Cell shape and gene expression in human intervertebral disc cells: in vitro tissue engineering studies

Differential efficacy of two small molecule PHLPP inhibitors to promote nucleus Pulposus cell health

Background

Intervertebral disc (IVD) degeneration is associated with chronic back pain. We previously demonstrated that the phosphatase pleckstrin homology domain and leucine-rich repeat protein phosphatase (PHLPP) 1 was positively correlated with IVD degeneration and its deficiency decelerated IVD degeneration in both mouse IVDs and human nucleus pulposus (NP) cells. Small molecule PHLPP inhibitors may offer a translatable method to alleviate IVD degeneration. In this study, we tested the effectiveness of the two PHLPP inhibitors NSC117079 and NSC45586 in promoting a healthy NP phenotype.

Methods

Tail IVDs of 5-month-old wildtype mice were collected and treated with NSC117079 or NSC45586 under low serum conditions ex vivo. Hematoxylin & eosin staining was performed to examine IVD structure and NP cell morphology. The expression of KRT19 was analyzed through immunohistochemistry. Cell apoptosis was assessed by TUNEL assay. Human NP cells were obtained from patients with IVD degeneration. The gene expression of KRT19, ACAN, SOX9, and MMP13 was analyzed via real time qPCR, and AKT phosphorylation and the protein expression of FOXO1 was analyzed via immunoblot.

Results

In a mouse IVD organ culture model, NSC45586, but not NSC117079, preserved vacuolated notochordal cell morphology and KRT19 expression while suppressing cell apoptosis, counteracting the degenerative changes induced by serum deprivation, especially in males. Likewise, in degenerated human NP cells, NSC45586 increased cell viability and the expression of KRT19, ACAN, and SOX9 and reducing the expression of MMP13, while NSC117079 treatment only increased KRT19 expression. Mechanistically, NSC45586 treatment increased FOXO1 protein expression in NP cells, and inhibiting FOXO1 offset NSC45586-induced regenerative potential, especially in males.

Conclusions

Our study indicates that NSC45586 was effective in promoting NP cell health, especially in males, suggesting that PHLPP plays a key role in NP cell homeostasis and that NSC45586 might be a potential drug candidate in treating IVD degeneration.

Micro-mechanical damage of needle puncture on bovine annulus fibrosus fibrils studied using polarization-resolved Second Harmonic Generation(P-SHG) microscopy

Needle injection has been widely used in spinal therapeutic or diagnostic processes, such as discography. The use of needles has been suspected in causing mild disc degeneration which can lead to long-term back pain. However, the localised microscopic damage caused by needles has not been well studied. The local progressive damage on a microscopic level caused by needle punctures on the surface of bovine annulus fibrosus was investigated. Four different sizes of needle were used for the puncture and twenty-nine bovine intervertebral discs were studied. Polarization-resolved second harmonic generation and fluorescent microscopy were used to study the local microscopic structural changes in collagen and cell nuclei due to needle damage. Repeated 70 cyclic loadings at ±5% of axial strain were applied after the needle puncture in order to assess progressive damage caused by the needle. Puncture damage on annulus fibrosus were observed either collagen fibre bundles being pushed aside, being cut through or combination of both with part being lift or pushed in. The progressive damage was found less relevant to the needle size and more progressive damage was only observed using the larger needle. Two distinct populations of collagen, in which one was relatively more organised than the other population, were observed especially after the puncture from skewed distribution of polarization-SHG analysis. Cell shape was found rounder near the puncture site where collagen fibres were damaged.

In vitro toxicity model: Upgrades to bridge the gap between preclinical and clinical research

The Centers for Disease Control and Prevention (CDC) provides extensive data that indicate our need for drugs to maintain human population health. Despite the substantial availability of drugs on the market, many patients lack specific drugs. New drugs are required to tackle this issue. Moreover, we need more reliable models for testing drug toxicity, as too many drug approval failures occur with the current models. This article briefly describes various approaches of the currently used models for toxicity screening, to justify the selection of in vitro cell-based models. Cell-based toxicity models have the best potential to reliably predict drug toxicity in humans, as they are developed using the cells of the target organism. However, currently, a large gap exists between in vitro cell-based approach to toxicity testing and the clinical approach, which may be contributing to drug approval failures. We propose improvements to in vitro cell-based toxicity models, which is often an insight approach, to better match this approach with the clinical homeostatic approach. This should enable a more accurate comparison of data between the preclinical as well as clinical models and provide a more comprehensive understanding of human physiology and biological effects of drugs.

