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Xiang H, Zhao W, Jiang K, He J, Chen L, Cui W, Li Y. Progress in regulating inflammatory biomaterials for intervertebral disc regeneration. Bioact Mater 2024; 33:506-531. [PMID: 38162512 PMCID: PMC10755503 DOI: 10.1016/j.bioactmat.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/04/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Intervertebral disc degeneration (IVDD) is rising worldwide and leading to significant health issues and financial strain for patients. Traditional treatments for IVDD can alleviate pain but do not reverse disease progression, and surgical removal of the damaged disc may be required for advanced disease. The inflammatory microenvironment is a key driver in the development of disc degeneration. Suitable anti-inflammatory substances are critical for controlling inflammation in IVDD. Several treatment options, including glucocorticoids, non-steroidal anti-inflammatory drugs, and biotherapy, are being studied for their potential to reduce inflammation. However, anti-inflammatories often have a short half-life when applied directly and are quickly excreted, thus limiting their therapeutic effects. Biomaterial-based platforms are being explored as anti-inflammation therapeutic strategies for IVDD treatment. This review introduces the pathophysiology of IVDD and discusses anti-inflammatory therapeutics and the components of these unique biomaterial platforms as comprehensive treatment systems. We discuss the strengths, shortcomings, and development prospects for various biomaterials platforms used to modulate the inflammatory microenvironment, thus providing guidance for future breakthroughs in IVDD treatment.
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Affiliation(s)
- Honglin Xiang
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
| | - Weikang Zhao
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Orthopedic Laboratory of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, PR China
| | - Ke Jiang
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
| | - Jiangtao He
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
| | - Lu Chen
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
| | - Wenguo Cui
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, PR China
| | - Yuling Li
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
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Zhang X, Zhang Z, Zou X, Wang Y, Qi J, Han S, Xin J, Zheng Z, Wei L, Zhang T, Zhang S. Unraveling the mechanisms of intervertebral disc degeneration: an exploration of the p38 MAPK signaling pathway. Front Cell Dev Biol 2024; 11:1324561. [PMID: 38313000 PMCID: PMC10834758 DOI: 10.3389/fcell.2023.1324561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/28/2023] [Indexed: 02/06/2024] Open
Abstract
Intervertebral disc (IVD) degeneration (IDD) is a worldwide spinal degenerative disease. Low back pain (LBP) is frequently caused by a variety of conditions brought on by IDD, including IVD herniation and spinal stenosis, etc. These conditions bring substantial physical and psychological pressure and economic burden to patients. IDD is closely tied with the structural or functional changes of the IVD tissue and can be caused by various complex factors like senescence, genetics, and trauma. The IVD dysfunction and structural changes can result from extracellular matrix (ECM) degradation, differentiation, inflammation, oxidative stress, mechanical stress, and senescence of IVD cells. At present, the treatment of IDD is basically to alleviate the symptoms, but not from the pathophysiological changes of IVD. Interestingly, the p38 mitogen-activated protein kinase (p38 MAPK) signaling pathway is involved in many processes of IDD, including inflammation, ECM degradation, apoptosis, senescence, proliferation, oxidative stress, and autophagy. These activities in degenerated IVD tissue are closely relevant to the development trend of IDD. Hence, the p38 MAPK signaling pathway may be a fitting curative target for IDD. In order to better understand the pathophysiological alterations of the intervertebral disc tissue during IDD and offer potential paths for targeted treatments for intervertebral disc degeneration, this article reviews the purpose of the p38 MAPK signaling pathway in IDD.
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Affiliation(s)
- Xingmin Zhang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
| | - Zilin Zhang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
| | - Xiaosong Zou
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
| | - Yongjie Wang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
| | - Jinwei Qi
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
| | - Song Han
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
| | - Jingguo Xin
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
| | - Zhi Zheng
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
| | - Lin Wei
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
| | - Tianhui Zhang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
| | - Shaokun Zhang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China
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Tu Z, Han F, Zhu Z, Yu Q, Liu C, Bao Y, Li B, Zhou F. Sustained release of basic fibroblast growth factor in micro/nanofibrous scaffolds promotes annulus fibrosus regeneration. Acta Biomater 2023; 166:241-253. [PMID: 37230436 DOI: 10.1016/j.actbio.2023.05.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 05/14/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
Tissue engineering has promising applications in the treatment of intervertebral disc degeneration (IDD). The annulus fibrosus (AF) is critical for maintaining the physiological function of the intervertebral disc (IVD), but the lack of vessels and nutrition in AF makes it difficult to repair. In this study, we used hyaluronan (HA) micro-sol electrospinning and collagen type I (Col-I) self-assembly techniques to fabricate layered biomimetic micro/nanofibrous scaffolds, which released basic fibroblast growth factor (bFGF) to promote AF repair and regeneration after discectomy and endoscopic transforaminal discectomy. The bFGF enveloped in the core of the poly-L-lactic-acid (PLLA) core-shell structure was released in a sustained manner and promoted the adhesion and proliferation of AF cells (AFCs). Col-I could self-assemble on the shell of the PLLA core-shell scaffold to mimic the extracellular matrix (ECM) microenvironment, providing structural and biochemical cues for the regeneration of AF tissue. The in vivo studies showed that the micro/nanofibrous scaffolds promoted the repair of AF defects by simulating the microstructure of native AF tissue and inducing endogenous regeneration mechanism. Taken together, the biomimetic micro/nanofibrous scaffolds have clinical potential for the treatment of AF defects caused by IDD. STATEMENT OF SIGNIFICANCE: The annulus fibrosus (AF) is essential for the intervertebral disc (IVD) physiological function, yet it lacks vascularity and nutrition, making repair difficult. Micro-sol electrospinning technology and collagen type I (Col-I) self-assembly technique were combined in this study to create a layered biomimetic micro/nanofibrous scaffold that releases basic fibroblast growth factor (bFGF) to promote AF repair and regeneration. Col-I could mimic the extracellular matrix (ECM) microenvironment, in vivo, offering structural and biochemical cues for AF tissue regeneration. This research indicates that micro/nanofibrous scaffolds have clinical potential for treating AF deficits induced by IDD.
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Affiliation(s)
- Zhengdong Tu
- Department of Orthopaedic Surgery, Orthopedic Institute, The First Affiliated Hospital, School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Feng Han
- Department of Orthopaedic Surgery, Orthopedic Institute, The First Affiliated Hospital, School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Zhuang Zhu
- Department of Orthopaedic Surgery, Orthopedic Institute, The First Affiliated Hospital, School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Qifan Yu
- Department of Orthopaedic Surgery, Orthopedic Institute, The First Affiliated Hospital, School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Changjiang Liu
- Department of Orthopaedic Surgery, Orthopedic Institute, The First Affiliated Hospital, School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Yu Bao
- Department of Orthopaedic Surgery, Orthopedic Institute, The First Affiliated Hospital, School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Bin Li
- Department of Orthopaedic Surgery, Orthopedic Institute, The First Affiliated Hospital, School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China.
| | - Feng Zhou
- Department of Orthopaedic Surgery, Orthopedic Institute, The First Affiliated Hospital, School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China.
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Shnayder NA, Ashkhotov AV, Trefilova VV, Nurgaliev ZA, Novitsky MA, Petrova MM, Narodova EA, Al-Zamil M, Chumakova GA, Garganeeva NP, Nasyrova RF. Molecular Basic of Pharmacotherapy of Cytokine Imbalance as a Component of Intervertebral Disc Degeneration Treatment. Int J Mol Sci 2023; 24:ijms24097692. [PMID: 37175399 PMCID: PMC10178334 DOI: 10.3390/ijms24097692] [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: 04/04/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Intervertebral disc degeneration (IDD) and associated conditions are an important problem in modern medicine. The onset of IDD may be in childhood and adolescence in patients with a genetic predisposition. With age, IDD progresses, leading to spondylosis, spondylarthrosis, herniated disc, spinal canal stenosis. One of the leading mechanisms in the development of IDD and chronic back pain is an imbalance between pro-inflammatory and anti-inflammatory cytokines. However, classical therapeutic strategies for correcting cytokine imbalance in IDD do not give the expected response in more than half of the cases. The purpose of this review is to update knowledge about new and promising therapeutic strategies based on the correction of the molecular mechanisms of cytokine imbalance in patients with IDD. This review demonstrates that knowledge of the molecular mechanisms of the imbalance between pro-inflammatory and anti-inflammatory cytokines may be a new key to finding more effective drugs for the treatment of IDD in the setting of acute and chronic inflammation.
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Affiliation(s)
- Natalia A Shnayder
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia
- Shared Core Facilities "Molecular and Cell Technologies", V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia
| | - Azamat V Ashkhotov
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia
| | - Vera V Trefilova
- Department of Neurology, Hospital for War Veterans, 193079 Saint Petersburg, Russia
| | - Zaitun A Nurgaliev
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia
- Department of Neurology, Hospital for War Veterans, 193079 Saint Petersburg, Russia
| | - Maxim A Novitsky
- Department of Neurology, Hospital for War Veterans, 193079 Saint Petersburg, Russia
| | - Marina M Petrova
- Shared Core Facilities "Molecular and Cell Technologies", V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia
| | - Ekaterina A Narodova
- Shared Core Facilities "Molecular and Cell Technologies", V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia
| | - Mustafa Al-Zamil
- Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples' Friendship University of Russia, 117198 Moscow, Russia
| | - Galina A Chumakova
- Department of Therapy and General Medical Practice with a Course of Postgraduate Professional Education, Altai State Medical University, 656038 Barnaul, Russia
| | - Natalia P Garganeeva
- Department of General Medical Practice and Outpatient Therapy, Siberian State Medical University, 634050 Tomsk, Russia
| | - Regina F Nasyrova
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia
- International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, 443016 Samara, Russia
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Platelet-Rich Plasma-Releasate (PRPr) for the Treatment of Discogenic Low Back Pain Patients: Long-Term Follow-Up Survey. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030428. [PMID: 35334604 PMCID: PMC8952290 DOI: 10.3390/medicina58030428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022]
Abstract
Background and Objectives: Clinical studies of platelet-rich plasma (PRP) for the treatment of low back pain (LBP) have been reported; however, less is known about its long-term efficiency. Materials and Methods: This study was a long-term follow-up of a previous prospective clinical feasibility study for the use of PRP releasate (PRPr) to treat discogenic LBP patients. Among 14 patients, 11 patients were evaluated for a long-term survey. The efficacy was assessed by a visual analogue scale (VAS) for LBP intensity and the Roland-Morris Disability Questionnaire (RDQ) for LBP-related disability. Radiographic disc height was evaluated for seven patients. Results: Improvements in VAS and RDQ were sustained at an average of 5.9 years after the intradiscal injection of PRPr (p < 0.01 vs. baseline, respectively). Clinically meaningful improvements (more than 30% decrease from baseline) in VAS and RDQ were identified in 91% of patients at final survey. The radiographic measurement of disc height of PRPr-injected discs showed a mild decrease (13.8% decrease compared to baseline) during the average 5.9 years. Conclusions: The results of this study with a small number of patients suggest that the intradiscal injection of PRPr has a safe and efficacious effect on LBP improvement for more than 5 years after treatment. Further large-scale studies would be needed to confirm the clinical evidence for the use of PRPr for the treatment of patients with discogenic LBP.
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DiStefano TJ, Vaso K, Danias G, Chionuma HN, Weiser JR, Iatridis JC. Extracellular Vesicles as an Emerging Treatment Option for Intervertebral Disc Degeneration: Therapeutic Potential, Translational Pathways, and Regulatory Considerations. Adv Healthc Mater 2022; 11:e2100596. [PMID: 34297485 PMCID: PMC8783929 DOI: 10.1002/adhm.202100596] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/08/2021] [Indexed: 12/14/2022]
Abstract
Emergent approaches in regenerative medicine look toward the use of extracellular vesicles (EVs) as a next-generation treatment strategy for intervertebral disc (IVD) degeneration (IVDD) because of their ability to attenuate chronic inflammation, reduce apoptosis, and stimulate proliferation in a number of tissue systems. Yet, there are no Food and Drug Administration (FDA)-approved EV therapeutics in the market with an indication for IVDD, which motivates this article to review the current state of the field and provide an IVD-specific framework to assess its efficacy. In this systematic review, 29 preclinical studies that investigate EVs in relation to the IVD are identified, and additionally, the regulatory approval process is reviewed in an effort to accelerate emerging EV-based therapeutics toward FDA submission and timeline-to-market. The majority of studies focus on nucleus pulposus responses to EV treatment, where the main findings show that stem cell-derived EVs can decelerate the progression of IVDD on the molecular, cellular, and organ level. The findings also highlight the importance of the EV parent cell's pathophysiological and differentiation state, which affects downstream treatment responses and therapeutic outcomes. This systematic review substantiates the use of EVs as a promising cell-free strategy to treat IVDD and enhance endogenous repair.
