantation of biomaterials etc. Among these researches, few reported unsatisfying regenerative outcomes. However, these advanced therapies have barely achieved successful clinical translation. The main reason for the inconsistency between satisfying preclinical results and poor clinical translation may largely rely on the animal models that cannot actually simulate the human disc degeneration. The inappropriate animal model also leads to difficulties in comparing the efficacies among biomaterials in different reaches. Therefore, animal models that better simulate the clinical charateristics of human IDD should be acknowledged. In addition, in vivo regenerative outcomes should be carefully evaluated to obtain robust results. Nevertheless, many researches neglect certain critical characteristics, such as adhesive properties for biomaterials blocking annulus fibrosus defects and hyperalgesia that is closely related to the clinical manifestations, e.g., low back pain. Herein, in this review, we summarized the animal models established for IDD, and highlighted the proper models and parameters that may result in acknowledged IDD models. Then, we discussed the existing biomaterials for disc regeneration and the characteristics that should be considered for regenerating different parts of discs. Finally, well-established assays and parameters for in vivo disc regeneration are explored.
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Affiliation(s)
- Yizhong Peng
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiangcheng Qing
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Hongyang Shu
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China,Hubei Key Laboratory of Genetics and Molecular Mechanism of Cardiologic Disorders, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Shuo Tian
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Wenbo Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Songfeng Chen
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Hui Lin
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiao Lv
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Lei Zhao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xi Chen
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Feifei Pu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Donghua Huang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xu Cao
- Department of Orthopaedic Surgery, Institute for Cell Engineering, Johns Hopkins University, Baltimore, MD, USA,Corresponding authors: Zengwu Shao, ; Xu Cao,
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China,Corresponding authors: Zengwu Shao, ; Xu Cao,
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Abstract
Intervertebral disc (IVD) degeneration is a leading cause of chronic low back pain (LBP) that results in serious disability and significant economic burden. IVD degeneration alters the disc structure and spine biomechanics, resulting in subsequent structural changes throughout the spine. Currently, treatments of chronic LBP due to IVD degeneration include conservative treatments, such as pain medication and physiotherapy, and surgical treatments, such as removal of herniated disc without or with spinal fusion. However, none of these treatments can completely restore a degenerated disc and its function. Thus, although the exact pathogenesis of disc degeneration remains unclear, there are studies examining the effectiveness of biological approaches, such as growth factor injection, gene therapy, and cell transplantation, in promoting IVD regeneration. Furthermore, tissue engineering using a combination of cell transplantation and biomaterials has emerged as a promising new approach for repair or restoration of degenerated discs. The main purpose of this review was to provide an overview of the current status of tissue engineering applications for IVD regenerative therapy by performing literature searches using PubMed. Significant advances in tissue engineering have opened the door to a new generation of regenerative therapies for the treatment of chronic discogenic LBP.
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12
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Zhang L, Zhang W, Hu Y, Fei Y, Liu H, Huang Z, Wang C, Ruan D, Heng BC, Chen W, Shen W. Systematic Review of Silk Scaffolds in Musculoskeletal Tissue Engineering Applications in the Recent Decade. ACS Biomater Sci Eng 2021; 7:817-840. [PMID: 33595274 DOI: 10.1021/acsbiomaterials.0c01716] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
During the past decade, various novel tissue engineering (TE) strategies have been developed to maintain, repair, and restore the biomechanical functions of the musculoskeletal system. Silk fibroins are natural polymers with numerous advantageous properties such as good biocompatibility, high mechanical strength, and low degradation rate and are increasingly being recognized as a scaffolding material of choice in musculoskeletal TE applications. This current systematic review examines and summarizes the latest research on silk scaffolds in musculoskeletal TE applications within the past decade. Scientific databases searched include PubMed, Web of Science, Medline, Cochrane library, and Embase. The following keywords and search terms were used: musculoskeletal, tendon, ligament, intervertebral disc, muscle, cartilage, bone, silk, and tissue engineering. Our Review was limited to articles on musculoskeletal TE, which were published in English from 2010 to September 2019. The eligibility of the articles was assessed by two reviewers according to prespecified inclusion and exclusion criteria, after which an independent reviewer performed data extraction and a second independent reviewer validated the data obtained. A total of 1120 articles were reviewed from the databases. According to inclusion and exclusion criteria, 480 articles were considered as relevant for the purpose of this systematic review. Tissue engineering is an effective modality for repairing or replacing injured or damaged tissues and organs with artificial materials. This Review is intended to reveal the research status of silk-based scaffolds in the musculoskeletal system within the recent decade. In addition, a comprehensive translational research route for silk biomaterial from bench to bedside is described in this Review.
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Affiliation(s)
- Li Zhang
- Department of Orthopedic Surgery of The Second Affiliated Hospital and Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China.,Department of Orthopaedics, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Wei Zhang
- School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China.,Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, Nanjing, Jiangsu 210096, China
| | - Yejun Hu
- Department of Orthopedic Surgery of The Second Affiliated Hospital and Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China.,Orthopaedics Research Institute, Zhejiang Univerisity, Hangzhou, Zhejiang 310000, China
| | - Yang Fei
- Department of Orthopedic Surgery of The Second Affiliated Hospital and Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China.,Orthopaedics Research Institute, Zhejiang Univerisity, Hangzhou, Zhejiang 310000, China
| | - Haoyang Liu
- School of Medicine, Southeast University, Nanjing, Jiangsu 210009, China.,Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, Nanjing, Jiangsu 210096, China
| | - Zizhan Huang
- Department of Orthopedic Surgery of The Second Affiliated Hospital and Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China.,Orthopaedics Research Institute, Zhejiang Univerisity, Hangzhou, Zhejiang 310000, China
| | - Canlong Wang
- Department of Orthopedic Surgery of The Second Affiliated Hospital and Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China.,Orthopaedics Research Institute, Zhejiang Univerisity, Hangzhou, Zhejiang 310000, China
| | - Dengfeng Ruan
- Department of Orthopedic Surgery of The Second Affiliated Hospital and Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China.,Orthopaedics Research Institute, Zhejiang Univerisity, Hangzhou, Zhejiang 310000, China
| | | | - Weishan Chen
- Department of Orthopedic Surgery of The Second Affiliated Hospital and Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China.,Orthopaedics Research Institute, Zhejiang Univerisity, Hangzhou, Zhejiang 310000, China
| | - Weiliang Shen
- Department of Orthopedic Surgery of The Second Affiliated Hospital and Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China.,Department of Sports Medicine, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, China.,Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Key Laboratory of Sports System Disease Research and Accurate Diagnosis and Treatment of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Orthopaedics Research Institute, Zhejiang Univerisity, Hangzhou, Zhejiang 310000, China.,China Orthopaedic Regenerative Medicine (CORMed), Chinese Medical Association, Hangzhou, Zhejiang, China
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13
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Panebianco C, Meyers J, Gansau J, Hom W, Iatridis J. Balancing biological and biomechanical performance in intervertebral disc repair: a systematic review of injectable cell delivery biomaterials. Eur Cell Mater 2020; 40:239-258. [PMID: 33206993 PMCID: PMC7706585 DOI: 10.22203/ecm.v040a15] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Discogenic back pain is a common condition without approved intervertebral disc (IVD) repair therapies. Cell delivery using injectable biomaterial carriers offers promise to restore disc height and biomechanical function, while providing a functional niche for delivered cells to repair degenerated tissues. This systematic review advances the injectable IVD cell delivery biomaterials field by characterising its current state and identifying themes of promising strategies. Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guidelines were used to screen the literature and 183 manuscripts met the inclusion criteria. Cellular and biomaterial inputs, and biological and biomechanical outcomes were extracted from each study. Most identified studies targeted nucleus pulposus (NP) repair. No consensus exists on cell type or biomaterial carrier, yet most common strategies used mesenchymal stem cell (MSC) delivery with interpenetrating network/co-polymeric (IPN/CoP) biomaterials composed of natural biomaterials. All studies reported biological outcomes with about half the studies reporting biomechanical outcomes. Since the IVD is a load-bearing tissue, studies reporting compressive and shear moduli were analysed and two major themes were found. First, a competitive balance, or 'seesaw' effect, between biomechanical and biological performance was observed. Formulations with higher moduli had inferior cellular performance, and vice versa. Second, several low-modulus biomaterials had favourable biological performance and matured throughout culture duration with enhanced extracellular matrix synthesis and biomechanical moduli. Findings identify an opportunity to develop next-generation biomaterials that provide high initial biomechanical competence to stabilise and repair damaged IVDs with a capacity to promote cell function for long-term healing.