Autophagy in the Degenerating Human Intervertebral Disc: In Vivo Molecular and Morphological Evidence, and Induction of Autophagy in Cultured Annulus Cells Exposed to Proinflammatory Cytokines-Implications for Disc Degeneration

STUDY DESIGN

Autophagy-related gene expression and ultrastructural features of autophagy were studied in human discs.

OBJECTIVE

To obtain molecular/morphological data on autophagy in human disc degeneration and cultured human annulus cells exposed to proinflammatory cytokines.

SUMMARY OF BACKGROUND DATA

Autophagy is an important process by which cytoplasm and organelles are degraded; this adaptive response to sublethal stresses (such as nutrient deprivation present in disc degeneration) supplies needed metabolites. Little is known about autophagic processes during disc degeneration.

METHODS

Human disc specimens were obtained after institutional review board approval. Annulus mRNA was analyzed to determine autophagy-related gene expression levels. Immunolocalization and ultrastructural studies for p62, ATG3, ATG4B, ATG4C, ATG7, L3A, ULK-2, and beclin were conducted. In vitro experiments used IL-1β- or TNF-α-treated human annulus cells to test for autophagy-related gene expression.

RESULTS

More degenerated versus healthier discs showed significantly greater upregulation of well-recognized autophagy-related genes (P ≤ 0.028): beclin 1 (upregulated 1.6-fold); ATG8 (LC3) (upregulated 2.0-fold); ATG12 (upregulated 4.0-fold); presenilin 1 (upregulated 1.6-fold); cathepsin B (upregulated 4.5-fold). p62 was localized, and ultrastructure showed autophagic vacuolization and autophagosomes with complex, redundant whorls of membrane-derived material. In vitro, proinflammatory cytokines significantly upregulated autophagy-related genes (P ≤ 0.04): DRAM1 (6.24-fold); p62 (4.98-fold); PIM-2 oncogene, a positive regulator of autophagy (3-fold); WIPI49 (linked to starvation-induced autophagy) (upregulated 2.3-fold).

CONCLUSION

Data provide initial molecular and morphological evidence for the presence of autophagy in the degenerating human annulus. In vivo gene analyses showed greater autophagy-related gene expression in more degenerated than healthier discs. In vitro data suggested a mechanism implicating a role of TNF-α and IL-1β in disc autophagy. Findings suggest the importance of future work to investigate the relationship of autophagy to apoptosis, cell death, cell senescence, and mitochondrial dysfunction in the aging and degenerating disc.

LEVEL OF EVIDENCE

N/A.

Characterization of chondrocyte scaffold carriers for cell-based gene therapy in articular cartilage repair

Articular cartilage lesions in the knee are common injuries. Chondrocyte transplant represents a promising therapeutic modality for articular cartilage injuries. Here, we characterize the viability and transgene expression of articular chondrocytes cultured in three-dimensional scaffolds provided by four types of carriers. Articular chondrocytes are isolated from rabbit knees and cultured in four types of scaffolds: type I collagen sponge, fibrin glue, hyaluronan, and open-cell polylactic acid (OPLA). The cultured cells are transduced with adenovirus expressing green fluorescence protein (AdGFP) and luciferase (AdGL3-Luc). The viability and gene expression in the chondrocytes are determined with fluorescence microscopy and luciferase assay. Cartilage matrix production is assessed by Alcian blue staining. Rabbit articular chondrocytes are effectively infected by AdGFP and exhibited sustained GFP expression. All tested scaffolds support the survival and gene expression of the infected chondrocytes. However, the highest transgene expression is observed in the OPLA carrier. At 4 weeks, Alcian blue-positive matrix materials are readily detected in OPLA cultures. Thus, our results indicate that, while all tested carriers can support the survival of chondrocytes, OPLA supports the highest transgene expression and is the most conductive scaffold for matrix production, suggesting that OPLA may be a suitable scaffold for cell-based gene therapy of articular cartilage repairs.

Regenerating nucleus pulposus of the intervertebral disc using biodegradable nanofibrous polymer scaffolds

Low back pain is a leading health problem in the United States, which is most often resulted from nucleus pulposus (NP) degeneration. To date, the replacement of degenerated NP relies entirely on mechanical devices. However, a biological NP replacement implant is more desirable. Here, we report the regeneration of NP tissue using a biodegradable nanofibrous (NF) scaffold. Rabbit NP cells were seeded on the NF scaffolds to regenerate NP-like tissue both in vitro and in a subcutaneous implantation model. The NP cells on the NF scaffolds proliferated faster than those on control solid-walled (SW) scaffolds in vitro. Significantly more extracellular matrix (ECM) production (glycosaminoglycan and type II collagen) was found on the NF scaffolds than on the control SW scaffolds. The constructs were then implanted in the caudal spine of athymic rats for up to 12 weeks. The tissue-engineered NP could survive, produce functional ECM, remain in place, and maintain the disc height, which is similar to the native NP tissue.