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Affiliation(s)
- Tyler J. DiStefano
- Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Keti Vaso
- Department of Chemical Engineering, The Cooper Union for the Advancement of Science and Art, New York NY, USA
| | - George Danias
- Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Henry N. Chionuma
- Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York NY, USA
| | - Jennifer R. Weiser
- Department of Chemical Engineering, The Cooper Union for the Advancement of Science and Art, New York NY, USA
| | - James C. Iatridis
- Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York NY, USA
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Platelet-Rich Plasma Releasate versus Corticosteroid for the Treatment of Discogenic Low Back Pain: A Double-Blind Randomized Controlled Trial. J Clin Med 2022; 11:jcm11020304. [PMID: 35053999 PMCID: PMC8777786 DOI: 10.3390/jcm11020304] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 12/15/2022] Open
Abstract
Clinical application of platelet-rich plasma is gaining popularity in treating low back pain (LBP). This study investigated the efficacy and safety of platelet-rich plasma releasate (PRPr) injection into degenerated discs of patients with discogenic LBP. A randomized, double-blind, active-controlled clinical trial was conducted. Sixteen patients with discogenic LBP received an intradiscal injection of either autologous PRPr or corticosteroid (CS). Patients in both groups who wished to have PRPr treatment received an optional injection of PRPr eight weeks later. The primary outcome was change in VAS from baseline at eight weeks. Secondary outcomes were pain, disability, quality of life (QOL), image analyses of disc degeneration, and safety for up to 60 weeks. The VAS change at eight weeks did not significantly differ between the two groups. Fifteen patients received the optional injection. Compared to the CS group, the PRPr group had a significantly improved disability score at 26 weeks and walking ability scores at four and eight weeks. Radiographic disc height and MRI grading score were unchanged from baseline. PRPr caused no clinically important adverse events. PRPr injection showed clinically significant improvements in LBP intensity equal to that of CS. PRPr treatment relieved pain, and improved disability and QOL during 60 weeks of observation.
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8
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Muresanu C, Somasundaram SG, Vissarionov SV, Gavryushova LV, Nikolenko VN, Mikhaleva LM, Kirkland CE, Aliev G. Hypothetical Role of Growth Factors to Reduce Intervertebral Disc Degeneration Significantly through Trained Biological Transformations. Curr Pharm Des 2021; 27:2221-2230. [PMID: 33076800 DOI: 10.2174/1381612826666201019104201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/11/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Given the evidence of little or no therapeutic benefit of injection-based growth factor therapies, it has been proposed that a naturally triggered uninterrupted blood circulation of the growth factors would be superior. OBJECTIVE We seek to stimulate discussions and more research about the possibility of using the already available growth factors found in the prostate gland and endometrium by starting novel educable physiology, known as biological transformations controlled by the mind. METHODS We summarized the stretch-gated ion channel mechanism of the cell membrane and offer several practical methods that can be applied by anyone, in order to stimulate and enhance the blood circulation of the growth factors from the seminal fluid to sites throughout the body. This study describes, in detail, the practical application of our earlier published studies about biological transformations. RESULTS A previously reported single-patient case study has been extended, adding more from his personal experiences to continually improve this novel physiological training and extending the ideas from our earlier findings in detail. CONCLUSION The biological transformation findings demonstrate the need for additional research to establish the benefits of these natural therapies to repair and rejuvenate tissues affected by various chronic diseases or aging processes.
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Affiliation(s)
- Cristian Muresanu
- Research Center for Applied Biotechnology in Diagnosis and Molecular Therapies (BIODIATECH), Str. Trifoiului nr. 12 G, 400478, Cluj-Napoca, Romania
| | - Siva G Somasundaram
- Department of Biological Sciences, Salem University, Salem, WV 26426, United States
| | - Sergey V Vissarionov
- Department of Spinal Pathology and Neurosurgery, Turner Scientific and Research Institute for Children's Orthopedics, Street Parkovskya 64-68, Pushkin, Saint-Petersburg, 196603, Russian Federation
| | - Liliya V Gavryushova
- Saratov State Medical University named after V.I. Razumovsky, 410012, Saratov, Russian Federation
| | - Vladimir N Nikolenko
- I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow, 119991, Russian Federation
| | - Liudmila M Mikhaleva
- Federal State Budgetary Institution, Research Institute of Human Morphology, 3, Tsyurupy Str., Moscow, 117418, Russian Federation
| | - Cecil E Kirkland
- Department of Biological Sciences, Salem University, Salem, WV 26426, United States
| | - Gjumrakch Aliev
- I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str., Moscow, 119991, Russian Federation
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9
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A comparative study of mesenchymal stem cell transplantation and NTG-101 molecular therapy to treat degenerative disc disease. Sci Rep 2021; 11:14804. [PMID: 34285277 PMCID: PMC8292352 DOI: 10.1038/s41598-021-94173-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 07/07/2021] [Indexed: 02/06/2023] Open
Abstract
Cellular replacement therapy using mesenchymal stem cells (MSCs) and/or the delivery of growth factors are at the forefront of minimally invasive biological treatment options for Degenerative Disc Disease (DDD). In this study, we compared the therapeutic potential of a novel drug candidate, NTG-101 to MSCs, including rat cartilage derived stem cells (rCDSCs), bone marrow stem cells (rBMSCs) and human Umbilical Cord Derived Mesenchymal Stem Cells (hUCMSCs) for the treatment of DDD. We induced DDD using a validated image-guided needle puncture injury in rat-tail IVDs. Ten weeks post-injury, animals were randomized and injected with MSCs, NTG-101 or vehicle. At the end of the study, histological analysis of the IVD-Nucleus Pulposus (NPs) injected with NTG-101 or rCDSCs showed a healthy or mild degenerative phenotype in comparison to vehicle controls. Immunohistochemical analysis revealed strong expression of aggrecan, collagen 2, brachyury and Oct4 in IVD-NPs injected with NTG-101. Our results also demonstrated suppression of inflammation induced p38 and NFκB resulting in inhibition of catabolic genes, but activation of Smad-2/3, Erk-1/2 and Akt-dependent signaling inducing anabolic genes in IVD-NP on treatment with NTG-101. In conclusion, a single injection of NTG-101 into the degenerative disc demonstrated superior benefits compared to stem cell transplantation.
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10
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Kritschil R, Zhang Z, Lei C, Zhong J, Dong Q, Lee J, Conover CA, Sowa G, Vallejo AN, Vo N. Effects of suppressing bioavailability of insulin-like growth factor on age-associated intervertebral disc degeneration. JOR Spine 2020; 3:e1112. [PMID: 33392450 PMCID: PMC7770198 DOI: 10.1002/jsp2.1112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 01/07/2023] Open
Abstract
Suppression of the insulin-like growth factor-1 (IGF-1) signaling pathway reduces age-related disorders and increases lifespan across species, making the IGF-1 pathway a key regulator of aging. Previous in vitro intervertebral disc cell studies have reported the pro-anabolic effect of exogenously adding IGF-1 on matrix production. However, the overall effects of suppressing IGF-1 signaling on age-related intervertebral disc degeneration (IDD) is not known. Here, the effects of suppressing IGF-1 signaling on age-related IDD in vivo were examined using PAPPA -/- mice. These are animals with targeted deletion of pregnancy-associated plasma protein A (PAPPA), the major protease that cleaves inhibitory IGF binding proteins that control bioavailability of IGF-1 for cell signaling. Compared to age-matched wild-type (Wt) littermates, reduced levels of matrix proteoglycan (PG) and aggrecan were seen in discs of 23-month old PAPPA -/- mice. Decreased aggrecanolysis and expression of two key catabolic markers, matrix metalloproteinase-3 and a disintegrin and metalloproteinase with thrombospondin motifs-4, were also observed in discs of old PAPPA -/- mice compared to Wt littermates. Suppressing IGF-1 signaling has been implicated to shift cellular metabolism toward maintenance rather than growth and decreasing cellular senescence. Along this line, discs of old PAPPA -/- mice also exhibited lower cellular senescence, assessed by p53 and lamin B1 markers. Collectively, the data reveal complex regulation of disc matrix homeostasis by PAPPA/IGF-1 signaling during chronologic aging, that is, reduced IGF-1 bioavailability confers the benefit of decreasing disc cellular senescence and matrix catabolism but also the disadvantage of decreasing disc PG matrix anabolism. This pathway requires further mechanistic elucidation before IGF-1 could be considered as a therapeutic growth factor for treating IDD.
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Affiliation(s)
- Rebecca Kritschil
- Department of Orthopedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Zhongying Zhang
- Department of Orthopedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Orthopedic SurgeryKobe University Graduate School of MedicineKobeJapan
| | - Changbin Lei
- Department of Orthopedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryFirst Affiliated Hospital of Jinan UniversityGuangdongChina
| | - Jiongbiao Zhong
- Department of Orthopedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Spinal SurgeryThe First Affiliated Hospital of University of South ChinaHengyangHunanP.R.China
| | - Qing Dong
- Department of Orthopedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Joon Lee
- Department of Orthopedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Gwendolyn Sowa
- Department of Orthopedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Physical Medicine and RehabilitationUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Abbe N. Vallejo
- Department of Pediatrics, UPMC Children's Hospital of PittsburghUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Nam Vo
- Department of Orthopedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
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11
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Abstract
Biologics are a growing field that has shown immense promise for the treatment of musculoskeletal conditions both in orthopedic sports medicine and interventional pain management. These procedures utilize injection of supraphysiologic levels of platelets and growth factors to invoke the body's own inflammatory cascade to augment the healing of many bony and soft tissue conditions. While many patients improve with conservative care, there is a need to address the gap between those that improve with rehabilitation alone and those who ultimately require operative management. Orthobiologic procedures have the potential to fill this void. The purpose of this review is to summarize the basic science, evidence for use, and post-injection rehabilitation concepts of platelet-rich plasma (PRP) and mesenchymal stromal cells (MSCs) as they pertain to joints, tendons, ligaments, and the spine.
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Affiliation(s)
- Robert L Bowers
- Department of Physical Medicine and Rehabilitation, Emory University School of Medicine, Atlanta, GA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA.
| | - Wesley D Troyer
- Department of Physical Medicine and Rehabilitation, Emory University School of Medicine, Atlanta, GA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
| | - Rudolph A Mason
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA; Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA
| | - Kenneth R Mautner
- Department of Physical Medicine and Rehabilitation, Emory University School of Medicine, Atlanta, GA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA
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12
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Watanabe A, Mainil-Varlet P, Decambron A, Aschinger C, Schiavinato A. Efficacy of HYADD®4-G single intra-discal injections in a rabbit model of intervertebral disc degeneration. Biomed Mater Eng 2019; 30:403-417. [PMID: 31498118 DOI: 10.3233/bme-191062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Various biomaterials/technologies have been tested for treatment of intervertebral disc (IVD) degeneration (IDD). Only few non-surgical options exist. OBJECTIVE Assessment of efficacy and safety of the hyaluronic acid derivative hydrogel HYADD®4-G in IDD using a well-established rabbit annular puncture model. METHODS Rabbits were punctured at two IVDs to induce IDD. Thirty days after, IVDs were injected with HYADD®4-G or saline. IVD hydration, height, appearance and tissue organization were assessed by radiographs, MRI and histopathology. Safety of HYADD®4-G injection was evaluated in non-punctured IVDs. RESULTS HYADD®4-G injection restored disc height to over 75% of the pre-punctured disc, saline injections led to 50% of initial disc height. Compared to saline, HYADD®4-G treatment resulted in improved water retention as revealed by MRI quantification. 83.3% of HYADD®4-G injected discs had normal appearance and reached grade I of the Pfirrmann scale. Regarding tissue organization and cellularity, HYADD®4-G treatment resulted in significantly lower IDD scores than saline (p < 0.01). HYADD®4-G injected into healthy IVDs did not induce inflammation or foreign body reactions. CONCLUSIONS Intra-discal HYADD®4-G injection is safe and has therapeutic benefits: IDD could be limited through restoration of disc height and hydration and maintenance of normal IVD tissue organization.