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Affiliation(s)
| | | | | | | | - J.C. Iatridis
- Address for correspondence: James C. Iatridis, Ph.D., One Gustave Levy Place, Box 1188, Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. Telephone number: +1 2122411517
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14
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Harmon MD, Ramos DM, Nithyadevi D, Bordett R, Rudraiah S, Nukavarapu SP, Moss IL, Kumbar SG. Growing a backbone - functional biomaterials and structures for intervertebral disc (IVD) repair and regeneration: challenges, innovations, and future directions. Biomater Sci 2020; 8:1216-1239. [PMID: 31957773 DOI: 10.1039/c9bm01288e] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Back pain and associated maladies can account for an immense amount of healthcare cost and loss of productivity in the workplace. In particular, spine related injuries in the US affect upwards of 5.7 million people each year. The degenerative disc disease treatment almost always arises due to a clinical presentation of pain and/or discomfort. Preferred conservative treatment modalities include the use of non-steroidal anti-inflammatory medications, physical therapy, massage, acupuncture, chiropractic work, and dietary supplements like glucosamine and chondroitin. Artificial disc replacement, also known as total disc replacement, is a treatment alternative to spinal fusion. The goal of artificial disc prostheses is to replicate the normal biomechanics of the spine segment, thereby preventing further damage to neighboring sections. Artificial functional disc replacement through permanent metal and polymer-based components continues to evolve, but is far from recapitulating native disc structure and function, and suffers from the risk of unsuccessful tissue integration and device failure. Tissue engineering and regenerative medicine strategies combine novel material structures, bioactive factors and stem cells alone or in combination to repair and regenerate the IVD. These efforts are at very early stages and a more in-depth understanding of IVD metabolism and cellular environment will also lead to a clearer understanding of the native environment which the tissue engineering scaffold should mimic. The current review focusses on the strategies for a successful regenerative scaffold for IVD regeneration and the need for defining new materials, environments, and factors that are so finely tuned in the healthy human intervertebral disc in hopes of treating such a prevalent degenerative process.
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Affiliation(s)
- Matthew D Harmon
- Department of Materials Science and Engineering, University of Connecticut, Storrs, CT, USA. and Department of Orthopedics Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Daisy M Ramos
- Department of Materials Science and Engineering, University of Connecticut, Storrs, CT, USA. and Department of Orthopedics Surgery, University of Connecticut Health, Farmington, CT, USA
| | - D Nithyadevi
- Department of Orthopedics Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Rosalie Bordett
- Department of Orthopedics Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Swetha Rudraiah
- Department of Pharmaceutical Sciences, University of Saint Joseph, Hartford, CT, USA
| | - Syam P Nukavarapu
- Department of Materials Science and Engineering, University of Connecticut, Storrs, CT, USA. and Department of Orthopedics Surgery, University of Connecticut Health, Farmington, CT, USA and Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Isaac L Moss
- Department of Orthopedics Surgery, University of Connecticut Health, Farmington, CT, USA
| | - Sangamesh G Kumbar
- Department of Materials Science and Engineering, University of Connecticut, Storrs, CT, USA. and Department of Orthopedics Surgery, University of Connecticut Health, Farmington, CT, USA and Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
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15
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Dorishetty P, Dutta NK, Choudhury NR. Silk fibroins in multiscale dimensions for diverse applications. RSC Adv 2020; 10:33227-33247. [PMID: 35515035 PMCID: PMC9056751 DOI: 10.1039/d0ra03964k] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/18/2020] [Indexed: 12/17/2022] Open
Abstract
Silk biomaterials in different forms such as particles, coatings and their assemblies, represent unique type of materials in multiple scales and dimensions. Herein, we provide an overview of multi-scale silk fibroin materials including silk particles, silk coatings and silk assemblies, each of which represents a unique type of material with wide range of applications. They feature tunable structures and mechanical properties with excellent biocompatibility, which are essentially required for various biomedical and drug delivery applications. The review focuses on bringing a new perspective on the utilization of regenerated silk fibroins in modern biomedicine by beginning with the fabrication of silk in multiscale dimensions and their state-of-the-art applications in various biomedical and bioelectronic fields. It covers the fundamentals of processing silk fibroins in multi-dimensions (sizes and shapes) with a specific emphasis on its structural tunability at various length scales (nano-micro) by using the latest fabrication methods/mechanisms and advanced fabrication technologies, followed by their recent applications in diverse fields of biomedicine.