Human adipose-derived mesenchymal stem cells: direction to a phenotype sharing similarities with the disc, gene expression profiling, and coculture with human annulus cells

Biologic therapies for disc degeneration hold great promise as an emerging concept. Due to ease of harvest and abundance, adipose derived-mesenchymal stem cells (AD-MSC) are a readily available cell source for such therapies. Our objectives in this study were (1) to develop/validate methods to harvest AD-MSC and direct them to a disc-like phenotype by three-dimensional (3D) culture and transforming growth factor (TGF)-beta3 exposure, (2) to assess cell phenotypes with gene expression profiling for these human AD-MSC and annulus cells, and (3) to test whether disc cell-AD-MSC coculture could augment glycosaminoglycan (GAG) production. When AD-MSC were exposed to TGF-beta3, greater extracellular matrix was formed containing types I and II collagen, keratan sulfate, and decorin. Biochemical GAG measurement showed that production was significantly greater in TGF-beta3-treated AD-MSC in 3D culture versus untreated controls (p < 0.05). Gene expression patterns in AD-MSC were compared to annulus cells; 4424 genes were significantly upregulated, and 2290 genes downregulated. Coculture resulted in a 44% greater GAG content compared with AD-MSC or annulus culture alone (p = 0.04). Data indicated that human AD-MSC can successfully be manipulated in 3D culture to express gene products important in the disc, and that coculture of annulus cells with AD-MSC enhances total GAG production.

Micromass culture of human anulus cells: morphology and extracellular matrix production

STUDY DESIGN

Micromass culture was assessed as a cell culture microenvironment for anulus cells from the human intervertebral disc.

OBJECTIVE

To determine whether the micromass culture technique might be useful for the culture of human anulus cells.

SUMMARY OF BACKGROUND DATA

Culture of cells in micromass has been traditionally used as a method to culture chondrocytes in a three-dimensional (3D) microenvironment with specialized chondrocyte media which allows expression of the chondrocytic phenotype. Recently it has also been used for disc cell 3D culture.

METHODS

Following approval of our human subjects Institutional Review Board, cells isolated from human anulus intervertebral disc tissue was cultured in micromass culture under control conditions or with addition of 5 ng/mL transforming growth factor-beta (TGF-beta). Cultures were grown for 7 days, and then analyzed for morphology with light microscopy, for extracellular matrix (ECM) production with transmission electron microscopy and quantitative measurement of total sulfated proteoglycan production. Immunohistochemistry was also performed to assess types I and II collagen, decorin, keratan sulfate, and chondroitin sulfate content of ECM.

RESULTS

Human anulus cells form multilayered colonies when cultured with minimal media and 20% fetal bovine serum in the micromass methodology. Stimulation of ECM production occurs when 5 ng/mL TGF-beta was added to the micromass media. TGF-beta also significantly increased the production of sulfated proteoglycans (P = 0.026). Under both control and TGF-beta-supplementation, the resulting micromass formed by anulus cells is not as compact as the micromass which results when stem cells cultured in chondrogenic media. Ultrastructural studies showed the presence of apoptotic cells and the presence of peroxisomes within cells. Immunohistochemical studies on production of type I collagen, decorin and keratan sulfate showed that there was localized production of these ECM components in focal regions; chondroitin sulfate and type II collagen, however, showed a more uniform overall production by cells within the micromass.

CONCLUSION

Human anulus cells were successfully cultured under micromass conditions in nonchondrogenic media and with TGF-beta supplementation which increased ECM production. The resulting anulus cell micromass, however, was not as rounded or compact as that which occurs with routine chondrocyte micromass or stem cells induced into chondrocyte differentiation. The presence of peroxisomes noted on ultrastructural studies may reflect cell stress or uneven distribution of nutrition within the micromass during the 7-day micromass culture period. Immunohistochemical studies showed nonuniform ECM gene expression and production within the micromass, suggesting variable gene expression patterns with this culture method.