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Affiliation(s)
- Atsuya Watanabe
- Department of General Medical Sciences, Chiba University, Chiba, Japan
| | | | - Adeline Decambron
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Surgery Unit CHUVA, Maisons-Alfort Cedex, France
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13
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Chen Z, Zhang W, Zhang N, Zhou Y, Hu G, Xue M, Liu J, Li Y. Down-regulation of insulin-like growth factor binding protein 5 is involved in intervertebral disc degeneration via the ERK signalling pathway. J Cell Mol Med 2019; 23:6368-6377. [PMID: 31290273 PMCID: PMC6714225 DOI: 10.1111/jcmm.14525] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/07/2019] [Accepted: 06/11/2019] [Indexed: 12/27/2022] Open
Abstract
It is obvious that epigenetic processes influence the evolution of intervertebral disc degeneration (IDD). However, its molecular mechanisms are poorly understood. Therefore, we tested the hypothesis that IGFBP5, a potential regulator of IDD, modulates IDD via the ERK signalling pathway. We showed that IGFBP5 mRNA was significantly down-regulated in degenerative nucleus pulposus (NP) tissues. IGFBP5 was shown to significantly promote NP cell proliferation and inhibit apoptosis in vitro, which was confirmed by MTT, flow cytometry and colony formation assays. Furthermore, IGFBP5 was shown to exert its effects by inhibiting the ERK signalling pathway. The effects induced by IGFBP5 overexpression on NP cells were similar to those induced by treatment with an ERK pathway inhibitor (PD98059). Moreover, qRT-PCR and Western blot analyses were performed to examine the levels of apoptosis-related factors, including Bax, caspase-3 and Bcl2. The silencing of IGFBP5 up-regulated the levels of Bax and caspase-3 and down-regulated the level of Bcl2, thereby contributing to the development of human IDD. Furthermore, these results were confirmed in vivo using an IDD rat model, which showed that the induction of Igfbp5 mRNA expression abrogated the effects of IGFBP5 silencing on intervertebral discs. Overall, our findings elucidate the role of IGFBP5 in the pathogenesis of IDD and provide a potential novel therapeutic target for IDD.
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Affiliation(s)
- Zhonghui Chen
- Orthopedic SurgeryRenmin Hospital of Wuhan University, Hubei General HospitalWuchang District, WuhanChina
| | - Weibing Zhang
- Orthopedic SurgeryRenmin Hospital of Wuhan University, Hubei General HospitalWuchang District, WuhanChina
| | - Nu Zhang
- Orthopedic SurgeryRenmin Hospital of Wuhan University, Hubei General HospitalWuchang District, WuhanChina
| | - Yan Zhou
- Orthopedic SurgeryRenmin Hospital of Wuhan University, Hubei General HospitalWuchang District, WuhanChina
| | - Geliang Hu
- Orthopedic SurgeryRenmin Hospital of Wuhan University, Hubei General HospitalWuchang District, WuhanChina
| | - Mingdi Xue
- Orthopedic SurgeryRenmin Hospital of Wuhan University, Hubei General HospitalWuchang District, WuhanChina
| | - Junhua Liu
- Orthopedic SurgeryChibi Third Renmin HospitalChibiChina
| | - Yaming Li
- Orthopedic SurgeryRenmin Hospital of Wuhan University, Hubei General HospitalWuchang District, WuhanChina
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14
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Intervertebral Disc Nucleus Repair: Hype or Hope? Int J Mol Sci 2019; 20:ijms20153622. [PMID: 31344903 PMCID: PMC6696292 DOI: 10.3390/ijms20153622] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/19/2019] [Accepted: 07/20/2019] [Indexed: 12/28/2022] Open
Abstract
Chronic back pain is a common disability, which is often accredited to intervertebral disc degeneration. Gold standard interventions such as spinal fusion, which are mainly designed to mechanically seal the defect, frequently fail to restore the native biomechanics. Moreover, artificial implants have limited success as a repair strategy, as they do not alter the underlying disease and fail to promote tissue integration and subsequent native biomechanics. The reported high rates of spinal fusion and artificial disc implant failure have pushed intervertebral disc degeneration research in recent years towards repair strategies. Intervertebral disc repair utilizing principles of tissue engineering should theoretically be successful, overcoming the inadequacies of artificial implants. For instance, advances in the development of scaffolds aided with cells and growth factors have opened up new possibilities for repair strategies. However, none has reached the stage of clinical trials in humans. In this review, we describe the hitches encountered in the musculoskeletal field and summarize recent advances in designing tissue-engineered constructs for promoting nucleus pulposus repair. Additionally, the review focuses on the effect of biomaterial aided with cells and growth factors on achieving effective functional reparative potency, highlighting the ways to enhance the efficacy of these treatments.
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15
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Wang SZ, Fan WM, Jia J, Ma LY, Yu JB, Wang C. Is exclusion of leukocytes from platelet-rich plasma (PRP) a better choice for early intervertebral disc regeneration? Stem Cell Res Ther 2018; 9:199. [PMID: 30021649 PMCID: PMC6052621 DOI: 10.1186/s13287-018-0937-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 06/07/2018] [Accepted: 06/19/2018] [Indexed: 02/06/2023] Open
Abstract
Background Platelet-rich plasma (PRP) is becoming a promising strategy to treat early intervertebral disc degeneration (IDD) in clinics. Pure PRP without leukocytes (P-PRP) may decrease the catabolic and inflammatory changes in the early degenerated intervertebral discs. The aim of this study was to investigate the effects of P-PRP on nucleus pulposus-derived stem cells (NPSCs) isolated from early degenerated intervertebral discs in vitro. Methods NPSCs isolated from early degenerated discs of rabbits were treated with P-PRP or leukocyte-platelet-rich PRP (L-PRP) in vitro, followed by measuring cell proliferation, stem cell marker expression, inflammatory gene expression, and anabolic and catabolic protein expression by immunostaining, quantitative real-time polymerase chain reaction, Western blot, and enzyme-linked immunosorbent assay. Results Cell proliferation was induced by P-PRP in a dose-dependent manner with maximum proliferation at 10% P-PRP dose. P-PRP induced differentiation of NPSCs into active nucleus pulposus cells. P-PRP mainly increased the expression of anabolic genes and relative proteins, aggrecan (AGC), collagen types II (Col II), while L-PRP predominantly increased the expression of catabolic and inflammatory genes, matrix metalloproteinase-1 (MMP-1), MMP-13, interleukin-1 beta (IL-1β), IL-6, tumor necrosis factor alpha (TNF-α), and protein production of IL-1β and TNF-α. Conclusions Leukocytes in PRP activate inflammatory and catabolic effects on NPSCs from early degenerated intervertebral discs. Hence, P-PRP may be a more suitable therapeutic strategy for early IDD.
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Affiliation(s)
- Shan-Zheng Wang
- The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China.,Department of Orthopaedics, Zhongda Hospital, Medical School of Southeast University, 87 Ding Jia Qiao Road, Nanjing, Jiangsu, 210009, People's Republic of China
| | - Wei-Min Fan
- The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, People's Republic of China.
| | - Jun Jia
- Department of Orthopaedics, Zhongda Hospital, Medical School of Southeast University, 87 Ding Jia Qiao Road, Nanjing, Jiangsu, 210009, People's Republic of China
| | - Liang-Yu Ma
- Department of Orthopaedics, Zhongda Hospital, Medical School of Southeast University, 87 Ding Jia Qiao Road, Nanjing, Jiangsu, 210009, People's Republic of China
| | - Jia-Bin Yu
- Department of Orthopaedics, Zhongda Hospital, Medical School of Southeast University, 87 Ding Jia Qiao Road, Nanjing, Jiangsu, 210009, People's Republic of China
| | - Chen Wang
- Department of Orthopaedics, Zhongda Hospital, Medical School of Southeast University, 87 Ding Jia Qiao Road, Nanjing, Jiangsu, 210009, People's Republic of China.
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16
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Flouzat-Lachaniette CH, Jullien N, Bouthors C, Beohou E, Laurent B, Bierling P, Dubory A, Rouard H. A novel in vivo porcine model of intervertebral disc degeneration induced by cryoinjury. INTERNATIONAL ORTHOPAEDICS 2018; 42:2263-2272. [DOI: 10.1007/s00264-018-3971-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 05/01/2018] [Indexed: 01/07/2023]
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17
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Mohammed S, Yu J. Platelet-rich plasma injections: an emerging therapy for chronic discogenic low back pain. JOURNAL OF SPINE SURGERY 2018; 4:115-122. [PMID: 29732431 DOI: 10.21037/jss.2018.03.04] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Autologous platelet-rich plasma (PRP) injections have been investigated in recent years as an emerging therapy for various musculoskeletal conditions, including lumbar degenerative disc disease. Although PRP has received increasing attention from medical science experts, comprehensive clinical reports of its efficacy are limited to those treating knee osteoarthritis and epicondylitis. Use of PRP is gaining popularity in the area of degenerative disc disease, but there is a clear need for reliable clinical evidence of its applications and effectiveness. In this article, we review the current literature on PRP therapy and its potential use in the treatment of chronic discogenic low back pain, with a focus on evidence from clinical trials.
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Affiliation(s)
- Suja Mohammed
- Australian Medical Research Institute, New South Wales, Australia
| | - James Yu
- Australian Medical Research Institute, New South Wales, Australia.,Sydney Spine and Pain, Hurstville, New South Wales, Australia
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18
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Hu MH, Yang KC, Chen YJ, Sun YH, Lin FH, Yang SH. Optimization of puncture injury to rat caudal disc for mimicking early degeneration of intervertebral disc. J Orthop Res 2018; 36:202-211. [PMID: 28594131 DOI: 10.1002/jor.23628] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 06/05/2017] [Indexed: 02/04/2023]
Abstract
The caudal discs of rats have been proposed as a puncture model in which intervertebral disc (IVD) degeneration can be induced and novel therapies can be tested. For biological repair, treatments for ongoing IVD degeneration are ideally administered during the earlier stages. The purpose of this study was to elucidate the optimal puncture needle size for creating a model that mimicked the earlier stages of IVD degeneration. According to the disc height index, histologic score, and MRI grading, a puncture needle sized 21G or larger induced rapid degenerative processes in rat caudal discs during the initial 2-4 weeks. The degenerative changes were severe and continued deteriorating after 4 weeks. Conversely, puncture injury induced by needles sized 25G or smaller also produced degenerative changes in rat caudal discs during initial 2-4 weeks; however, the changes were less severe. Furthermore, the degenerative process became stabilized and showed no further deterioration or spontaneous recovery after 4 weeks. In the discs punctured by 25G needles, the expression of collagen I was increased at 2-4 weeks with a gradually fibrotic transformation thereafter. The expressions of collagen II and SOX9 were enhanced initially but returned to pre-injury levels at 4-8 weeks. The above-mentioned findings were more compatible with earlier degeneration in discs punctured by needles sized 25G or smaller than by needles sized 21G or larger, and the appropriate timing for intradiscal administration of proposed therapeutic agents would be 4 weeks or longer after puncture. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:202-211, 2018.
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Affiliation(s)
- Ming-Hsiao Hu
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.,Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Kai-Chiang Yang
- Department of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yeong-Jang Chen
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Yuan-Hui Sun
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Feng-Huei Lin
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.,Institute of Biomedical Engineering & Nanomedicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Shu-Hua Yang
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
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19
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Peck SH, McKee KK, Tobias JW, Malhotra NR, Harfe BD, Smith LJ. Whole Transcriptome Analysis of Notochord-Derived Cells during Embryonic Formation of the Nucleus Pulposus. Sci Rep 2017; 7:10504. [PMID: 28874804 PMCID: PMC5585380 DOI: 10.1038/s41598-017-10692-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 08/14/2017] [Indexed: 01/07/2023] Open
Abstract
Recapitulation of developmental signals represents a promising strategy for treating intervertebral disc degeneration. During development, embryonic notochord-derived cells (NDCs) are the direct progenitors of cells that populate the adult nucleus pulposus (NP) and are an important source of secreted signaling molecules. The objective of this study was to define global gene expression profiles of NDCs at key stages of embryonic disc formation. NDCs were isolated from Shh-cre;ROSA:YFP mice at embryonic day 12.5 and postnatal day 0, representing opposite ends of the notochord to NP transformation. Differences in global mRNA abundance across this developmental window were established using RNA-Seq. Protein expression of selected molecules was confirmed using immunohistochemistry. Principal component analysis revealed clustering of gene expression at each developmental stage with more than 5000 genes significantly differentially expressed between E12.5 and P0. There was significantly lower mRNA abundance of sonic hedgehog pathway elements at P0 vs E12.5, while abundance of elements of the transforming growth factor-beta and insulin-like growth factors pathways, and extracellular matrix components including collagen 6 and aggrecan, were significantly higher at P0. This study represents the first transcriptome-wide analysis of embryonic NDCs. Results suggest signaling and biosynthesis of NDCs change dramatically as a function of developmental stage.