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Affiliation(s)
- Pramod Dorishetty
- School of Engineering, RMIT University Melbourne Victoria 3000 Australia
| | - Naba K Dutta
- School of Engineering, RMIT University Melbourne Victoria 3000 Australia
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16
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Chuah YJ, Tan JR, Wu Y, Lim CS, Hee HT, Kang Y, Wang DA. Scaffold-Free tissue engineering with aligned bone marrow stromal cell sheets to recapitulate the microstructural and biochemical composition of annulus fibrosus. Acta Biomater 2020; 107:129-137. [PMID: 32105832 DOI: 10.1016/j.actbio.2020.02.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 02/05/2020] [Accepted: 02/19/2020] [Indexed: 12/19/2022]
Abstract
Current tissue engineering strategies through scaffold-based approaches fail to recapitulate the complex three-dimensional microarchitecture and biochemical composition of the native Annulus Fibrosus tissue. Considering limited access to healthy annulus fibrosus cells from patients, this study explored the potential of bone marrow stromal cells (BMSC) to fabricate a scaffold-free multilamellar annulus fibrosus-like tissue by integrating micropatterning technologies into multi-layered BMSC engineering. BMSC sheet with cells and collagen fibres aligned at ~30° with respect to their longitudinal dimension were developed on a microgroove-patterned PDMS substrate. Two sheets were then stacked together in alternating directions to form an angle-ply bilayer tissue, which was rolled up, sliced to form a multi-lamellar angle-ply tissue and cultured in a customized medium. The development of the annulus fibrosus-like tissue was further characterized by histological, gene expression and microscopic and mechanical analysis. We demonstrated that the engineered annulus fibrosus-like tissue with aligned BMSC sheet showed parallel collagen fibrils, biochemical composition and microstructures that resemble the native disk. Furthermore, aligned cell sheet showed enhanced expression of annulus fibrosus associated extracellular matrix markers and higher mechanical strength than that of the non-aligned cell sheet. The present study provides a new strategy in annulus fibrosus tissue engineering methodology to develop a scaffold-free annulus fibrosus-like tissue that resembles the microarchitecture and biochemical attributes of a native tissue. This can potentially lead to a promising avenue for advancing BMSC-mediated annulus fibrosus regeneration towards future clinical applications.
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17
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Wang S, He YF, Ma J, Yu L, Wen JK, Ye XJ. Dynamic Bioreactor Culture for Infiltration of Bone Mesenchymal Stem Cells within Electrospun Nanofibrous Scaffolds for Annulus Fibrosus Repair. Orthop Surg 2020; 12:304-311. [PMID: 31944618 PMCID: PMC7031622 DOI: 10.1111/os.12615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 12/17/2019] [Accepted: 12/22/2019] [Indexed: 12/03/2022] Open
Abstract
Objective To compare the ability of three culture strategies of static culture, intermittent centrifugal culture and dynamic bioreactor culture in promoting the infiltration of bone marrow mesenchymal stem cells (BMSCs) throughout electrospun nanoporous aligned nanoyarn scaffold (AYS). Methods AYS was constructed by the method of conjugated electrospinning, using the blended solution of poly (L‐lactide‐co‐caprolactone) (P (LLA‐CL)) and gelatin. Then the bone marrow mesenchymal stem cells (BMSCs) were transplanted on the scaffolds. Culture the scaffold‐cells using three methods of static culture, intermittent centrifugal culture and dynamic bioreactor culture. After 7 and 14 days in culture, the infiltration depth of the cells were observed and measured by hematoxylin and eosin (HE) or 4′, 6‐diamidino‐2‐phenylindole (DAPI) staining. Result In the current study, on the 7th day, the BMSCs in the scaffolds of static culture group, intermittent centrifugal culture group, and dynamic bioreactor culture group infiltrated to an average depth of 11.88 ± 1.82 μm, 21.17 ± 13.17 μm, and 26.27 ± 7.42 μm, respectively. There were differences between the bioreactor culture group with the static culture group and the intermittent centrifugal culture group. On the time point of 14 days, the depth of infiltration of BMSCs in dynamic bioreactor culture was the most (115.13 ± 25.44 μm, P < 0.05), and the infiltration of the cells in the intermittent centrifugal culture group was 42.53 ± 13.07 μm, deeper than that of the static culture group (24.53 ± 6.06, P < 0.05). Conclusion Dynamic bioreactor culture may be a preferred method for tissue engineering approaches involving scaffolds with a low porosity, such as those needed for repair of the annulus fibrosus (AF).
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Affiliation(s)
- Shuang Wang
- Department of Spinal Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yun-Fei He
- Department of Orthopedics, The 940th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou, China
| | - Jun Ma
- Department of Orthopedics, Central Theater Command General Hospital of the Chinese People's Liberation Army, Wuhan, China
| | - Lei Yu
- Department of Spinal Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Jian-Kun Wen
- Department of Spinal Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xiao-Jian Ye
- Department of Spinal Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China
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18
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Barakat AH, Elwell VA, Lam KS. Stem cell therapy in discogenic back pain. JOURNAL OF SPINE SURGERY (HONG KONG) 2019; 5:561-583. [PMID: 32043007 PMCID: PMC6989932 DOI: 10.21037/jss.2019.09.22] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Chronic low back pain has both substantial social and economic impacts on patients and healthcare budgets. Adding to the magnitude of the problem is the difficulty in identifying the exact causes of disc degeneration with modern day diagnostic and imaging techniques. With that said, current non-operative and surgical treatment modalities for discogenic low back pain fails to meet the expectations in many patients and hence the challenge. The objective for newly emerging stem cell regenerative therapy is to treat degenerative disc disease (DDD) by restoring the disc's cellularity and modulating the inflammatory response. Appropriate patient selection is crucial for the success of stem cell therapy. Regenerative modalities for discogenic pain currently focus on the use of either primary cells harvested from the intervertebral discs or stem cells from other sources whether autogenic or allogenic. The microenvironment in which stem cells are being cultured has been recognized to play a crucial role in directing or maintaining the production of the desired phenotypes and may enhance their regenerative potential. This has led to a more specific focus on innovating more effective culturing techniques, delivery vehicles and scaffolds for stem cell application. Although stem cell therapy might offer an attractive alternative treatment option, more clinical studies are still needed to establish on the safety and feasibility of such therapy. In this literature review, we aim to present the most recent in vivo and in vitro studies related to the use of stem cell therapy in the treatment of discogenic low back pain.
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Affiliation(s)
- Ahmed H. Barakat
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Vivian A. Elwell
- Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
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19
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Stergar J, Gradisnik L, Velnar T, Maver U. Intervertebral disc tissue engineering: A brief review. Bosn J Basic Med Sci 2019; 19:130-137. [PMID: 30726701 DOI: 10.17305/bjbms.2019.3778] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 07/29/2018] [Indexed: 12/12/2022] Open
Abstract
Intervertebral disc (IVD) degeneration (IDD) is associated with low back pain and significantly affects the patient's quality of life. Degeneration of the IVD alters disk height and the mechanics of the spine, leading to chronic segmental spinal instability. The pathophysiology of IVD disease is still not well understood. Current therapies for IDD include conservative and invasive approaches, but none of those treatments are able to restore the disc structure and function. Recently, tissue engineering techniques emerged as a possible approach to treat IDD, by replacing a damaged IVD with scaffolds and appropriate cells. Advances in manufacturing techniques, material processing and development, surface functionalization, drug delivery systems and cell incorporation furthered the development of tissue engineering therapies. In this review, biomaterial scaffolds and cell-based therapies for IVD regeneration are briefly discussed.
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Affiliation(s)
- Janja Stergar
- Institute of Biomedical Sciences, Faculty of Medicine, University of Maribor, Maribor, Slovenia Laboratory of Inorganic Chemistry, Faculty of Chemistry and Chemical Technology, University of Maribor, Maribor, Slovenia.