Mechanical design criteria for intervertebral disc tissue engineering

Due to the inability of current clinical practices to restore function to degenerated intervertebral discs, the arena of disc tissue engineering has received substantial attention in recent years. Despite tremendous growth and progress in this field, translation to clinical implementation has been hindered by a lack of well-defined functional benchmarks. Because successful replacement of the disc is contingent upon replication of some or all of its complex mechanical behaviors, it is critically important that disc mechanics be well characterized in order to establish discrete functional goals for tissue engineering. In this review, the key functional signatures of the intervertebral disc are discussed and used to propose a series of native tissue benchmarks to guide the development of engineered replacement tissues. These benchmarks include measures of mechanical function under tensile, compressive, and shear deformations for the disc and its substructures. In some cases, important functional measures are identified that have yet to be measured in the native tissue. Ultimately, native tissue benchmark values are compared to measurements that have been made on engineered disc tissues, identifying where functional equivalence was achieved, and where there remain opportunities for advancement. Several excellent reviews exist regarding disc composition and structure, as well as recent tissue engineering strategies; therefore this review will remain focused on the functional aspects of disc tissue engineering.

Nanofibrous biologic laminates replicate the form and function of the annulus fibrosus

Successful engineering of load-bearing tissues requires recapitulation of their complex mechanical functions. Given the intimate relationship between function and form, biomimetic materials that replicate anatomic form are of great interest for tissue engineering applications. However, for complex tissues such as the annulus fibrosus, scaffolds have failed to capture their multi-scale structural hierarchy. Consequently, engineered tissues have yet to reach functional equivalence with their native counterparts. Here, we present a novel strategy for annulus fibrosus tissue engineering that replicates this hierarchy with anisotropic nanofibrous laminates seeded with mesenchymal stem cells. These scaffolds directed the deposition of an organized, collagen-rich extracellular matrix that mimicked the angle-ply, multi-lamellar architecture and achieved mechanical parity with native tissue after 10 weeks of in vitro culture. Furthermore, we identified a novel role for inter-lamellar shearing in reinforcing the tensile response of biologic laminates, a mechanism that has not previously been considered for these tissues.

Immunolocalization of MMP-19 in the human intervertebral disc: implications for disc aging and degeneration

Matrix metalloproteinases (MMPs) degrade components of the extracellular matrix of the disc, but the presence of MMP-19 has not been explored. In other tissues, MMP-19 is known to act in proteolysis of the insulin-like growth factor (IGF) binding protein-3, thereby exposing this protein to make it available to influence cell behavior. MMP-19 also has been shown to inhibit capillary-like formation and thus play a role in the avascular nature of the disc. Using immunohistochemistry, normal discs from six subjects aged newborn through 10 years and 20 disc specimens from control donors or surgical patients aged 15-76 (mean age 40.2 years) were examined for immunolocalization of MMP-19; six Thompson grade I discs, five Thompson grade II, eight Thompson grade III, five Thompson grade IV, and one Thompson grade V discs were analyzed. The results indicate that in discs from young subjects, MMP-19 was uniformly localized in the outer annulus. In discs from adult donors and surgical patients, outer and inner annulus cells only occasionally showed MMP-19 localization. The greatest expression of MMP-19 was observed in young discs, and little expression was seen in older or degenerating discs. Because MMP-19 has been shown to regulate IGF-mediated proliferation in other tissues, its decline in the aging/degenerating disc may contribute to the age-related decrease in disc cell numbers.

Immunolocalization and biochemical evidence of pregnancy-associated plasma protein A in the intervertebral disc

STUDY DESIGN

Studies were approved by the authors' Human Subjects Institutional Review Board and Institutional Animal Care and Use Committee. Anulus tissue was used in studies of the immunocytochemical localization of pregnancy-associated plasma protein A (PAPP-A) in disc tissue from the sand rat and from human disc surgical specimens and specimens from control donors. Cultured human disc cells were also tested for production of PAPP-A.

OBJECTIVES

(1) To determine the immunohistochemical localization of PAPP-A in human and sand rat discs; (2) To test for gene expression of PAPP-A in the human disc in vivo and in vitro production by cultured cells; and (3) To test for expression of insulin-like growth factor binding proteins (IGFBP)-2, -4, and -5 in vivo and in vitro by human disc cells.

SUMMARY OF BACKGROUND DATA

PAPP-A is a metalloproteinase expressed by several cell types, including fibroblasts, osteoblasts, and smooth muscle cells. PAPP-A has an extremely important role because it cleaves IGFBP-2, -4, and -5 in the extracellular matrix, thereby increasing the bioavailability of IGF to nearby cells. METHODS.: Specimens of human disc tissue and lumbar discs from sand rats were assessed for immunocytochemical localization of PAPP-A, and the percentage of positive cells determined. Human disc cells in three-dimensional culture were assessed for production of PAPP-A using an enzyme linked immunosorbent assay. Molecular gene expression studies were carried out using microarray analysis.