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Affiliation(s)
- Sun H Peck
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kendra K McKee
- Department of Molecular Genetics and Microbiology, The Genetics Institute, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - John W Tobias
- Penn Genomics Analysis Core, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Neil R Malhotra
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Brian D Harfe
- Department of Molecular Genetics and Microbiology, The Genetics Institute, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Lachlan J Smith
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. .,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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20
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Tian FM, Li SY, Yang K, Luo Y, Dai MW, Liu GY, Song HP, Zhang L. Orally administered simvastatin partially preserves lumbar vertebral bone mass but not integrity of intervertebral discs in ovariectomized rats. Exp Ther Med 2017; 13:877-884. [PMID: 28450913 PMCID: PMC5403518 DOI: 10.3892/etm.2017.4043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/10/2016] [Indexed: 12/29/2022] Open
Abstract
The present study aimed to investigate the effect of orally administered simvastatin on lumbar vertebral bone mass and intervertebral disc (IVD) degeneration in ovariectomized (OVX) rats. A total of 30 female Sprague-Dawley (SD) rats were subjected to either bilateral ovariectomy (n=20) or sham surgery (n=10). After 12 weeks, the OVX rats were orally administered either saline vehicle (OVX + V group; n=10), or 5 mg/kg/day simvastatin (OVX + SIM group; n=10). Following 12 weeks of treatment, necropsy was conducted and bone mineral density (BMD) was determined in the L5-6 vertebrae. Furthermore, the microstructure and biomechanical properties of the L3 vertebrae were detected by micro-computed tomography and compression testing, respectively. The L5-6 vertebrae were analyzed by measurement of IVD height, observation of histological changes by van Gieson staining, and evaluation of collagen-II (col-II), aggrecan (AGG) and collagen I (col-I) expression by immunohistochemical analysis. Rats in the OVX+V group had lower BMD, bone volume/trabecular volume ratio, maximum load and elastic modulus than the sham group. Rats in the OVX + SIM group had higher BMD and biomechanical strength values than the rats in the OVX+V group. Histological analysis showed that the OVX + V and OVX + SIM groups exhibited significantly higher disc degeneration scores and significantly lower IVD height than the sham group. Immunohistochemical analysis revealed lower expression levels of col-II and AGG, but higher levels of col-I in the annulus fibrosis and endplate in OVX+V rats compared with the sham group. The OVX + SIM group exhibited levels of col-II, AGG and col-I expression comparable with those of OVX+V rats, with the exception of an upregulation of col-II expression in the annulus fibrosis. These data demonstrate that simvastatin treatment partially prevented bone loss and the deterioration of biomechanical properties of lumbar vertebrae, but not the progression of IVD degeneration in OVX rats.
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Affiliation(s)
- Fa-Ming Tian
- Medical Research Center, North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Shu-Yang Li
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Kai Yang
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Yang Luo
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Mu-Wei Dai
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Guang-Yuan Liu
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Hui-Ping Song
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
| | - Liu Zhang
- Department of Orthopedic Surgery, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei 063000, P.R. China
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21
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Li P, Zhang R, Gan Y, Wang L, Zhao C, Luo L, Zhang C, Zhou Q. Effects of osteogenic protein-1 on intervertebral disc regeneration: A systematic review of animal studies. Biomed Pharmacother 2017; 88:260-266. [DOI: 10.1016/j.biopha.2016.12.137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 12/12/2016] [Accepted: 12/14/2016] [Indexed: 01/31/2023] Open
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22
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Huang Z, Zhang L, Feng X, Chen T, Bi S. A new in vivo method to retard progression of intervertebral disc degeneration through stimulation of endogenous stem cells with simvastatin. Med Hypotheses 2017; 101:65-66. [PMID: 28351496 DOI: 10.1016/j.mehy.2017.02.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 02/27/2017] [Indexed: 01/07/2023]
Abstract
Degenerative disc disease is a worldwide problem, however, conservative treatment and surgical treatment can only partly relieve symptoms, but do not have therapeutic effect on the degenerated intervertebral disc (IVD) itself. The use of stem cell transplantation has become one of the most popular treatments. With gradually understanding of the endogenous mechanism of stem cells migration and movement in vivo, endogenous IVD stem cells can be activated to repair and reconstruct the degenerated IVD. Nucleus pulposus mensenchymal stem cells exhibit more potent biological activity in the hypoxic environment of the IVD. Hypoxia inducible factor can regulate the energy metabolism of IVD cells by activating Glucose transporter 1 pathway. The simvastatin can enhance the theraprutic effect of many kinds of stem cells by increasing number and function of the stem cell. Herein we postulate that simvastatin can regulate the differentiation of nucleus pulposus mensenchymal stem cells into nucleus pulposus cell by promoting expression of hypoxia inducible factor to repair and reconstruct degenerated IVD.
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Affiliation(s)
- Zenan Huang
- Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China; Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, Jiangsu Province, China
| | - Liang Zhang
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, Jiangsu Province, China.
| | - Xinmin Feng
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, Jiangsu Province, China
| | - Tao Chen
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, Jiangsu Province, China; Xiangya School of Medicine Central South University, Changsha 410013, Hunan Province, China
| | - Songchao Bi
- Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China; Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, Jiangsu Province, China
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23
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Yang SH, Hu MH, Lo WY, Sun YH, Wu CC, Yang KC. The influence of oxygen concentration on the extracellular matrix production of human nucleus pulposus cells during isolation-expansion process. J Biomed Mater Res A 2017; 105:1575-1582. [PMID: 28142219 DOI: 10.1002/jbm.a.36020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 01/22/2017] [Accepted: 01/26/2017] [Indexed: 12/19/2022]
Abstract
Nucleus pulposus (NP) cells locate in the center of avascular intervertebral discs, and thus have presumably adapted to a hypoxic environment. The purpose of this study was to investigate the influences of hypoxic condition, during isolation-expansion of human NP cells, on the cellular proliferation and extracellular matrix (ECM) synthesis in later three-dimensional cultures. Human NP tissues were obtained from patients who underwent lumbar disc surgeries. Immediately after retrieval, NP tissues from each patient were divided into two aliquots for in vitro cultivation either under classical normoxic (21% O2 ) or hypoxic (3.5% O2 ) condition. After isolation-expansion processes, microtissues of NP cells were formed and the analysis was performed after one-week culture. Experiments of pretreatment with TGF-β1 or lovastatin were designed to investigate if the isolation-expansion conditions affect the responsiveness to later exogenous treatments. Hypoxic isolation-expansion stimulated NP cell proliferation during monolayer culture. Hypoxia also upregulated mRNA levels of SOX9 and HIF-1α but downregulated type X collagen as well as improved aggrecan and type II collagen synthesis. Although TGF-β1 had no substantial effect, lovastatin pretreatment showed a greater enhancement on type II collagen expression in hypoxic group. Normoxia negatively affected the biochemical composition of regenerated ECM attributable to downregulation of SOX9 and HIF-1α, while hypoxia enhanced cellular proliferation, improved matrix production, and maintained a functional phenotype of NP cells. Hypoxic isolation-expansion of human NP cells is important to achieve better regenerative cells for later cultivation or cell transplantation. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 1575-1582, 2017.
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Affiliation(s)
- Shu-Hua Yang
- Department of Orthopedics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan
| | - Ming-Hsiao Hu
- Department of Orthopedics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan
- Institute of Biomedical Engineering, College of Medicine and Engineering, National Taiwan University, Taipei, 10031, Taiwan
| | - Wan-Yu Lo
- Department of Orthopedics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan
| | - Yuan-Hui Sun
- Department of Orthopedics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan
| | - Chang-Chin Wu
- Department of Orthopedics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 10002, Taiwan
- Department of Biomedical Engineering, Yuanpei University of Medical Technology, Hsinchu, 30015, Taiwan
- Department of Orthopedics, En Chu Kong Hospital, New Taipei City, 23702, Taiwan
| | - Kai-Chiang Yang
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan
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Chou PH, Wang ST, Ma HL, Liu CL, Chang MC, Lee OKS. Development of a two-step protocol for culture expansion of human annulus fibrosus cells with TGF-β1 and FGF-2. Stem Cell Res Ther 2016; 7:89. [PMID: 27405858 PMCID: PMC4942939 DOI: 10.1186/s13287-016-0332-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/27/2016] [Accepted: 04/28/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Different biologic approaches to treat disc regeneration, including growth factors (GFs) application, are currently under investigation. Human annulus fibrosus (hAF) repair or regeneration is one of the key elements for maintenance and restoration of nucleus pulposus function. However, so far there is no effective treatment for this purpose. The aim of the present study was to investigate the response of hAF cells to different combinations of GFs, and develop a protocol for efficient culture expansion. METHODS hAF cells were harvested from degenerated disc tissues during surgical intervertebral disc removal, and hAF cells were expanded in a monolayer. The experiments were categorized based on different protocols with transforming growth factor (TGF-β1) and fibroblast growth factor (FGF-2) culture for 14 days: group 1 had no GFs (control group); group 2 received TGF-β1; group 3 received FGF-2; group 4 received both GFs; and group 5 (two-step) received both GFs for the first 10 days and TGF-β1 only for the next 4 days. Cell proliferation, collagen, and noncollagen extracellular matrix (ECM) production and genes expression were compared among these groups. RESULTS At days 3, 7 and 10 of cultivation, groups 4 and 5 had significantly more cell numbers and faster cell proliferation rates than groups 1, 2, and 3. At 14 days of cultivation, significantly more cell numbers were observed in groups 3 and 4 than in group 5. The group 4 had the most cell numbers and the fastest proliferation rate at 14 days of cultivation. After normalization for cell numbers, group 5 (two-step) produced the most collagen and noncollagen ECM at 10 and 14 days of cultivation among the five groups. In group 5, ECM gene expression was significantly upregulated. High expression of matrix metalloproteinase-1 was upregulated with FGF-2 on the different days as compared to the other groups. Annulus fibrosus cell phenotypes were only marginally retained under the different protocols based on quantitative polymerase chain reaction results. CONCLUSION Taken together, the two-step protocol was the most efficient among these different protocols with the most abundant ECM production after normalization for cell numbers for culture expansion of hAF cells. The protocol may be useful in further cell therapy and tissue engineering approaches for disc regeneration.
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Affiliation(s)
- Po-Hsin Chou
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei city, Taiwan.,School of Medicine, National Yang-Ming University, Taipei city, Taiwan
| | - Shih-Tien Wang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei city, Taiwan.,School of Medicine, National Yang-Ming University, Taipei city, Taiwan
| | - Hsiao-Li Ma
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei city, Taiwan.,School of Medicine, National Yang-Ming University, Taipei city, Taiwan
| | - Chien-Lin Liu
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei city, Taiwan.,School of Medicine, National Yang-Ming University, Taipei city, Taiwan
| | - Ming-Chau Chang
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei city, Taiwan.,School of Medicine, National Yang-Ming University, Taipei city, Taiwan
| | - Oscar Kuang-Sheng Lee
- Institute of Clinical Medicine, National Yang-Ming University , Taipei city, Taiwan. .,Department of Medical Research, Taipei Veterans General Hospital, Taipei city, Taiwan. .,Taipei City General Hospital, No.145, Zhengzhou Rd., Datong Dist., Taipei City, 10341, Taiwan (R.O.C.).
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Feng C, Liu H, Yang M, Zhang Y, Huang B, Zhou Y. Disc cell senescence in intervertebral disc degeneration: Causes and molecular pathways. Cell Cycle 2016; 15:1674-84. [PMID: 27192096 PMCID: PMC4957599 DOI: 10.1080/15384101.2016.1152433] [Citation(s) in RCA: 193] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The accumulation of senescent disc cells in degenerative intervertebral disc (IVD) suggests the detrimental roles of cell senescence in the pathogenesis of intervertebral disc degeneration (IDD). Disc cell senescence decreased the number of functional cells in IVD. Moreover, the senescent disc cells were supposed to accelerate the process of IDD via their aberrant paracrine effects by which senescent cells cause the senescence of neighboring cells and enhance the matrix catabolism and inflammation in IVD. Thus, anti-senescence has been proposed as a novel therapeutic target for IDD. However, the development of anti-senescence therapy is based on our understanding of the molecular mechanism of disc cell senescence. In this review, we focused on the molecular mechanism of disc cell senescence, including the causes and various molecular pathways. We found that, during the process of IDD, age-related damages together with degenerative external stimuli activated both p53-p21-Rb and p16-Rb pathways to induce disc cell senescence. Meanwhile, disc cell senescence was regulated by multiple signaling pathways, suggesting the complex regulating network of disc cell senescence. To understand the mechanism of disc cell senescence better contributes to developing the anti-senescence-based therapies for IDD.