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Tissue Engineering Strategies for Intervertebral Disc Treatment Using Functional Polymers. Polymers (Basel) 2019; 11:polym11050872. [PMID: 31086085 PMCID: PMC6572548 DOI: 10.3390/polym11050872] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 04/24/2019] [Accepted: 05/02/2019] [Indexed: 02/07/2023] Open
Abstract
Intervertebral disc (IVD) is the fibrocartilage between the vertebrae, allowing the spine to move steadily by bearing multidirectional complex loads. Aging or injury usually causes degeneration of IVD, which is one of the main reasons for low back pain prevalent worldwide and reduced quality of life. While various treatment strategies for degenerative IVD have been studied using in vitro studies, animal experiments, and clinical trials, there are unsolved limitations for endogenous regeneration of degenerative IVD. In this respect, several tissue engineering strategies that are based on the cell and scaffolds have been extensively researched with positive outcomes for regeneration of IVD tissues. Scaffolds made of functional polymers and their diverse forms mimicking the macro- and micro-structure of native IVD enhance the biological and mechanical properties of the scaffolds for IVD regeneration. In this review, we discuss diverse morphological and functional polymers and tissue engineering strategies for endogenous regeneration of degenerative IVD. Tissue engineering strategies using functional polymers are promising therapeutics for fundamental and endogenous regeneration of degenerative IVD.
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21
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Isa ILM, Günay B, Joyce K, Pandit A. Tissue Engineering: Biomaterials for Disc Repair. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s40610-018-0106-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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22
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van Uden S, Catto V, Perotto G, Athanassiou A, Redaelli ACL, Greco FG, Riboldi SA. Electrospun fibroin/polyurethane hybrid meshes: Manufacturing, characterization, and potentialities as substrates for haemodialysis arteriovenous grafts. J Biomed Mater Res B Appl Biomater 2018; 107:807-817. [PMID: 30102833 DOI: 10.1002/jbm.b.34177] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/20/2018] [Accepted: 05/28/2018] [Indexed: 11/10/2022]
Abstract
Several attempts made so far to combine silk fibroin and polyurethane, in order to prepare scaffolds encompassing the bioactivity of the former with the elasticity of the latter, suffer from critical drawbacks concerning industrial and clinical applicability (e.g., separation of phases upon processing, use of solvents unaddressed by the European Pharmacopoeia, and use of degradable polyurethanes). Overcoming these limitations, in this study, we report the successful blending of regenerated silk fibroin with a medical-grade, non-degradable polyurethane using formic acid and dichloromethane, and the manufacturing of hybrid, semi-degradable electrospun tubular meshes with different ratios of the two materials. Physicochemical analyses demonstrated the maintenance of the characteristic features of fibroin and polyurethane upon solubilization, blending, electrospinning, and postprocessing with ethanol or methanol. Envisioning their possible application as semidegradable substrates for haemodialysis arteriovenous grafts, tubular meshes were further characterized, showing submicrometric fibrous morphologies, tunable mechanical properties, permeability before and after puncture in the same order of magnitude as commercial grafts currently used in the clinics. Results demonstrate the potential of this material for the development of hybrid, new-generation vascular grafts with disruptive potential in the field of in situ tissue engineering. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 807-817, 2019.
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Affiliation(s)
- Sebastião van Uden
- Bioengineering Laboratories S.r.l., Cantù (CO), Italy.,Politecnico di Milano, Milano (MI), Italy
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Chu G, Shi C, Wang H, Zhang W, Yang H, Li B. Strategies for Annulus Fibrosus Regeneration: From Biological Therapies to Tissue Engineering. Front Bioeng Biotechnol 2018; 6:90. [PMID: 30042942 PMCID: PMC6048238 DOI: 10.3389/fbioe.2018.00090] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 06/18/2018] [Indexed: 12/17/2022] Open
Abstract
Intervertebral disc (IVD) is an avascular tissue which contributes to the weight bearing, motion, and flexibility of spine. However, IVD is susceptible to damage and even failure due to injury, pathology, and aging. Annulus fibrosus (AF), the structural and functional integrity of which is critically essential to confine nucleus pulpous (NP) and maintain physiological intradiscal pressure under mechanical loading, plays a critical role in the biomechanical properties of IVD. AF degeneration commonly results in substantial deterioration of IVD. During this process, the biomechanical properties of AF and the balance between anabolism and catabolism in IVD are progressively disrupted, leading to chronic back pain, and even disability of individuals. Therefore, repairing and regenerating AF are effective treatments to degeneration-associated pains. However, they remain highly challenging due to the complexity of natural AF tissue in the aspects of cell phenotype, biochemical composition, microstructure, and mechanical properties. Tissue engineering (TE), by combining biological science and materials engineering, shed lights on AF regeneration. In this article, we review recent advances in the pro-anabolic approaches in the form of cell delivery, bioactive factors delivery, gene therapy, and TE strategies for achieving AF regeneration.
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Affiliation(s)
- Genglei Chu
- Orthopaedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, China
- Department of Orthopaedic Surgery, First Affiliated Hospital, Soochow University, Suzhou, China
| | - Chen Shi
- Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore
| | - Huan Wang
- Orthopaedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, China
- Department of Orthopaedic Surgery, First Affiliated Hospital, Soochow University, Suzhou, China
| | - Weidong Zhang
- Orthopaedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, China
- Department of Orthopaedic Surgery, First Affiliated Hospital, Soochow University, Suzhou, China
| | - Huilin Yang
- Orthopaedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, China
- Department of Orthopaedic Surgery, First Affiliated Hospital, Soochow University, Suzhou, China
| | - Bin Li
- Orthopaedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, China
- Department of Orthopaedic Surgery, First Affiliated Hospital, Soochow University, Suzhou, China
- China Orthopaedic Regenerative Medicine Group, Hangzhou, China
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24
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Fernandez-Moure J, Moore CA, Kim K, Karim A, Smith K, Barbosa Z, Van Eps J, Rameshwar P, Weiner B. Novel therapeutic strategies for degenerative disc disease: Review of cell biology and intervertebral disc cell therapy. SAGE Open Med 2018; 6:2050312118761674. [PMID: 29568524 PMCID: PMC5858682 DOI: 10.1177/2050312118761674] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 02/05/2018] [Indexed: 12/17/2022] Open
Abstract
Intervertebral disc degeneration is a disease of the discs connecting adjoining vertebrae in which structural damage leads to loss of disc integrity. Degeneration of the disc can be a normal process of ageing, but can also be precipitated by other factors. Literature has made substantial progress in understanding the biological basis of intervertebral disc, which is reviewed here. Current medical and surgical management strategies have shortcomings that do not lend promise to be effective solutions in the coming years. With advances in understanding the cell biology and characteristics of the intervertebral disc at the molecular and cellular level that have been made, alternative strategies for addressing disc pathology can be discovered. A brief overview of the anatomic, cellular, and molecular structure of the intervertebral disc is provided as well as cellular and molecular pathophysiology surrounding intervertebral disc degeneration. Potential therapeutic strategies involving stem cell, protein, and genetic therapy for intervertebral disc degeneration are further discussed.