RESULTS

Positive cytoplasmic immunolocalization of PAPP-A was present in the majority of cells of the human and sand rat outer anulus (OA). In the human outer anulus, the percentage of cells positive for PAPP-A localization did not differ in Grades I-II discs vs. Grades III-V discs (OA: 77.4% +/- 10.5 vs. 75.1% +/- 7.4 [mean +/- SEM] respectively). In the inner anulus, however, the percentage of cells positive for PAPP-A localization in more degenerate discs was significantly greater than the percentage in healthier discs (60.7% +/- 10.1 vs. 15.6 +/- 5.4, P = 0.024). % positive cells in the inner anulus correlated significantly with disc grade (r = 0.579; P = 0.01). Over a 5-day three-dimensional culture period, human anulus cells produced and secreted abundant PAPP-A into the culture media. Molecular studies confirmed the expression of IGFBP-2, -4, and -5 both in vivo and in vitro.

CONCLUSIONS

Data provide important new insights into disc cell expression of PAPP-A at the translational level. The presence of a significantly greater proportion of cells positive for PAPP-A in the inner anulus of more degenerate Grade III-V discs compared with healthier Grade I-II discs supports our previous observation of increased gene expression of PAPP-A in more degenerated discs. Biochemical data shown here documented production of PAPP-A by disc cells in vitro. Production of PAPP-A by disc cells is important since PAPP-A cleaves IGF-binding proteins, and makes IGF-I, a potent mitogen and antiapoptotic agent, available to cells. Future studies are indicated to further investigate PAPP-A and IGF-BP function in the disc.

Current developments in tissue engineering of nucleus pulposus for the treatment of intervertebral disc degeneration

The main cause for back pain is considered to be the degenerative changes in the intervertebral disc (IVD). Some evidence indicates that IVD degeneration originates from the nucleus pulposus (NP). The IVD does not possess self repair capacity. Current treatment options range from pain management to invasive procedures. The science of disc cell transplantation is still in its infancy. Advancement in bioengineering based upon tissue engineering techniques may offer the possibility of repairing damaged disc, if an engineered NP with the appropriate functional properties can be generated to augment the degenerated disc. This is likely to require triaxial stimulation of tissue engineering constructs.

1,25(OH)2-vitamin D3 inhibits proliferation and decreases production of monocyte chemoattractant protein-1, thrombopoietin, VEGF, and angiogenin by human annulus cells in vitro

STUDY DESIGN

Human lumbar anulus tissue and cultured human lumbar anulus cells were used in retrospective studies of the immunocytochemical localization of the vitamin D receptor (VDR) in disc tissue, and of the in vitro effects of the active metabolite of vitamin D, 1,25(OH)2D3, on anulus cell proliferation, cytokine, and proteoglycan (PG) production. 24,25-D3 was also analyzed. Studies were approved by the authors' Human Subjects Institutional Review Board. Discs were obtained from surgical specimens and from control donors.

OBJECTIVES

To determine if human anulus cells express the VDR in vivo, and to test the effect of in vitro exposure to 1,25(OH)2D3 and 24,25-D3 on anulus cell proteoglycan and cytokine production in 3-dimensional culture.

SUMMARY OF BACKGROUND DATA

Intragenic polymorphisms in the VDR gene have been associated with disc degeneration. 1,25(OH)2D3 has well-recognized effects on calcium homeostasis and bone mineralization, and is a negative growth regulator of a variety of normal and tumor cells. Its effects on human disc cells, however, are unexplored.

METHODS

Immunocytochemistry was performed on human lumbar disc anulus tissue from 19 subjects; human disc cells were cultured to test the effect of 1,25(OH)2D3 on proliferation of anulus cells from 5 subjects. A paired experimental design was used to determine proteoglycan production in control or 1,25(OH)2D3-treated cells, or in control or 24,25-D3-treated cells using the dimethylmethylene blue assay. A paired experimental design was also used to identify differences in cytokine production in conditioned media from control or 1,25(OH)2D3-treated cells, or in control or 24,25-D3-treated cells using ELISA assays.

RESULTS

Immunocytochemistry documented expression of the VDR in anulus cells. Young donor discs (aged newborn, 15 years) showed positive localization in all cells of the outer anulus, and some inner anulus cells. In adults (mean age, 38.9 years), some, but not all anulus cells, showed positive localization. Exposure to 10M 1,25(OH)2D3 in monolayer significantly reduced cell proliferation in vitro (P = 0.03). PG production in 3-dimensional was unchanged from control in both 1,25(OH)2D3- and 24,25-D3-treated cells. Cytokine production differed, however. 1,25(OH)2D3-treated cells showed significantly decreased production of vascular endothelial growth factor (VEGF) (P = 0.01), monocyte chemoattractant protein-1 (MCP-1) (P = 0.0006), angiogenin (P = 0.002), and thrombopoietin (P = 0.03) compared with controls. 24,25-D3-treated cells showed significantly elevated vascular endothelial growth factor-D (P = 0.01), beta-fibroblast growth factor (0.03), and significantly decreased interleukin-8, interferon-gamma, leptin, MCP-1, and TIMP-2 (tissue inhibitor of metalloproteinases-2) compared with controls (P <or= 0.01).