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Affiliation(s)
- Chencheng Feng
- a Department of Orthopedics , Xinqiao Hospital, Third Military Medical University , Chongqing , People's Republic of China
| | - Huan Liu
- a Department of Orthopedics , Xinqiao Hospital, Third Military Medical University , Chongqing , People's Republic of China
| | - Minghui Yang
- a Department of Orthopedics , Xinqiao Hospital, Third Military Medical University , Chongqing , People's Republic of China
| | - Yang Zhang
- a Department of Orthopedics , Xinqiao Hospital, Third Military Medical University , Chongqing , People's Republic of China
| | - Bo Huang
- a Department of Orthopedics , Xinqiao Hospital, Third Military Medical University , Chongqing , People's Republic of China
| | - Yue Zhou
- a Department of Orthopedics , Xinqiao Hospital, Third Military Medical University , Chongqing , People's Republic of China
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The effect of capacitively coupled (CC) electrical stimulation on human disc nucleus pulposus cells and the relationship between CC and BMP-7. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 26:240-247. [DOI: 10.1007/s00586-016-4439-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 02/04/2016] [Accepted: 02/04/2016] [Indexed: 10/22/2022]
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Liao JC. Cell Therapy Using Bone Marrow-Derived Stem Cell Overexpressing BMP-7 for Degenerative Discs in a Rat Tail Disc Model. Int J Mol Sci 2016; 17:ijms17020147. [PMID: 26805824 PMCID: PMC4783881 DOI: 10.3390/ijms17020147] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/13/2016] [Accepted: 01/14/2016] [Indexed: 01/08/2023] Open
Abstract
Degenerative discs can cause low back pain. Cell-based transplantation or growth factors therapy have been suggested as a strategy to stimulate disc regeneration. Bone marrow-derived mesenchymal stem cells (BMDMSC) containing bone morphogenetic protein-7 (BMP-7) gene were constructed. We evaluated the effectiveness of these BMP-7 overexpressing cells on degenerative discs in rat tails. In vitro and in vivo studies were designed. In the first stage, the rats were divided into two group according to discs punctured by different needle gauges (18 gauge and 22 gauge). In the second stage, the ideal size of needle was used to induce rat tail disc degeneration. These animals are divided into three groups according to timing of treatment (zero-week, two-week, four-week). Each group was divided into three treating subgroups: control group, BMDMSC group, and Baculo-BMP-7-BMDMSC group. Each rat undergoes radiography examination every two weeks. After eight weeks, the discs were histologically examined with hematoxylin and eosin stain and Alcian blue stain. The 18-gauge group exhibited significant decrease in disc height index (%) than 22-gauge group at eight weeks at both Co6-7 (58.1% ± 2.8% vs. 63.7% ± 1.0%, p = 0.020) and Co8-9 discs (62.7% ± 2.8% vs. 62.8% ± 1.5%, p = 0.010). Baculo-BMP-7-BMDMSCs group showed significant difference in disc height index compared to the BMDMSCs group at both Co6-7 (93.7% ± 1.5% vs. 84.8% ± 1.0%, p = 0.011) and Co8-9 (86.0% ± 2.1% vs. 81.8% ± 1.7%, p = 0.012). In Baculo-BMP-7-BMDMSCs group, the zero-week treatment subgroup showed significant better in disc height index compared to two-week treatment group (p = 0.044), and four-week treatment group (p = 0.011). The zero-week treatment subgroup in Baculo-BMP-7-BMDMSCs group also had significant lower histology score than two-week treatment (4.3 vs. 5.7, p = 0.045) and four-week treatment (4.3 vs. 6.0, p = 0.031). In conclusion, Baculo-BMP-7-BMDMSC can slow down the progression of disc degeneration, but could not provide evidence of regeneration. Early treatment might obtain more distinct results.
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Affiliation(s)
- Jen-Chung Liao
- Department of Orthopedics Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, No._5, Fu-Shin Street; Kweishian, Taoyuan 333, Taiwan.
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Priyadarshani P, Li Y, Yang S, Yao L. Injectable hydrogel provides growth-permissive environment for human nucleus pulposus cells. J Biomed Mater Res A 2015; 104:419-26. [PMID: 26422588 DOI: 10.1002/jbm.a.35580] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/09/2015] [Accepted: 09/25/2015] [Indexed: 01/07/2023]
Abstract
Degeneration of intervertebral discs (IVDs) results in an overall alteration of the biomechanics of the spinal column and becomes a major cause of low back pain. In this study, an injectable hydrogel composite is fabricated and characterized as a potential scaffold for the treatment of degenerated IVDs. Crosslinking of type II collagen-hyaluronic acid (HA) hydrogel with 1-ethyl-3(3-dimethyl aminopropyl) carbodiimide (EDC) increases the gel stability against collagenase digestion and reduces water uptake in comparison with non-crosslinked gel. Cell viability assay exhibits the proliferation of human nucleus pulposus (HNP) cells in hydrogels. The cells in non-crosslinked gel and the gel crosslinked with a low concentration of EDC (0.1 mM) show superior cell viability and morphology compared with cells in gels crosslinked with higher concentration of EDC. Quantitative PCR assay demonstrates the gene expression of extracellular matrix (ECM) by cells cultured in the gels. The expression of ECM genes by HNP cells in the gels demonstrated the phenotypic change of the cells. This study suggests that the type II collagen-HA hydrogel and crosslinked hydrogel (0.1 mM EDC) are permissive matrix for the growth of HNP cells and can be potentially applied in NP repair.
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Affiliation(s)
- Priyanka Priyadarshani
- Department of Biological Sciences, Wichita State University, Fairmount 1845, Wichita, Kansas, 67260
| | - Yongchao Li
- Department of Biological Sciences, Wichita State University, Fairmount 1845, Wichita, Kansas, 67260
| | - ShangYou Yang
- Department of Biological Sciences, Wichita State University, Fairmount 1845, Wichita, Kansas, 67260
| | - Li Yao
- Department of Biological Sciences, Wichita State University, Fairmount 1845, Wichita, Kansas, 67260
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Wang SZ, Chang Q, Lu J, Wang C. Growth factors and platelet-rich plasma: promising biological strategies for early intervertebral disc degeneration. INTERNATIONAL ORTHOPAEDICS 2015; 39:927-34. [PMID: 25653173 DOI: 10.1007/s00264-014-2664-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 12/28/2014] [Indexed: 12/20/2022]
Abstract
Intervertebral disc degeneration (IDD) is a complex process with the mechanism not fully elucidated. The current clinical treatments for IDD are mainly focused on providing symptomatic relief without addressing the underlying cause of the IDD. Biological therapeutic strategies to repair and regenerate the degenerated discs are drawing more attention. Growth factor therapy is one of the biological strategies and holds promising prospects. As a promising bioactive substance, platelet-rich plasma (PRP) is considered to be an ideal growth factor "cocktail" for intervertebral disc (IVD) restoration. Results from many in vitro and in vivo studies have confirmed the efficacy of growth factors and PRP in IVD repair and regeneration. It is essential to advance the research on growth factor therapy and associated mechanism for IDD. This article reviews the background of IDD, current concepts in growth factor and PRP-related therapy for IDD. Future research perspectives and clinical directions are also discussed.
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Affiliation(s)
- Shan-zheng Wang
- Department of Orthopaedics, Zhongda Hospital, Medical School of Southeast University, 87 Ding Jia Qiao Road, Nanjing, Jiangsu, 210009, People's Republic of China
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Chen ZH, Jin SH, Wang MY, Jin XL, Lv C, Deng YF, Wang JL. Enhanced NLRP3, caspase-1, and IL- 1β levels in degenerate human intervertebral disc and their association with the grades of disc degeneration. Anat Rec (Hoboken) 2014; 298:720-6. [PMID: 25284686 DOI: 10.1002/ar.23059] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/07/2014] [Accepted: 08/21/2014] [Indexed: 12/12/2022]
Abstract
The NACHT, LRR, and PYD domains-containing protein 3 (NLRP3) inflammasome plays an important role in a variety of diseases. However, the role of NLRP3 in the human intervertebral disc (IVD) degeneration remains unknown. In the present study, we assessed the expression levels of the NLRP3 inflammasome and its downstream targets caspase-1 and IL-1β in 45 degenerate and seven nondegenerate IVD samples. The correlation between the degeneration scores and expression levels of NLRP3, caspase-1, and IL-1β were also analyzed. The mRNA expression levels of the three molecules (NLRP3, caspase-1, and IL-1β) were higher in the degenerate IVDs group than the controls (nondegenerate IVDs group). Immunohistochemistry showed that the expression levels of all three molecules were markedly increased in the nucleus pulposus of degenerate IVDs compared with nondegenerate IVDs. There was a positive correlation between the degeneration scores and the expression levels of the NLRP3 inflammasome as well as its downstream targets caspase-1 and IL-1β. The findings suggest that excessive activation of the NLRP3 inflammasome results in overproduction of downstream IL-1β, which participates in the pathogenesis of human IVD degeneration. Therefore, the NLRP3 inflammasome might serve as a potential therapeutic target for the prevention and treatment of IVD degeneration.
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Affiliation(s)
- Zhong-Hua Chen
- Department of Anesthesiology, Shaoxing People's Hospital and Shaoxing Hospital of Zhejiang University, Shaoxing, People's Republic of China
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Wang SZ, Rui YF, Tan Q, Wang C. Enhancing intervertebral disc repair and regeneration through biology: platelet-rich plasma as an alternative strategy. Arthritis Res Ther 2014; 15:220. [PMID: 24165687 PMCID: PMC3978730 DOI: 10.1186/ar4353] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Intervertebral disc degeneration (IDD) is a common orthopedic disease associated with mechanical changes that may result in significant pain. Current treatments for IDD mainly depend on conservative therapies and spinal surgeries that are only able to relieve the symptoms but do not address the cause of the degeneration and even accelerate the degeneration of adjacent segments. This has prompted research to improve our understanding of the biology of intervertebral disc healing and into methods to enhance the regenerative process. Recently, biological therapies, including active substances, gene therapy and tissue engineering based on certain cells, have been attracting more attention in the field of intervertebral disc repair and regeneration. Early selection of suitable biological treatment is an ideal way to prevent or even reverse the progressive trend of IDD. Growth factors have been enjoying more popularity in the field of regeneration of IDD and many have been proved to be effective in reversing the degenerative trend of the intervertebral disc. Identification of these growth factors has led to strategies to deliver platelet-derived factors to the intervertebral disc for regeneration. Platelet-rich plasma (PRP) is the latest technique to be evaluated for promoting intervertebral disc healing. Activation of the PRP leads to the release of growth factors from the α-granules in the platelet cytoplasm. These growth factors have been associated with the initiation of a healing cascade that leads to cellular chemotaxis, angiogenesis, synthesis of collagen matrix, and cell proliferation. This review describes the current understanding of IDD and related biological therapeutic strategies, especially the promising prospects of PRP treatment. Future limitations and perspectives of PRP therapy for IDD are also discussed.
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Dudli S, Ferguson SJ, Haschtmann D. Severity and pattern of post-traumatic intervertebral disc degeneration depend on the type of injury. Spine J 2014; 14:1256-64. [PMID: 24583791 DOI: 10.1016/j.spinee.2013.07.488] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 02/26/2013] [Accepted: 07/30/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The burst fracture of a vertebra is the result of a complex loading procedure and is often associated with intervertebral disc (IVD) degeneration. Likewise, the presumed etiologies are (i) the structural perturbation of the IVD/end plate, (ii) the impact of loading energy alone, and (iii) the depressurization of the nucleus pulposus. PURPOSE To describe the pathogenesis of post-traumatic disc degeneration (DD) by comparing the severity and patterns of degeneration with different injury models. STUDY DESIGN New data from an in vitro organ culture study are compared with the previous work on the same model system. METHODS To investigate in detail the contribution of each factor (i-iii) to DD, we extended our previous work to compare three different segmental trauma processes in a rabbit full-organ in vitro model: burst fracture (Group A, etiologies i-iii), equienergetic loading without a fracture (Group B, ii), and endplate puncturing (Group C, iii). DD markers (apoptosis, necrosis, matrix remodeling, inflammation) were monitored up to 28 days posttrauma. Gene transcription data were subjected to principal component analysis and agglomerative hierarchical clustering to identify and compare pathologic patterns. RESULTS Only Group A showed the full profile of DD: reduced glycosaminoglycan content, increased caspase-3/7 and lactate dehydrogenase (LDH) activity, and elevated messenger RNA of catabolic (matrix metalloproteinase-1, -3, -13) and proinflammatory (tumor necrosis factor-alpha, interleukin [IL]-6, IL-8, and monocyte chemotactic protein-1) genes. In Group B, only catabolic and proinflammatory genes were slightly upregulated. In Group C, LDH but not caspase-3/7 activity was increased. Catabolic and proinflammatory genes were upregulated, although less compared with Group A. Principal component analysis revealed different transcription patterns for Group C. CONCLUSIONS The structural perturbation of the end plate/IVD, but not the loading energy or nuclear depressurization, promotes DD. In addition, end-plate puncturing triggers a different pathogenesis, consistent with a more continuous matrix remodeling process.