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Affiliation(s)
- Joseph Fernandez-Moure
- Department of Surgery, Houston Methodist Hospital, Houston, TX, USA.,Department of Regenerative and Biomimetic Medicine, Houston Methodist Research Institute, Houston, TX, USA
| | - Caitlyn A Moore
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | | | - Azim Karim
- Department of Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - Kevin Smith
- Department of Orthopedic Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - Zonia Barbosa
- Department of Regenerative and Biomimetic Medicine, Houston Methodist Research Institute, Houston, TX, USA
| | - Jeffrey Van Eps
- Department of Surgery, Houston Methodist Hospital, Houston, TX, USA.,Department of Regenerative and Biomimetic Medicine, Houston Methodist Research Institute, Houston, TX, USA
| | - Pranela Rameshwar
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Bradley Weiner
- Department of Regenerative and Biomimetic Medicine, Houston Methodist Research Institute, Houston, TX, USA.,Department of Orthopedic Surgery, Houston Methodist Hospital, Houston, TX, USA
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25
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Silk-based multilayered angle-ply annulus fibrosus construct to recapitulate form and function of the intervertebral disc. Proc Natl Acad Sci U S A 2017; 115:477-482. [PMID: 29282316 DOI: 10.1073/pnas.1715912115] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Recapitulation of the form and function of complex tissue organization using appropriate biomaterials impacts success in tissue engineering endeavors. The annulus fibrosus (AF) represents a complex, multilamellar, hierarchical structure consisting of collagen, proteoglycans, and elastic fibers. To mimic the intricacy of AF anatomy, a silk protein-based multilayered, disc-like angle-ply construct was fabricated, consisting of concentric layers of lamellar sheets. Scanning electron microscopy and fluorescence image analysis revealed cross-aligned and lamellar characteristics of the construct, mimicking the native hierarchical architecture of the AF. Induction of secondary structure in the silk constructs was confirmed by infrared spectroscopy and X-ray diffraction. The constructs showed a compressive modulus of 499.18 ± 86.45 kPa. Constructs seeded with porcine AF cells and human mesenchymal stem cells (hMSCs) showed ∼2.2-fold and ∼1.7-fold increases in proliferation on day 14, respectively, compared with initial seeding. Biochemical analysis, histology, and immunohistochemistry results showed the deposition of AF-specific extracellular matrix (sulfated glycosaminoglycan and collagen type I), indicating a favorable environment for both cell types, which was further validated by the expression of AF tissue-specific genes. The constructs seeded with porcine AF cells showed ∼11-, ∼5.1-, and ∼6.7-fold increases in col Iα 1, sox 9, and aggrecan genes, respectively. The differentiation of hMSCs to AF-like tissue was evident from the enhanced expression of the AF-specific genes. Overall, the constructs supported cell proliferation, differentiation, and ECM deposition resulting in AF-like tissue features based on ECM deposition and morphology, indicating potential for future studies related to intervertebral disc replacement therapy.
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26
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Pereira DR, Silva-Correia J, Oliveira JM, Reis RL, Pandit A, Biggs MJ. Nanocellulose reinforced gellan-gum hydrogels as potential biological substitutes for annulus fibrosus tissue regeneration. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2017; 14:897-908. [PMID: 29170112 DOI: 10.1016/j.nano.2017.11.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 11/01/2017] [Accepted: 11/09/2017] [Indexed: 11/30/2022]
Abstract
Intervertebral disc (IVD) degeneration is associated with both structural damage and aging related degeneration. Annulus fibrosus (AF) defects such as annular tears, herniation and discectomy require novel tissue engineering strategies to functionally repair AF tissue. An ideal construct will repair the AF by providing physical and biological support, facilitating regeneration. The presented strategy herein proposes a gellan gum-based construct reinforced with cellulose nanocrystals (nCell) as a biological self-gelling AF substitute. Nanocomposite hydrogels were fabricated and characterized with respect to hydrogel swelling capacity, degradation rate in vitro and mechanical properties. Rheological evaluation on the nanocomposites demonstrated the GGMA reinforcement with nCell promoted matrix entanglement with higher scaffold stiffness observed upon ionic crosslinking. Compressive mechanical tests demonstrated compressive modulus values close to those of the human AF tissue. Furthermore, cell culture studies with encapsulated bovine AF cells indicated that nanocomposite constructs promoted cell viability and a physiologically relevant cell morphology for up to fourteen days in vitro.
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Affiliation(s)
- Diana R Pereira
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Univ. Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Taipas, Guimarães, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal; CÚRAM, SFI Centre for Research in Medical Devices, National University of Ireland, Galway
| | - Joana Silva-Correia
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Univ. Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Taipas, Guimarães, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Joaquim M Oliveira
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Univ. Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Taipas, Guimarães, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Rui L Reis
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, Univ. Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Taipas, Guimarães, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga, Guimarães, Portugal
| | - Abhay Pandit
- CÚRAM, SFI Centre for Research in Medical Devices, National University of Ireland, Galway
| | - Manus J Biggs
- CÚRAM, SFI Centre for Research in Medical Devices, National University of Ireland, Galway.
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27
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Xin L, Xu W, Yu L, Fan S, Wang W, Yu F, Wang Z. Effects of annulus defects and implantation of poly(lactic-co-glycolic acid) (PLGA)/fibrin gel scaffolds on nerves ingrowth in a rabbit model of annular injury disc degeneration. J Orthop Surg Res 2017; 12:73. [PMID: 28499451 PMCID: PMC5429511 DOI: 10.1186/s13018-017-0572-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 04/26/2017] [Indexed: 12/01/2022] Open
Abstract
Background Growth of nerve fibers has been shown to occur in a rabbit model of intravertebral disc degeneration (IVD) induced by needle puncture. As nerve growth may underlie the process of chronic pain in humans affected by disc degeneration, we sought to investigate the factors underlying nerve ingrowth in a minimally invasive annulotomy rabbit model of IVD by comparing the effects of empty disc defects with those of defects filled with poly(lactic-co-glycolic acid)/fibrin gel (PLGA) plugs. Methods New Zealand white rabbits (n = 24) received annular injuries at three lumbar levels (L3/4, L4/5, and L5/6). The discs were randomly assigned to four groups: (a) annular defect (1.8-mm diameter; 4-mm depth) by mini-trephine, (b) annular defect implanted with a PLGA scaffold containing a fibrin gel, (c) annular puncture by a 16G needle (5-mm depth), and (d) uninjured L2/3 disc (control). Disc degeneration was evaluated by radiography, MRI, histology, real-time PCR, and analysis of proteoglycan (PG) content. Nerve ingrowth into the discs was assessed by immunostaining with the nerve marker protein gene product 9.5. Results Injured discs showed a progressive disc space narrowing with significant disc degeneration and proteoglycan loss, as confirmed by imaging results, molecular and compositional analysis, and histological examinations. In 16G punctured discs, nerve ingrowth was observed on the surface of scar tissue. In annular defects, nerve fibers were found to be distributed along small fissures within the fibrocartilaginous-like tissue that filled the AF. In discs filled with PLGA/ fibrin gel, more nerve fibers were observed growing deeper into the inner AF along the open annular track. In addition, innervations scores showed significantly higher than those of punctured discs and empty defects. A limited vascular proliferation was found in the injured sites and regenerated tissues. Conclusions Nerve ingrowth was significantly higher in PLGA/fibrin-filled discs than in empty defects. Possible explanations include (i) annular fissures along the defect and early loss of proteoglycan may facilitate the ingrowth process and (ii) biodegradable PLGA/fibrin gel may promote adverse growth of nerves and blood vessels into deeper parts of injured disc. The rabbit annular defect model of disc degeneration appears suitable to investigate the effects of nerve ingrowth in relation to pain generation.