CONCLUSION

Data suggest that 1,25(OH)2D3 and 24,25-D3 may play roles as regulators of cell proliferation and production of specific cytokines in the lumbar anulus.

Cell viability, proliferation and extracellular matrix production of human annulus fibrosus cells cultured within PDLLA/Bioglass composite foam scaffolds in vitro

The objective of this study was to assess cell viability, attachment, morphology, proliferation, and collagen and sulphated glycosaminoglycan (s-GAG) production by human annulus fibrosus (HAF) cells cultured in vitro in poly(d,l-lactide) (PDLLA)/Bioglass composite foams. PDLLA foams with different percentages (0, 5 and 30wt.%) of Bioglass particles were prepared by thermally induced phase separation (TIPS) and characterized by scanning electron microscopy (SEM). HAF cell viability in the PDLLA/Bioglass foam was analysed using Live/Dead staining. HAF cell attachment was observed using SEM. An assessment of cell proliferation was conducted using the WST-1 assay. The level of s-GAG and collagen produced by HAF cells was quantified using the 1,9-dimethylmethylene blue (DMMB) assay and Sircoltrade mark assay after 4 weeks of culture. The presence of collagen types I and II within the PDLLA/Bioglass composite foams was analysed using immunohistochemistry. Live/dead staining showed that many viable HAF cells were present on the top surface of the foams as well as penetrating into the internal pore structure, suggesting that the PDLLA/Bioglass composite materials are non-toxic and that the presence of Bioglass particles within PDLLA scaffolds does not inhibit HAF cell growth. The SEM observations revealed that more clusters of HAF cells were attached to the pore walls of both the PDLLA/5BG foam and the PDLLA/30BG foam when compared with the PDLLA/0BG foam. WST-1 assay performed over a period of 4 weeks showed an increased tendency of HAF cells to proliferate within both the PDLLA/5BG foam and the PDLLA/30BG foam when compared with both the tissue culture plastic control and the PDLLA/0BG foam, indicating the presence of Bioglass in the foam has a positive effect on HAF cell proliferation. Sircoltrade mark and DMMB assays showed that HAF cells cultured within the PDLLA/30BG foam had a greater ability to deposit collagen and proteoglycan when compared with the control and the PDLLA/0BG foam after 4 weeks in culture, suggesting that the increase of Bioglass content may induce microenvironmental changes which promote the production of extracellular matrix containing abundant collagen and s-GAG. The immunohistochemical analysis of collagen production demonstrated that collagen produced in all cultures was predominantly of type I. These findings provide preliminary evidence for the use of PDLLA/Bioglass composite as cell-carrier materials for future treatments of the intervertebral disc with damaged AF region.

Cell polarity in the anulus of the human intervertebral disc: morphologic, immunocytochemical, and molecular evidence

STUDY DESIGN

Human intervertebral disc tissue was obtained in a prospective study of cell morphology and gene expression. Experimental studies were approved by the authors' Human Subjects Institutional Review Board. Discs were obtained from surgical specimens or control donors.

OBJECTIVES

To determine if there is morphologic and molecular evidence for polarity in cells of the human anulus.

SUMMARY OF BACKGROUND DATA

In many tissues, cells become polarized as they develop functional specializations, which involve cell-cell and cell-extracellular matrix interactions and polarized targeting mechanisms. The highly specialized lamellar organization of the anulus is well recognized and suggests that this structure may be the result of directed secretion of extracellular matrix components by polarized disc cells.

METHODS

Human disc specimens from donor and surgical patients were examined with light and electron microscopy to assess morphology. Specimens were examined for immunocytochemical localization of PAR3 and claudin-1 and -11, recognized polarity proteins, and additional anulus specimens were examined for expression of polarity-related genes using microarray analysis. In vitro monolayer and 3-dimensional anulus cultures were also studied for gene expression, and additional surgical anulus specimens were used to obtain gene expression data using real time RT-PCR.