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Affiliation(s)
- Stefan Dudli
- Institute for Biomechanics, ETH Zürich, Schafmattstrasse 30, CH-8093 Zürich, Switzerland; Institute for Biomechanics, ETH Zürich, Wolfgang-Pauli-Strasse 10, CH-8093 Zürich, Switzerland.
| | - Stephen J Ferguson
- Institute for Biomechanics, ETH Zürich, Schafmattstrasse 30, CH-8093 Zürich, Switzerland
| | - Daniel Haschtmann
- Schulthess Klinik, Wirbelsäulenzentrum, Lengghalde 2, CH-8008 Zürich, Switzerland
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Yang X, Jin L, Yao L, Shen FH, Shimer AL, Li X. Antioxidative nanofullerol prevents intervertebral disk degeneration. Int J Nanomedicine 2014; 9:2419-30. [PMID: 24876775 PMCID: PMC4035310 DOI: 10.2147/ijn.s60853] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Compelling evidence suggests that reactive oxygen species (ROS) play a pivotal role in disk degeneration. Fullerol nanoparticles prepared in aqueous solution have been demonstrated to have outstanding ability to scavenge ROS. In this report, in vitro and in vivo models were used to study the efficacy of fullerol in preventing disk degeneration. For in vitro experiments, a pro-oxidant H2O2 or an inflammatory cytokine interleukin (IL)-1β was employed to induce degenerated phenotypes in human nucleus pulposus cells encapsulated in alginate beads, and fullerol was added in the culture medium. For the animal study, an annulus-puncture model with rabbit was created, and fullerol was injected into disks. It was shown that cytotoxicity and cellular ROS level induced by H2O2 were significantly diminished by fullerol. IL-1β-induced nitric oxide generation in culture medium was suppressed by fullerol as well. Gene-profile and biochemical assays showed that fullerol effectively reversed the matrix degradation caused by either H2O2 or IL-1β. The animal study delineated that intradiskal injection of fullerol prevented disk degeneration, increasing water and proteoglycan content and inhibiting ectopic bone formation. These results suggest that antioxidative fullerol may have a potential therapeutic application for disk degeneration.
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Affiliation(s)
- Xinlin Yang
- Orthopaedic Research Laboratories, University of Virginia, Charlottesville, VA, USA
| | - Li Jin
- Orthopaedic Research Laboratories, University of Virginia, Charlottesville, VA, USA
| | - Lu Yao
- School of Life Science, Beijing Institute of Technology, Beijing, People's Republic of China ; Research Institute of Beijing Tongrentang Co., Ltd, Beijing, People's Republic of China
| | - Francis H Shen
- Orthopaedic Research Laboratories, University of Virginia, Charlottesville, VA, USA
| | - Adam L Shimer
- Orthopaedic Research Laboratories, University of Virginia, Charlottesville, VA, USA
| | - Xudong Li
- Orthopaedic Research Laboratories, University of Virginia, Charlottesville, VA, USA
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Bone morphogenetic protein-7 antagonizes tumor necrosis factor-α-induced activation of nuclear factor κB and up-regulation of the ADAMTS, leading to decreased degradation of disc matrix macromolecules aggrecan and collagen II. Spine J 2014; 14:505-12. [PMID: 24176808 DOI: 10.1016/j.spinee.2013.08.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 07/23/2013] [Accepted: 08/20/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Tumor necrosis factor-α (TNF-α) is a regulatory cytokine that can increase the activity of enzymes such as ADAMTS (a disintegrin and metalloproteinase with thrombospondin motifs), which degrade disc matrix. ADAMTS are enzymes that break down disc matrix and thereby mediate disc degeneration. Bone morphogenetic protein-7 (BMP-7), on the other hand, stimulates synthesis of the disc extracellular matrix and is a potential therapeutic molecule for the treatment of disc degeneration. However, the effects of BMP-7 on TNF-α and ADAMTS are unknown. PURPOSE We investigated the effects of BMP-7 on the catabolic regulators such as TNF-α and ADAMTS and evaluated the molecular mechanism by which BMP-7 affects the catabolic regulators. STUDY DESIGN This was an in vitro study in which we used human intervertebral disc cells cultured in alginate beads. METHODS Human intervertebral disc cells were cultured in alginate beads, and treated with TNF-α, or TNF- α plus BMP-7, pharmacological inhibitor of ERK1/2 (U0126), p38 (SB203580), or NFκB (BAY 11-7082). The mRNA levels of target genes were measured by real-time polymerase chain reaction, and the protein levels were determined by the Western blots. The nuclear factor (NF)κB activity was analyzed by measured phosphorylation and nuclear translocation of the NFκB protein p65. RESULTS TNF-α activated NFκB signaling and induced up-regulation of the catabolic regulators ADAMTS-4 and ADAMTS-5, contributing to degradation of the disc matrix macromolecules aggrecan and collagen II. BMP-7 antagonized the TNF-α-induced activation of NFκB protein p65 and blocked TNF-α-induced up-regulation of ADAMTS-4 and ADAMTS-5, leading to reversing TNF-α-mediated degradation of aggrecan and collagen II. Moreover, BMP-7 antagonized the TNF-α-induced activation of NFκB signaling by suppressing phosphorylation and nucleus translocation of NFκB protein p65. CONCLUSION BMP-7 antagonizes TNF-α-induced activation of NFκB and up-regulation of ADAMTS, leading to decreased degradation of disc matrix macromolecules. These data indicate that BMP-7 has a dual mechanism of action on disc metabolism: (1) the previously well-described positive effect on disc matrix synthesis and (2) an anticatabolic effect that is described here. This understanding is important as BMP-7 is being considered for treatment of disc degeneration.
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Regenerative Spinal Therapies for Low Back Pain. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2014. [DOI: 10.1007/s40141-014-0043-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Arslan E, Demirci I, Kılıncaslan MO, Hacıfazlıoglu C, Demir T, Demirkale I. Identification of intervertebral disc regeneration with magnetic resonance imaging after a long-term follow-up in patients treated with percutaneous diode laser nucleoplasty: a retrospective clinical and radiological analysis of 14 patients. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 23:1044-51. [PMID: 24477379 DOI: 10.1007/s00586-014-3194-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 01/08/2014] [Accepted: 01/10/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim of this study was to demonstrate regeneration of intervertebral discs undergoing laser therapy with sagittal relaxation time (T2) mapping after a long-term follow-up. MATERIALS AND METHODS Fourteen patients (9 men, 5 women; age range 20-57 years; mean age 36.5 years) treated with percutaneous 908-nm wave-length diode laser nucleoplasty for lumbar disc prolapsus at our clinic between January 2006 and June 2009 were studied. For the application of laser nucleoplasty in the past, patients who did not have central canal stenosis and/or lateral stenosis, sequestered disc fragment, operation scars and bleeding disorders were selected. The intervertebral disc levels undergoing laser therapy were L3-L4 (n = 2) or L4-L5 (n = 12). Patients were called for follow-up visits after a maximum 6-years (n = 2) or a minimum 3 years (n = 3) with a mean of 4.4 years. The patients' clinical status for leg pain was evaluated according to the visual analog scale (VAS) and subsequently, a lumbar magnetic resonance imaging was performed. Sagittal T2 mapping was performed for the intervertebral discs undergoing laser nucleoplasty. We analyzed the relationship between T2 in the regions of interest (ROIs), which is known to correlate with changes in the composition of intervertebral discs, and the degree of degeneration determined using the Pfirrmann grading system and VAS of patients. RESULTS On the basis of the evaluation of the results of intervertebral discs in all patients, there was a significant increase in T2 in the anterior NP (ROI 2, +10.3 ms; p < 0.05). A significant increase was noted in T2 in the middle NP (ROI 3, +24.6 ms; p < 0.001). The most significant increase was recorded for the posterior NP (ROI 4, +28.6 ms; p < 0.001). No significant decrease was found in T2 in the anterior and posterior AF (ROI 1, -1.5 ms; p = 0.925; ROI 5, -0.1 ms; p = 0.683). According to the Pfirrmann grading system, disc degeneration grades before laser therapy were recorded as grade III (n = 6) and grade IV (n = 8) whereas disc degeneration grades after laser therapy were found to be grade I (n = 6) and II (n = 8). A significant decrease was noted in Pfirrmann grades of disc degeneration after laser therapy (p < 0.0005). CONCLUSIONS In this study, there was a prolongation of T2 indicating regeneration in the nucleus pulposus after laser therapy and these results were found to be consistent with VAS measurements after a long-term follow-up. This study, which demonstrates the quantitative efficacy of laser therapy, indicates that MRG can be more effectively used in the future.
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Affiliation(s)
- Erhan Arslan
- Department of Neurosurgery, School of Medicine, Giresun University, Nizamiye Mah. Mumcular Sok. No:1/1, 28000, Merkez/Giresun, Turkey,
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Yan J, Yang S, Sun H, Guo D, Wu B, Ji F, Zhou D. Effects of releasing recombinant human growth and differentiation factor-5 from poly(lactic-co-glycolic acid) microspheres for repair of the rat degenerated intervertebral disc. J Biomater Appl 2013; 29:72-80. [DOI: 10.1177/0885328213515034] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The objective of this study was to investigate the therapeutic potential of poly(lactic- co-glycolic acid) (PLGA) microspheres loaded with recombinant human growth and differentiation factor-5 (rhGDF-5) on the disc degeneration induced by needle puncture in a rat caudal disc model. Methods: The rhGDF-5-loaded PLGA microspheres were prepared by the water-oil-water double-emulsion solvent evaporation method, and release kinetics was determined over 42 days. Rats that underwent 21-G needle puncture at rat tail discs were injected with rhGDF-5/PLGA microspheres at four weeks after needle injury. At eight weeks after the injection, disc height, glycosaminoglycans content, and DNA content of the discs were evaluated. In addition, gene expression analysis of aggrecan, collagen type I, and collagen type II in the rat nucleus pulposus was measured by real-time polymerase chain reaction. Rat discs were also assessed by histology using hematoxylin and eosin stain. Results: Encapsulation of rhGDF-5 in PLGA microspheres guaranteed a sustained release of active rhGDF-5 for more than 42 days. The injection of GDF-5/PLGA microspheres resulted in a statistically significant restoration of disc height ( p < 0.01), improvement of sulfated glycosaminoglycan ( p < 0.05), DNA content ( p < 0.05), and significantly increased mRNA levels of collagen type II ( p < 0.01), and the differentiation index (the ratio of collagen type II to collagen type I, p < 0.01). In addition, rhGDF-5/PLGA microspheres treatment also improved histological changes induced by needle puncture. Conclusions: The results of this study suggest that injection of rhGDF-5 loaded in PLGA microspheres into rat tail discs may be as a promising therapy strategy to regenerate or repair the degenerative disc.
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Affiliation(s)
- Jihong Yan
- Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Shu Yang
- Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Huaimei Sun
- Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Duo Guo
- Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Bo Wu
- Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Fengqing Ji
- Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Deshan Zhou
- Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
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Degenerative grade affects the responses of human nucleus pulposus cells to link-N, CTGF, and TGFβ3. ACTA ACUST UNITED AC 2013; 26:E86-94. [PMID: 22907063 DOI: 10.1097/bsd.0b013e31826e0ca4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN Cells isolated from moderately and severely degenerated human intervertebral disks (IVDs) cultured in an alginate scaffold. OBJECTIVE To compare the regenerative potential of moderately versus severely degenerated cells using 3 proanabolic stimulants. SUMMARY OF BACKGROUND DATA Injection of soluble cell signaling factors has potential to slow the progression of IVD degeneration. Although degenerative grade is thought to be an important factor in targeting therapeutic interventions it remains unknown whether cells in severely degenerated IVDs have impaired metabolic functions compared to lesser degenerative levels or if they are primarily influenced by the altered microenvironment. METHODS Nucleus pulposus (NP) cells were cultured in alginate for 21 days and treated with 3 different proanabolic stimulants: a growth factor/anti-inflammatory combination of transforming growth factor β3 (TGFβ3)+dexamethasone (Dex), or matricellular proteins connective tissue growth factor (CTGF) or Link-N. They were assayed for metabolic activity, DNA content, glycosaminoglycan, and qRT-PCR gene profiling. RESULTS Moderately degenerated cells responded to stimulation with increased proliferation, decreased IL-1β, MMP9, and COL1A1 expression, and upregulated HAS1 as compared with severely degenerated cells. TGFβR1 (ALK5) receptors were expressed at greater levels in moderately than severely degenerated cells. TGFβ3+Dex had a notable stimulatory effect on moderately degenerated NP cells with increased anabolic gene expression and decreased COL1A1 and ADAMTS5 gene expression. Link-N and CTGF had similar responses in all assays, and both treatments upregulated IL-1β expression and had a more catabolic response than TGFβ3+Dex, particularly in the more severely degenerated group. All groups, including different degenerative grades, produced similar amounts of glycosaminoglycan. CONCLUSIONS Proanabolic stimulants alone had limited capacity to overcome the catabolic and proinflammatory cytokine expression of severely degenerated NP cells and likely require additional anti-inflammatory treatments. Moderately degenerated NP cells had greater TGFβ receptor 1 expression and better responded to anabolic stimulation.