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Affiliation(s)
- Long Xin
- Department of Spine Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Weixing Xu
- Department of Spine Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Leijun Yu
- Department of Spine Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Shunwu Fan
- Department of Orthopedics, the Affiliated Sir Run Run Shaw Hospital, Zhejiang University, Zhejiang, China
| | - Wei Wang
- Department of Polymer Materials Science and Engineering, School of Material Science and Engineering, Tianjin University, Tianjin, China
| | - Fang Yu
- Department of Mental Health, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Zhenbin Wang
- Orthopedics Laboratory, Department of Spine Surgery, The Fourth Affiliated Hospital, Xinjiang Medical University, Urumqi, Xinjiang, 830000, China.
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28
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Tavakoli J. Tissue Engineering of the Intervertebral Disc's Annulus Fibrosus: A Scaffold-Based Review Study. Tissue Eng Regen Med 2017; 14:81-91. [PMID: 30603465 PMCID: PMC6171584 DOI: 10.1007/s13770-017-0024-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/10/2016] [Accepted: 06/08/2016] [Indexed: 12/11/2022] Open
Abstract
Tissue engineering as a high technology solution for treating disc's problem has been the focus of some researches recently; however, the upcoming successful results in this area depends on understanding the complexities of biology and engineering interface. Whereas the major responsibility of the nucleus pulposus is to provide a sustainable hydrated environment within the disc, the function of the annulus fibrosus (AF) is more mechanical, facilitating joint mobility and preventing radial bulging by confining of the central part, which makes the AF reconstruction important. Although the body of knowledge regarding the AF tissue engineering has grown rapidly, the opportunities to improve current understanding of how artificial scaffolds are able to mimic the AF concentric structure-including inter-lamellar matrix and cross-bridges-addressed unresolved research questions. The aim of this literature review was to collect and discuss, from the international scientific literature, information about tissue engineering of the AF based on scaffold fabrication and material properties, useful for developing new strategies in disc tissue engineering. The key parameter of this research was understanding if role of cross-bridges and inter-lamellar matrix has been considered on tissue engineering of the AF.
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Affiliation(s)
- Javad Tavakoli
- Medical Device Research Institute, School of Computer Science, Engineering and Mathematics, Flinders University, Adelaide, SA 5042 Australia
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29
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Oner T, Cengiz IF, Pitikakis M, Cesario L, Parascandolo P, Vosilla L, Viano G, Oliveira JM, Reis RL, Silva-Correia J. 3D segmentation of intervertebral discs: from concept to the fabrication of patient-specific scaffolds. ACTA ACUST UNITED AC 2017. [DOI: 10.2217/3dp-2016-0011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Aim: To develop a methodology for producing patient-specific scaffolds that mimic the annulus fibrosus (AF) of the human intervertebral disc by means of combining MRI and 3D bioprinting. Methods: In order to obtain the AF 3D model from patient's volumetric MRI dataset, the RheumaSCORE segmentation software was used. Polycaprolactone scaffolds with three different internal architectures were fabricated by 3D bioprinting, and characterized by microcomputed tomography. Results: The demonstrated methodology of a geometry reconstruction pipeline enabled us to successfully obtain an accurate AF model and 3D print patient-specific scaffolds with different internal architectures. Conclusion: The results guide us toward patient-specific intervertebral disc tissue engineering as demonstrated by a way of manufacturing personalized scaffolds using patient's MRI data.
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Affiliation(s)
- T Oner
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark – Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805–017 Barco GMR, Portugal
- ICVS/3B's – PT Government Associated Laboratory, Braga, Portugal
| | - IF Cengiz
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark – Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805–017 Barco GMR, Portugal
- ICVS/3B's – PT Government Associated Laboratory, Braga, Portugal
| | | | | | | | | | - G Viano
- Softeco Sismat Srl, Genova, Italy
| | - JM Oliveira
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark – Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805–017 Barco GMR, Portugal
- ICVS/3B's – PT Government Associated Laboratory, Braga, Portugal
| | - RL Reis
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark – Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805–017 Barco GMR, Portugal
- ICVS/3B's – PT Government Associated Laboratory, Braga, Portugal
| | - J Silva-Correia
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Avepark – Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805–017 Barco GMR, Portugal
- ICVS/3B's – PT Government Associated Laboratory, Braga, Portugal
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30
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Bowles RD, Setton LA. Biomaterials for intervertebral disc regeneration and repair. Biomaterials 2017; 129:54-67. [PMID: 28324865 DOI: 10.1016/j.biomaterials.2017.03.013] [Citation(s) in RCA: 216] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/05/2017] [Accepted: 03/10/2017] [Indexed: 12/11/2022]
Abstract
The intervertebral disc contributes to motion, weight bearing, and flexibility of the spine, but is susceptible to damage and morphological changes that contribute to pathology with age and injury. Engineering strategies that rely upon synthetic materials or composite implants that do not interface with the biological components of the disc have not met with widespread use or desirable outcomes in the treatment of intervertebral disc pathology. Here we review bioengineering advances to treat disc disorders, using cell-supplemented materials, or acellular, biologically based materials, that provide opportunity for cell-material interactions and remodeling in the treatment of intervertebral disc disorders. While a field still in early development, bioengineering-based strategies employing novel biomaterials are emerging as promising alternatives for clinical treatment of intervertebral disc disorders.
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Affiliation(s)
- Robert D Bowles
- Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA.
| | - Lori A Setton
- Department of Biomedical Engineering & Orthopedic Surgery, Washington University in St. Louis, St. Louis, MO 63130, USA.