RESULTS

At the ultrastructural level, anulus cells showed localization of secretory organelles and directed deposition of extracellular matrix in one portion of the cell, with the nucleus positioned in the opposite side of the cell. Expression of the polarity-related genes claudin-11 and PAR3 and PARD6 was confirmed using RT-PCR and microarray studies and immunocytochemical analyses. The percentage of cells positive for PAR3 immunolocalization was significantly greater in the outer anulus (100%) than in either the inner anulus (43.8%) or nucleus pulposus (22.6%).

CONCLUSIONS

At the macroscopic level, the characteristic anular lamellar morphology implies a specialized architectural formation and organization, which is achieved by the tissue-specific function of polarized cells. Morphologic and molecular studies provided evidence for the presence of polarity in cells in the anulus. These findings advance our understanding of anulus disc cell function in production of highly aligned collagen fibrils and macroaggregates of these collagen fibrils into lamellar collagen bundles. Such disc cell activity is important in development and maintenance of the tissue-specific extracellular matrix of the disc.

Three-dimensional culture of annulus fibrosus cells within PDLLA/Bioglass composite foam scaffolds: assessment of cell attachment, proliferation and extracellular matrix production

The objective of the present study was to assess cell attachment, proliferation and extracellular matrix (ECM) production by bovine annulus fibrosus (BAF) cells cultured in vitro in PDLLA/Bioglass composite foams. PDLLA foams incorporated with different percentages (0, 5 and 30wt%) of Bioglass particles were prepared by thermally induced phase separation (TIPS) process and characterized by scanning electron microscopy (SEM). BAF cell morphology and attachment within the PDLLA/Bioglass foams were analysed using SEM. An assessment of cell proliferation was conducted using the WST-1 assay. The amount of sulphated glycosaminoglycans (sGAG) were quantified using the 1,9-dimethylmethylene blue (DMMB) assay after 4 weeks in culture. Furthermore, the amount of collagen synthesis was determined using a hydroxyproline assay, and the presence of collagen types I and II was investigated using Western blotting. Our results reveal that PDLLA/Bioglass foam scaffolds can provide an appropriate microenvironment for BAF cell culture which enhances cell proliferation and promotes the production of sGAG, collagen type I and collagen type II. These findings provide preliminary evidence for the use of PDLLA/Bioglass composite scaffolds as cell-carrier materials for future treatments of intervertebral discs with damaged AF regions.

Immunolocalization of thrombospondin in the human and sand rat intervertebral disc

STUDY DESIGN

Human intervertebral disc tissue from the anulus was obtained in a prospective study investigating the presence of the matricellular protein thrombospondin (TSP) in human and sand rat discs. Studies were approved by the authors' Human Subjects Institutional Review Board and Institutional Animal Care and Use Committee.

OBJECTIVES

To determine whether TSP could be detected in the human or sand rat disc with immunohistochemistry, and to assess its localization.

SUMMARY OF BACKGROUND DATA

The role of the matricellular proteins in maintenance of disc health and extracellular matrix remodeling is as yet poorly understood. SPARC and tenascin have previously been shown to be present in the human disc. TSP has a well-recognized antiangiogenic activity in vivo and in vitro.

METHODS

Sixteen specimens of human disc tissue and discs from 7 sand rats were assessed for immunohistochemical localization of TSP. Three human disc cell cultures grown in three-dimensional culture were also evaluated. RESULTS.: Strong immunoreactivity was present in the outer anulus of both human and sand rat discs. Inner anulus showed lesser localization. In clusters, both immuno-positive and -negative cells were present. Similar patterns of localization were seen in the sand rat specimens. Human disc cells in three-dimensional culture produced abundant TSP.

CONCLUSIONS

The biologic basis for the avascular adult human disc does not appear to have been explored. Since TSP has recognized antiangiogenic effects both in vitro and in vivo, we suggest that the strong immunolocalization of TSP in the outer anulus indicates a role for TSP in the avascular status of the adult human and sand rat disc.

In vitro studies of annulus fibrosus disc cell attachment, differentiation and matrix production on PDLLA/45S5 Bioglass composite films

The aim of this study was to investigate the potential of using PDLLA/45S5 (PDLLA--poly(D,L-lactide)) Bioglass composite films for the culture of annulus fibrosus (AF) cells in vitro with a view to a tissue engineering application. PDLLA films incorporated with different percentages (0, 5 and 30 (wt%)) of Bioglass particles were prepared by solvent casting and characterized by scanning electron microscopy (SEM), water contact angle and white-light interferometry. Bovine AF cell morphology and attachment were analysed using SEM. Cytoskeletal organization was determined by actin labelling with FITC-phalloidin using fluorescence microscopy. The amount of sulphated glycosaminoglycan (sGAG) and collagen produced by AF cells were quantified using the 1,9-dimethylmethylene blue (DMMB) and Sircol assays after 4 weeks in culture. Composite films of PDLLA filled with Bioglass are an appropriate substrate for annulus cells and these films promote the production of an extracellular matrix (ECM) containing abundant sGAGs and collagen. These findings provide a basis for the understanding of the production of ECM molecules by cells cultured on 2D PDLLA/45S5 Bioglass composite films. The results will provide new insights into the design and development of composites containing Bioglass and resorbable polymers as scaffolds for intervertebral disc tissue repair.