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Yang SH, Hu MH, Sun YH, Lin FH. Differential phenotypic behaviors of human degenerative nucleus pulposus cells under normoxic and hypoxic conditions: influence of oxygen concentration during isolation, expansion, and cultivation. Spine J 2013; 13:1590-6. [PMID: 23800820 DOI: 10.1016/j.spinee.2013.05.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 05/04/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Intervertebral discs (IVDs) are the largest avascular structures in the body; therefore, cells within these discs might be adapted to low-oxygen conditions. Although it has been demonstrated that a low oxygen concentration could promote synthesis of the extracellular matrix by IVD cells in the in vitro culture, isolation, expansion, and cultivation of IVD cells under classical tissue culture O2 saturation could still be detrimental. PURPOSE To investigate the phenotypic differences between human degenerative nucleus pulposus (NP) cells during isolation and expansion under normoxic (Nx: 21% O2) or hypoxic (Hx: 3.5% O2) conditions. STUDY DESIGN We investigated in vitro isolation, expansion, and cultivation of human NP cells. METHODS Human NP tissue samples were obtained from patients who underwent lumbar disc surgeries. Nucleus pulposus cells were then isolated, expanded, and cultivated under normoxic or hypoxic conditions. To determine whether the effects of normoxic expansion are reversible, another group of cells was isolated and expanded in normoxic conditions and then cultivated under hypoxic conditions (Nx→Hx group). Cellular proliferation, RNA expression of selected genes, and immunohistochemical staining were performed to evaluate the phenotypic behaviors of human NP cells under different conditions. RESULTS Expressions of Type II collagen and aggrecan in the Nx→Hx group were significantly higher than those in the normoxic group but were significantly lower than those in the hypoxic group. The normoxic group showed higher expression of matrix metalloproteinase (MMP)-2 and MMP-13 than did the other groups. Expression levels of hypoxia-inducible factors (HIFs) were significantly higher in the normoxic groups; however, a greater degree of HIF-1α staining was found in the hypoxic group, whereas a greater degree of HIF-2α staining was found in the normoxic group. CONCLUSIONS Human degenerative NP cells isolated, expanded, and cultivated in hypoxic conditions could better preserve the cells' regenerative potential. Compromised properties that were observed during isolation and expansion under normoxic conditions could only be partially rescued by later hypoxic cultivation. The superior phenotypic behaviors of human NP cells under hypoxia may be related to higher HIF-1α production and lower HIF-2α production. Cells that are isolated, expanded, and cultivated under hypoxic conditions may show better regenerative results when transplanted; therefore, the isolation and expansion processes of human degenerative NP cells should be managed in a hypoxic environment.
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Affiliation(s)
- Shu-Hua Yang
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, No. 7, Jhong-Shan S Rd, Taipei, 10002, Taiwan
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Kim HY, Mcclincy M, Vo NV, Sowa GA, Kang JD, Bai M. Functional probe for annulus fibrosus-targeted intervertebral disc degeneration imaging. JOURNAL OF BIOMEDICAL OPTICS 2013; 18:101308. [PMID: 23839314 PMCID: PMC3710152 DOI: 10.1117/1.jbo.18.10.101308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 05/09/2013] [Accepted: 06/03/2013] [Indexed: 06/02/2023]
Abstract
Intervertebral disc degeneration (IDD) is closely associated with low back pain. Typically nonsurgical treatment of IDD is the most effective when detected early. As such, establishing reliable imaging methods for the early diagnosis of disc degeneration is critical. The cellular and tissue localization of a facile functional fluorescent probe, HYK52, that labels disc annulus fibrosus is reported. HYK52 was synthesized with high yield and purity via a two-step chemical reaction. Rabbit disc cell studies and ex vivo tissue staining images indicated intracellular localization and intervertebral disc (IVD) tissue binding of HYK52 with negligible cytotoxicity. Moreover, HYK52 is purposefully designed with a functional terminal carboxyl group to allow for coupling with various signaling molecules for multimodal imaging applications. These results suggest that this IVD-targeted probe may have great potential in early diagnosis of IDD.
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Affiliation(s)
- Hye-Yeong Kim
- University of Pittsburgh, Department of Radiology, School of Medicine, Molecular Imaging Laboratory, Pittsburgh, Pennsylvania 15219
| | - Michael Mcclincy
- University of Pittsburgh Medical Center, Department of Orthopedic Surgery, Ferguson Laboratory for Orthopaedic Research, Pittsburgh, Pennsylvania 15213
| | - Nam V. Vo
- University of Pittsburgh Medical Center, Department of Orthopedic Surgery, Ferguson Laboratory for Orthopaedic Research, Pittsburgh, Pennsylvania 15213
| | - Gwendolyn A. Sowa
- University of Pittsburgh Medical Center, Department of Orthopedic Surgery, Ferguson Laboratory for Orthopaedic Research, Pittsburgh, Pennsylvania 15213
- University of Pittsburgh Medical Center, Department of Physical Medicine and Rehabilitation, Pittsburgh, Pennsylvania 15213
| | - James D. Kang
- University of Pittsburgh Medical Center, Department of Orthopedic Surgery, Ferguson Laboratory for Orthopaedic Research, Pittsburgh, Pennsylvania 15213
| | - Mingfeng Bai
- University of Pittsburgh, Department of Radiology, School of Medicine, Molecular Imaging Laboratory, Pittsburgh, Pennsylvania 15219
- University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania 15213
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Tanaka M, Sakai D, Hiyama A, Arai F, Nakajima D, Nukaga T, Nakai T, Mochida J. Effect of cryopreservation on canine and human activated nucleus pulposus cells: a feasibility study for cell therapy of the intervertebral disc. Biores Open Access 2013; 2:273-82. [PMID: 23914334 PMCID: PMC3731681 DOI: 10.1089/biores.2013.0023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
It has been shown that coculture of bone marrow–derived stromal cells (BMSCs) with intervertebral disc (IVD) nucleus pulposus (NP) cells significantly activates the biological characteristics of NP cells in animal models and in humans. We therefore predicted that activated NP cells would be a useful graft source for cellular transplantation therapy in the treatment of degenerative IVDs. However, the activation protocol is based on fresh isolation and activation of NP cells, which limits the timing of clinical application. Cell transplantation therapy could be offered to more patients than is now possible if activated NP cells could be transplanted as and when required by the condition of the patient. No study has investigated the effect of cryopreservation on NP cells after enzymatic isolation. We investigated the effects of cryopreservation of canine and human NP cells in both cell and tissue form before coculture with autologous BMSCs. Cell viability, proliferation, glycosaminoglycan production, aggrecan transcriptional activity, colony generation, and gene expression profile of the cells after cryopreservation and subsequent coculture were analyzed. The influence of cryopreservation on cell chromosomal abnormalities and tumorigenesis was also studied. The results showed that there were no clear differences between the noncryopreserved and cryopreserved cells in terms of cell viability, proliferation capacity, and capacity to synthesize extracellular matrix. Furthermore, the cells showed no apparent chromosomal abnormalities or tumorigenic ability and exhibited similar patterns of gene expression. These findings suggest that by using cryopreservation, it may be possible to transplant activated NP cells upon request for patients' needs.
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Affiliation(s)
- Masahiro Tanaka
- Departments of Orthopedic Surgery and Surgical Science, and the Research Center for Regenerative Medicine, Tokai University School of Medicine , Isehara, Kanagawa, Japan
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The challenge and advancement of annulus fibrosus tissue engineering. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2013; 22:1090-100. [PMID: 23361531 DOI: 10.1007/s00586-013-2663-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 12/26/2012] [Accepted: 01/07/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Intervertebral disc degeneration, a main cause of back pain, is an endemic problem and a big economic burden for the health care system. Current treatments are symptom relieving but do not address underlying problems-biological and structural deterioration of the disc. Tissue engineering is an emerging approach for the treatment of intervertebral disc degeneration since it restores the functionality of native tissues. Although numerous studies have focused on the nucleus pulposus tissue engineering and achieved successes in laboratory settings, disc tissue engineering without annulus fibrosus for the end stage of disc degeneration is deemed to fail. The purpose of this article is to review the advancement of annulus fibrosus tissue engineering. MATERIAL AND METHODS Relevant articles regarding annulus fibrosus tissue engineering were identified in PubMed and Medline databases. RESULTS The ideal strategy for disc regeneration is to restore the function and integrity of the disc by using biomaterials, native matrices, growth factors, and cells that producing matrices. In the past decades there are tremendous advancement in annulus fibrosus tissue engineering including cell biology, biomaterials, and whole disc replacement. The recent promising results on whole disc tissue engineering-a composite of annulus fibrosus and nucleus pulposus-make the tissue engineering approach more appealing. CONCLUSION Despite the promising results in disc tissue engineering, there is still much work to be done regarding the clinical application.
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Wang Z, Kim SS, Hutton WC, Yoon ST. E-cadherin upregulates expression of matrix macromolecules aggrecan and collagen II in the intervertebral disc cells through activation of the intracellular BMP-Smad1/5 pathway. J Orthop Res 2012; 30:1746-52. [PMID: 22615104 DOI: 10.1002/jor.22153] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 05/02/2012] [Indexed: 02/04/2023]
Abstract
E-cadherin is a transmembrane protein that mediates cell-cell adhesion and cell-matrix interaction. Although the E-cadherin has been shown to mediate a broad-ranging cellular signals and functions, its effects on matrix metabolism of intervertebral discs (IVDs) are unknown. In this study, we investigated the effects of E-cadherin on IVD matrix synthesis using pharmacological and molecular biology methods. We showed that high levels of the E-cadherin are expressed in rabbits IVD cells. Our study indicates that the ectopic expression of E-cadherin can stimulate matrix anabolism of the IVD cells, which was evidenced by increased expression of the matrix macromolecules aggrecan and collagen II. We found that E-cadherin induces the expression of BMP-4 and BMP-7 genes and enhances Smad1/5 phosphorylation. Blocking BMP activity uses noggin suppressed E-cadherin-mediated upregulation of aggrecan and collagen II. Moreover, inhibition of Smad1/5 phosphorylation by dorsomorphin significantly repressed the E-cadherin induced expression of aggrecan and collagen II at the both mRNA and protein levels. Together this study demonstrates that the E-cadherin stimulates the synthesis of IVD matrix macromolecules aggrecan and collagen II through the induction of BMP genes and enhancement of the Smad1/5 phosphorylation. Thus E-cadherin may have value in the treatment of degenerated discs.
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Affiliation(s)
- Zili Wang
- Emory Spine Center, Emory University School of Medicine and VA Medical Center, VA Research Building, Atlanta, GA 30033, USA.