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31
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M JC, Reardon PJT, Konwarh R, Knowles JC, Mandal BB. Mimicking Hierarchical Complexity of the Osteochondral Interface Using Electrospun Silk-Bioactive Glass Composites. ACS APPLIED MATERIALS & INTERFACES 2017; 9:8000-8013. [PMID: 28181432 DOI: 10.1021/acsami.6b16590] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The anatomical complexity and slow regeneration capacity of hyaline cartilage at the osteochondral interface pose a great challenge in the repair of osteochondral defects (OCD). In this study, we utilized the processing feasibility offered by the sol derived 70S bioactive glass and silk fibroin (mulberry Bombyx mori and endemic Indian non-mulberry Antheraea assama), in fabricating a well-integrated, biomimetic scaffolding matrix with a coherent interface. Differences in surface properties such as wettability and amorphousness between the two silk groups resulted in profound variations in cell attachment and extracellular matrix protein deposition. Mechanical assessment showed that the biphasic composites exhibited both an elastic region pertinent for cartilage tissue and a stiff compression resistant region simulating the bone phase. In vitro biological studies revealed that the biphasic mats presented spatial confinement for the growth and maturation of both osteoblasts and chondrocytes, marked by increased alkaline phosphatase (ALP) activity, osteopontin (OPN), sulfated glycosaminoglycan (sGAG) and collagen secretion in the cocultured mats. The non-mulberry silk based biphasic composite mats performed better than their mulberry counterpart, as evidenced by enhanced expression levels of key cartilage and bone specific marker genes. Therefore, the developed biphasic scaffold show great promise for improving the current clinical strategies for osteochondral tissue repair.
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Affiliation(s)
- Joseph Christakiran M
- Biomaterial and Tissue Engineering Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati , Guwahati 781039, Assam, India
| | - Philip J T Reardon
- Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London , 256 Gray's Inn Road, London WC1X 8LD, U.K
| | - Rocktotpal Konwarh
- Biomaterial and Tissue Engineering Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati , Guwahati 781039, Assam, India
| | - Jonathan C Knowles
- Division of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, University College London , 256 Gray's Inn Road, London WC1X 8LD, U.K
| | - Biman B Mandal
- Biomaterial and Tissue Engineering Laboratory, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati , Guwahati 781039, Assam, India
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Blanquer SB, Gebraad AW, Miettinen S, Poot AA, Grijpma DW, Haimi SP. Differentiation of adipose stem cells seeded towards annulus fibrosus cells on a designed poly(trimethylene carbonate) scaffold prepared by stereolithography. J Tissue Eng Regen Med 2016; 11:2752-2762. [DOI: 10.1002/term.2170] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 01/06/2016] [Accepted: 02/10/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Sébastien B.G. Blanquer
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology; University of Twente; Enschede the Netherlands
- Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation; Davos Switzerland
| | - Arjen W.H. Gebraad
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology; University of Twente; Enschede the Netherlands
- Department of Oral and Maxillofacial Sciences, Clinicum; University of Helsinki; Helsinki Finland
| | - Susanna Miettinen
- Institute of Biosciences and Medical Technology (BioMediTech); University of Tampere; Tampere Finland
| | - André A. Poot
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology; University of Twente; Enschede the Netherlands
- Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation; Davos Switzerland
| | - Dirk W. Grijpma
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology; University of Twente; Enschede the Netherlands
- Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation; Davos Switzerland
- University of Groningen, University Medical Centre Groningen, W.J. Kolff Institute; Department of Biomedical Engineering; Groningen the Netherlands
| | - Suvi P. Haimi
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology; University of Twente; Enschede the Netherlands
- Department of Oral and Maxillofacial Sciences, Clinicum; University of Helsinki; Helsinki Finland
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33
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Xin L, Zhang C, Zhong F, Fan S, Wang W, Wang Z. Minimal invasive annulotomy for induction of disc degeneration and implantation of poly (lactic-co-glycolic acid) (PLGA) plugs for annular repair in a rabbit model. Eur J Med Res 2016; 21:7. [PMID: 26924131 PMCID: PMC4770696 DOI: 10.1186/s40001-016-0202-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 02/11/2016] [Indexed: 12/11/2022] Open
Abstract
Background The rabbit disc model is useful for the study of intervertebral disc (IVD) degeneration and experimental therapeutic interventions. The annulotomy-induced disc models present several drawbacks, particularly an excessive disruption of disc integrity and a rapidly disc degeneration; therefore, this study sought to establish a minimal invasive annulotomy for induction of disc degeneration model, combined to annulus repair using implantation of a PLGA (poly lactic-co-glycolic acid) plug. Methods New Zealand white rabbits (n = 24) received annular injuries in three discs (L3/4, L4/5 and L5/6). The experimental discs were randomly assigned to four groups: (a) annular defect with a 1.8 mm diameter mini-trephine; (b) annular puncture by 16G needle; (c) annular defect with a PLGA plug implanted by press-fit fashion; (d) uninjured L2/3 disc served as control. Postsurgical x-ray, MRI examination, and real-time PCR analysis were performed at 1, 3 and 6 months. Gross morphology and histology were evaluated at postoperative 6 months. Results Radiographic examinations showed a slow, progressive disc space narrowing and a significant degree of disc degeneration on MRI grade in the injured discs at 6 months in all rabbits. Histological examinations and aggrecan, Col1A1, Col2A1 and matrix metalloprotease (MMP)-3 mRNA expression confirmed the disc degeneration, supporting the imaging results. The PLGA implantation reduced the marked loss of T2-weighted signal intensity seen at MRI in the injured discs and slowly decreased the disc height index (DHI) over the follow-up period. HE/Safranin O staining showed that annular defect was replaced by regenerated connective tissue with significant loss of proteoglycan content. Conclusions The minimally invasive approach for the creation of annular defects by an appropriately sized mini-Trephine is a suitable option for the study of disc degeneration in a rabbit model. Implantation of a suitable PLGA plug induced a successful repair of the annulus fibrosus within the degenerated disc, and retarded the degenerative process in the annular injury model.
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Affiliation(s)
- Long Xin
- Clinical Laboratory, Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, China.
| | - Chun Zhang
- Clinical Laboratory, Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, China.
| | - Fuhua Zhong
- Clinical Laboratory, Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, China.
| | - Shunwu Fan
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Wei Wang
- Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, China. .,Department of Polymer Materials Science and Engineering, Tianjin University, Tianjin, China.
| | - Zhenbin Wang
- Clinical Laboratory, Department of Spine Surgery, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, China.