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Pattappa G, Li Z, Peroglio M, Wismer N, Alini M, Grad S. Diversity of intervertebral disc cells: phenotype and function. J Anat 2012; 221:480-96. [PMID: 22686699 DOI: 10.1111/j.1469-7580.2012.01521.x] [Citation(s) in RCA: 210] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The intervertebral disc (IVD) is a moderately moving joint that is located between the bony vertebrae and provides flexibility and load transmission throughout the spinal column. The disc is composed of different but interrelated tissues, including the central highly hydrated nucleus pulposus (NP), the surrounding elastic and fibrous annulus fibrosus (AF), and the cartilaginous endplate (CEP), which provides the connection to the vertebral bodies. Each of these tissues has a different function and consists of a specific matrix structure that is maintained by a cell population with distinct phenotype. Although the healthy IVD is able to balance the slow matrix turnover of synthesis and degradation, this balance is often disturbed, leading to degenerative disorders. Successful therapeutic management of IVD degeneration requires a profound understanding of the cellular and molecular characteristics of the functional IVD. Hence, the phenotype of IVD cells has been of significant interest from multiple perspectives, including development, growth, remodelling, degeneration and repair. One major challenge that complicates our understanding of the disc cells is that both the cellular phenotype and the extracellular matrix strongly depend on disc maturity and health and as a consequence are continuously evolving. This review delineates the diversity of the cell types found in the intervertebral disc, with emphasis on human, but with reference to other species. The cells of the NP appear rounded and express a proteoglycan-rich matrix, whereas the more elongated AF cells are embedded in a collagen fibre matrix and the CEPs represent a layer of cartilage. Even though all disc cells have often been referred to as 'intervertebral disc chondrocytes', distinct phenotypical differences in comparison with articular chondrocytes exist and have been reported recently. The availability of more specific markers has also improved our understanding of progenitor cell differentiation towards an IVD cell phenotype. Ultimately, new cell- and tissue-engineering approaches to regenerative therapies will only be successful if the specific characteristics of the individual tissues and their context in the function of the whole organ, are taken into consideration.
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Haschtmann D, Ferguson SJ, Stoyanov JV. BMP-2 and TGF-β3 do not prevent spontaneous degeneration in rabbit disc explants but induce ossification of the annulus fibrosus. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2012; 21:1724-33. [PMID: 22639297 DOI: 10.1007/s00586-012-2371-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 05/05/2012] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Different approaches for disc regeneration are currently under investigation. Beside gene therapy and tissue engineering techniques, the application of growth and differentiation factors own promising potential. Studies using reduced intervertebral disc models, such as cell or tissue fragment cultures, have limited validity and show controversial results depending on the employed experimental model. Therefore, the goal of the current study was to investigate the effect of BMP-2 and TGF-β3 on intervertebral disc degeneration using an in vitro full-organ disc/endplate culture system. MATERIALS AND METHODS Intervertebral rabbit disc explants were cultured in the presence of 1 μg/ml BMP-2 or TGF-β3 for 21 days in DMEM/F12 media. Nucleus and annulus were analyzed for gene expression of collagen type I and II (Col I/II), aggrecan, collagenases (MMP-1/MMP-13) with RT-qPCR, histological changes with bone and proteoglycan-specific staining (von Kossa, toluidine blue) and differences in cellularity (DNA) and proteoglycan content (alcian blue binding assay). RESULTS The results demonstrate that disc proteoglycan concentration decreased with time in the TGF-β3 and BMP-2 groups. In the annulus fibrosus (AF), TGF-β3 and BMP-2 resulted in an up-regulation of Col I and type II, and of aggrecan gene expression. In contrast, MMP genes were inhibited. In the nucleus, the growth factors decreased gene expression of aggrecan and spontaneous Col I up-regulation was inhibited by TGF-β3, whereas expression of Col II was decreased with BMP-2. There was no effect on expression of MMP-1 and MMP-13 for most sampling points. However, TGF-β3 and BMP-2 induced ossification of the AF was demonstrated by histology. CONCLUSION It can be concluded that both growth factors, at the tested concentrations, may not be suitable to regenerate the whole intervertebral disc organ but they are interesting candidates for being injected alone or in combination into a painful intervertebral disc to induce osseous fusion (spondylodesis).
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Affiliation(s)
- Daniel Haschtmann
- Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, 3014, Bern, Switzerland.
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Abbott RD, Purmessur D, Monsey RD, Iatridis JC. Regenerative potential of TGFβ3 + Dex and notochordal cell conditioned media on degenerated human intervertebral disc cells. J Orthop Res 2012; 30:482-8. [PMID: 21866573 PMCID: PMC3264846 DOI: 10.1002/jor.21534] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 07/29/2011] [Indexed: 02/04/2023]
Abstract
Injection of soluble cell signaling factors into degenerated intervertebral discs (IVDs) offers a minimally invasive treatment that could limit the processes of degeneration by stimulating native matrix repair. This study evaluated the regenerative capacity of degenerated nucleus pulposus (NP) cells obtained from patients undergoing anterior interbody fusions by measuring metabolic activity, DNA content, glycosaminoglycan (GAG) content, and cellular phenotype using qRT-PCR profiling with a custom array of 42 genes. NP cells were cultured in alginate for 7 days with 4 treatment groups: transforming growth factor beta 3 (TGFβ3) + dexamethasone (Dex), soluble factors released from notochordal cells (NCs) cultured in alginate (NCA), soluble factors released from NCs in their native tissue environment (NCT), and basal media. TGFβ3 + Dex stimulated degenerated human NP cells to proliferate and exhibit an anti-catabolic gene expression profile (with a decrease in ADAMTS5 and MMP1 compared to basal, and an increase in SOX9, decrease in ADAMTS5, MMP1, collagen I and collagen III compared to day 0), while NCA stimulated the greatest GAG per cell. We conclude that degenerated human NP cells exhibit regenerative potential, and that an optimal treatment will likely require treatments, such as TGFβ3 + Dex, which were able to increase cell metabolism and reduce catabolism, as well as treatments with factors found in NC conditioned medium, that were able to produce high amounts of GAG per cell. Additional studies to optimize NC culture conditions are required to determine if NC conditioned medium can be made with the capacity to enhance NP cell proliferation and metabolism.
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Affiliation(s)
- Rosalyn Delia Abbott
- School of Engineering and Department of Orthopaedics & Rehabilitation, University of Vermont, 33 Colchester Avenue, Burlington, Vermont 05405
| | - Devina Purmessur
- Department of Orthopaedics, Mount Sinai School of Medicine, New York, New York
| | - Robert Daniel Monsey
- School of Engineering and Department of Orthopaedics & Rehabilitation, University of Vermont, 33 Colchester Avenue, Burlington, Vermont 05405
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Sousa PRCD, Pereira LO. Sistema de fixação dinâmica de coluna lombar Dynesys: experiência clínica em 30 pacientes num período médio de 1 ano. COLUNA/COLUMNA 2012. [DOI: 10.1590/s1808-18512012000100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVOS: Utilizar um conceito novo de estabilização dinâmica em detrimento da artrodese convencional, no intuito de reproduzir os resultados até então já experimentados por vários serviços no Brasil e no mundo. MÉTODOS: Foram avaliados 30 pacientes submetidos a abordagem de um ou dois segmentos lombares. Destes, 19 eram homens e 11, mulheres, com uma idade média de 40,11 anos (22 a 56), nove deles submetidos a abordagem de dois níveis adjacentes (L4-L5 e L5-S1). A doença a ser tratada foi protrusão discal em oito casos, discopatia degenerativa em 16 casos e estenose de canal em seis casos. Seguimento foi feito em nível ambulatorial, variando entre 8 e 13 meses, com média de 12,3, utilizando parâmetros clínicos, escala analógica de dor e Oswestry, bem como notas dadas pelos pacientes quanto a satisfação com o procedimento, melhora de qualidade de vida e retorno a suas atividades laborais. RESULTADOS: O percentual de pacientes que conseguiu retorno pleno às atividades laborais foi de 76.6% (21 pacientes) nos primeiros três meses, tendo o restante retornado ao trabalho até meados do quinto mês. Houve melhora significativa da dor lombar demonstrada pela diminuição do VAS (Pré-operatório: 8,6 e 12 meses Pós-operatório: 1,8). Em relação à qualidade de vida houve melhora significativa observada pela redução dos índices de Oswestry (Pré-op: 68,6 e 12meses P.O.: 22,5). Em todos os pacientes houve retorno ao trabalho após o sexto mês de pós-operatório. CONCLUSÃO: Em função dos resultados, o sistema dinâmico se mostrou eficaz no tratamento das doenças a que se propõe.
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Mietsch A, Neidlinger-Wilke C, Schrezenmeier H, Mauer UM, Friemert B, Wilke HJ, Ignatius A. Evaluation of platelet-rich plasma and hydrostatic pressure regarding cell differentiation in nucleus pulposus tissue engineering. J Tissue Eng Regen Med 2011; 7:244-52. [DOI: 10.1002/term.524] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Revised: 05/17/2011] [Accepted: 09/21/2011] [Indexed: 01/24/2023]
Affiliation(s)
- Antje Mietsch
- Institute of Orthopaedic Research and Biomechanics, Center of Musculoskeletal Research; Ulm University; Germany
| | - Cornelia Neidlinger-Wilke
- Institute of Orthopaedic Research and Biomechanics, Center of Musculoskeletal Research; Ulm University; Germany
| | - Hubert Schrezenmeier
- Institute of Clinical Transfusion Medicine and Immunogenetics Ulm; German Red Cross Blood Transfusion Service Baden-Württemberg, Center of Musculoskeletal Research; Ulm University; Germany
| | - Uwe Max Mauer
- Department of Neurosurgery; German Armed Forces Hospital of Ulm; Germany
| | - Benedikt Friemert
- Department of Trauma Surgery and Orthopaedics; German Armed Forces Hospital of Ulm; Germany
| | - Hans-Joachim Wilke
- Institute of Orthopaedic Research and Biomechanics, Center of Musculoskeletal Research; Ulm University; Germany
| | - Anita Ignatius
- Institute of Orthopaedic Research and Biomechanics, Center of Musculoskeletal Research; Ulm University; Germany
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Kalb S, Martirosyan NL, Kalani MYS, Broc GG, Theodore N. Genetics of the degenerated intervertebral disc. World Neurosurg 2011; 77:491-501. [PMID: 22120330 DOI: 10.1016/j.wneu.2011.07.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 05/09/2011] [Accepted: 07/08/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Given the genetic and proteomic advances of the past decade, understanding of the molecular etiopathogenesis of several complex diseases is increasing. Intervertebral disc disease (IVDD) is no different from other complex diseases where both environmental and genetic constituents are considered causes. This concept has challenged the traditional view that age, occupation, smoking, obesity, and primarily wear and tear are the only sources of disc degeneration. METHODS We conducted a systematic Medline review of the most current articles related to gene involvement in the development of IVDD in humans. RESULTS Candidate gene linkage and association studies involving the functional components of the intervertebral disc, including collagen I, collagen IX, collagen XI, aggrecan, extracellular matrix-degrading enzymes, inflammatory cytokines (IL-1, IL-6, and TNFα), Fas/FasL and vitamin D receptors, have had promising results. CONCLUSIONS This review emphasizes the latest advances in gene association with specific degenerated disc phenotypes, single nucleotide polymorphisms, disease heredity, and gene-environmental interactions in relation to IVDD to help improve future studies related to the genetic mechanisms underlying IVDD.
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Affiliation(s)
- Samuel Kalb
- Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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Gantenbein-Ritter B, Benneker LM, Alini M, Grad S. Differential response of human bone marrow stromal cells to either TGF-β(1) or rhGDF-5. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 20:962-71. [PMID: 21086000 PMCID: PMC3099171 DOI: 10.1007/s00586-010-1619-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 10/11/2010] [Accepted: 10/31/2010] [Indexed: 12/13/2022]
Abstract
Cell therapy along with growth factor injection is currently widely investigated to restore the intervertebral disc. However, there is increasing evidence that transplanted unconditioned bone marrow-derived stromal cells (BMSCs) cannot thrive in the intervertebral disc "niche". Moreover, uncertainty exists with respect to the cell phenotype that would be suitable to inject. The intervertebral disc cell phenotype only recently has been started to be characterised using transcriptomics profiling. Recent findings suggest that cytokeratin 19 (KRT-19) could be used as a potential candidate marker for the intervertebral disc, or more specifically the nucleus pulposus cell (NPC) phenotype. We present in vitro cell culture data using alginate bead culture of primary human BMSCs exposed to the standard chondrogenic stimulus, transforming growth factor beta-1 (TGF-β), the growth and differentiation factor 5 and/or bovine NPCs to induce a potential "discogenic" pathway. Chondrogenic induction via TGF-β pathway provoked down-regulation of KRT-19 gene expression in four out of five donors after 18 days of culture, whereas KRT-19 expression remained unchanged in the "discogenic" groups. In addition, the ratio of aggrecan/collagen II gene expression showed a remarkable difference (of at least 3 magnitudes) between the chondrogenic stimulus (low ratio) and the discogenic stimulus (high ratio). Therefore, KRT-19 and aggrecan/collagen II ratio may be potential markers to distinguish chondrogenic from "discogenic" differentiation.
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Affiliation(s)
- Benjamin Gantenbein-Ritter
- AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, Switzerland
- ARTORG Center, Spine Research Center, University of Bern, Bern, Switzerland
| | | | - Mauro Alini
- AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, Switzerland
| | - Sibylle Grad
- AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, Switzerland
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