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The effect of the fibre orientation of electrospun scaffolds on the matrix production of rabbit annulus fibrosus-derived stem cells. Bone Res 2015; 3:15012. [PMID: 26273539 PMCID: PMC4472148 DOI: 10.1038/boneres.2015.12] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/18/2015] [Accepted: 04/14/2015] [Indexed: 01/07/2023] Open
Abstract
Annulus fibrosus (AF) tissue engineering has recently received increasing attention as a treatment for intervertebral disc (IVD) degeneration; however, such engineering remains challenging because of the remarkable complexity of AF tissue. In order to engineer a functional AF replacement, the fabrication of cell-scaffold constructs that mimic the cellular, biochemical and structural features of native AF tissue is critical. In this study, we fabricated aligned fibrous polyurethane scaffolds using an electrospinning technique and used them for culturing AF-derived stem/progenitor cells (AFSCs). Random fibrous scaffolds, also prepared via electrospinning, were used as a control. We compared the morphology, proliferation, gene expression and matrix production of AFSCs on aligned scaffolds and random scaffolds. There was no apparent difference in the attachment or proliferation of cells cultured on aligned scaffolds and random scaffolds. However, compared to cells on random scaffolds, the AFSCs on aligned scaffolds were more elongated and better aligned, and they exhibited higher gene expression and matrix production of collagen-I and aggrecan. The gene expression and protein production of collagen-II did not appear to differ between the two groups. Together, these findings indicate that aligned fibrous scaffolds may provide a favourable microenvironment for the differentiation of AFSCs into cells similar to outer AF cells, which predominantly produce collagen-I matrix.
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Current trends in biologics delivery to restore intervertebral disc anabolism. Adv Drug Deliv Rev 2015; 84:146-58. [PMID: 25174310 DOI: 10.1016/j.addr.2014.08.008] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 07/31/2014] [Accepted: 08/20/2014] [Indexed: 12/30/2022]
Abstract
Low back pain is generally attributed to intervertebral disc (IVD) degeneration. This is a multifactorial disease induced by genetic and environmental factors and that progresses with aging. Disc degeneration is characterized by a limited ability of IVD cells to produce functional matrix while producing abnormal amounts of matrix-degrading enzymes. The prolonged imbalance between anabolism and catabolism in degenerative discs alters their composition and hydration. In turn, this results in increased angiogenesis and the loss of the disc's ability to maintain its aneural condition. Inflammation in the IVD, in particular the presence of pro-inflammatory cytokines, was found to favor innervation and also sensitization of the nociceptive pathways, thereby exacerbating degenerative symptoms. In this review, we discuss anti-inflammatory approaches to encounter disc catabolism, potential treatments to lower discogenic pain and pro-anabolic approaches in the form of protein delivery, gene therapy and cell delivery, to trigger regeneration in the IVD.
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Guo Q, Liu C, Li J, Zhu C, Yang H, Li B. Gene expression modulation in TGF-β3-mediated rabbit bone marrow stem cells using electrospun scaffolds of various stiffness. J Cell Mol Med 2015; 19:1582-92. [PMID: 25752910 PMCID: PMC4511356 DOI: 10.1111/jcmm.12533] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 12/19/2014] [Indexed: 01/07/2023] Open
Abstract
Tissue engineering has recently evolved into a promising approach for annulus fibrosus (AF) regeneration. However, selection of an ideal cell source, which can be readily differentiated into AF cells of various regions, remains challenging because of the heterogeneity of AF tissue. In this study, we set out to explore the feasibility of using transforming growth factor-β3-mediated bone marrow stem cells (tBMSCs) for AF tissue engineering. Since the differentiation of stem cells significantly relies on the stiffness of substrate, we fabricated nanofibrous scaffolds from a series of biodegradable poly(ether carbonate urethane)-urea (PECUU) materials whose elastic modulus approximated that of native AF tissue. We cultured tBMSCs on PECUU scaffolds and compared their gene expression profile to AF-derived stem cells (AFSCs), the newly identified AF tissue-specific stem cells. As predicted, the expression of collagen-I in both tBMSCs and AFSCs increased with scaffold stiffness, whereas the expression of collagen-II and aggrecan genes showed an opposite trend. Interestingly, the expression of collagen-I, collagen-II and aggrecan genes in tBMSCs on PECUU scaffolds were consistently higher than those in AFSCs regardless of scaffold stiffness. In addition, the cell traction forces (CTFs) of both tBMSCs and AFSCs gradually decreased with scaffold stiffness, which is similar to the CTF change of cells from inner to outer regions of native AF tissue. Together, findings from this study indicate that tBMSCs had strong tendency to differentiate into various types of AF cells and presented gene expression profiles similar to AFSCs, thereby establishing a rationale for the use of tBMSCs in AF tissue engineering.
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Affiliation(s)
- Qianping Guo
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.,Orthopedic Institute, Soochow University, Suzhou, Jiangsu, China
| | - Chen Liu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jun Li
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Caihong Zhu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.,Orthopedic Institute, Soochow University, Suzhou, Jiangsu, China
| | - Huilin Yang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.,Orthopedic Institute, Soochow University, Suzhou, Jiangsu, China
| | - Bin Li
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.,Orthopedic Institute, Soochow University, Suzhou, Jiangsu, China
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Xu B, Du L, Zhang J, Zhu M, Ji S, Zhang Y, Kong D, Ma X, Yang Q, Wang L. Circumferentially oriented microfiber scaffold prepared by wet-spinning for tissue engineering of annulus fibrosus. RSC Adv 2015. [DOI: 10.1039/c5ra03347k] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Repairing damaged annulus fibrosus (AF) is one of the most challenging topics for treating intervertebral disc (IVD) disease.
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Qin G, Panilaitis BJ, Kaplan ZSDL. A cellulosic responsive “living” membrane. Carbohydr Polym 2014; 100:40-5. [DOI: 10.1016/j.carbpol.2013.06.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 05/09/2013] [Accepted: 06/14/2013] [Indexed: 02/02/2023]
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Vadalà G, Russo F, Di Martino A, Denaro V. Intervertebral disc regeneration: from the degenerative cascade to molecular therapy and tissue engineering. J Tissue Eng Regen Med 2013; 9:679-90. [PMID: 23512973 DOI: 10.1002/term.1719] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 12/21/2012] [Accepted: 01/05/2013] [Indexed: 12/21/2022]
Abstract
Low back pain is one of the major health problems in industrialized countries, as a leading source of disability in the working population. Intervertebral disc degeneration has been identified as its main cause, being a progressive process mainly characterized by alteration of extracellular matrix composition and water content. Many factors are involved in the degenerative cascade, such as anabolism/catabolism imbalance, reduction of nutrition supply and progressive cell loss. Currently available treatments are symptomatic, and surgical procedures consisting of disc removal are often necessary. Recent advances in our understanding of intervertebral disc biology led to an increased interest in the development of novel biological treatments aimed at disc regeneration. Growth factors, gene therapy, stem cell transplantation and biomaterials-based tissue engineering might support intervertebral disc regeneration by overcoming the limitation of the self-renewal mechanism. The aim of this paper is to overview the literature discussing the current status of our knowledge from the degenerative cascade of the intervertebral disc to the latest molecular, cell-based therapies and tissue-engineering strategies for disc regeneration.
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Affiliation(s)
- Gianluca Vadalà
- Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy
| | - Fabrizio Russo
- Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy
| | - Alberto Di Martino
- Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy
| | - Vincenzo Denaro
- Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy
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