Biomechanical and biochemical characterization of composite tissue-engineered intervertebral discs

Composite tissue-engineered intervertebral tissue was assembled in the shape of cylindrical disks composed of an outer shell of PGA mesh seeded with annulus fibrosus cells with an inner core of nucleus pulposus cells seeded into an alginate gel. Samples were implanted subcutaneously in athymic mice and retrieved at time points up to 16 weeks. At all retrieval times, samples maintained shape and contained regions of distinct tissue formation. Histology revealed progressive tissue formation with distinct morphological differences in tissue formation in regions seeded with annulus fibrosus and nucleus pulposus cells. Biochemical analysis indicated that DNA, proteoglycan, and collagen content in tissue-engineered discs increased with time, reaching >50% of the levels of native tissue by 16 weeks. The exception to this was the collagen content of the nucleus pulposus portion of the implants with were approximately 15% of native values. The equilibrium modulus of tissue-engineered discs was 49.0+/-13.2 kPa at 16 weeks, which was between the measured values for the modulus of annulus fibrosus and nucleus pulposus. The hydraulic permeability of tissue-engineered discs was 5.1+/-1.7x10(-14) m2/Pa at 16 weeks, which was between the measured values for the hydraulic permeability of annulus fibrosus and nucleus pulposus. These studies document the feasibility of creating composite tissue-engineered intevertebral disc implants with similar composition and mechanical properties to native tissue.

Evaluation of polymer scaffolds to be used in a composite injectable system for intervertebral disc tissue engineering

Adult porcine nucleus pulposus cells were seeded onto gelatin, demineralized bone matrix (DBM), and polylactide scaffolds and cultured in vitro. Cellular behavior in response to the scaffolds was analyzed using biochemical assays, histology, and real-time quantitative reverse transcriptase-polymerase chain reaction. Scanning electron microscopy showed pronounced differences in surface texture of the scaffolds. Nucleus pulposus cells attached and assumed an elongated fibroblast-like morphology on the gelatin and DBM scaffolds. The cells cultured on the gelatin and DBM were metabolically active and expressed types I and II collagen and aggrecan. Detached cellular aggregates with a rounded morphology were noted in the culture tubes containing the polylactide scaffolds. Both surface chemistry and texture likely had a role in causing differences in cellular behavior in response to scaffold material. Promising results were observed using the gelatin and demineralized bone scaffolds, but the behavior of cells cultured on these scaffolds will need to be characterized further. This initial research will be used to direct future work involved in developing this composite injectable tissue engineering system.

Formation of a nucleus pulposus-cartilage endplate construct in vitro

Intervertebral disc (IVD) degeneration is a common problem and treatment options for persistent symptomatic disease are limited. Tissue engineering is being explored for its ability to reconstitute the functional components of the IVD. The purpose of this study was to determine whether it was possible to form in vitro a triphasic construct consisting of nucleus pulposus (NP), cartilage endplate (CEP), and a porous calcium polyphosphate (CPP) bone substitute. Bovine articular chondrocytes were placed on the top surface of a porous CPP construct and allowed to form cartilage in vitro. Nucleus pulposus cells were then placed onto the in vitro-formed hyaline cartilage. At 24 h scanning electron microscopy demonstrated that the NP cells maintained their rounded morphology, similar to NP cells placed directly on porous CPP. At 8 weeks histological examination of the triphasic constructs by light microscopy showed that a continuous layer of NP tissue had formed and was fused to the underlying cartilage tissue, which itself was integrated with the porous CPP. The incorporation of the cartilage layer was beneficial to the construct by improving tissue attachment to the CPP, as demonstrated by increased peak load and increased energy required for failure during shear loading when compared to a biphasic construct composed of nucleus pulposus-bone substitute only. This study demonstrates that it is possible to generate a multi-component construct with the incorporation of a CEP-like layer resulting in improved bone substitute-to-IVD tissue interface characteristics.

Three-dimensional culture of human disc cells within agarose or a collagen sponge: assessment of proteoglycan production

The objective of the present study was to assess proteoglycan production by human intervertebral disc cells cultured in vitro in selected cell carriers. Based on previous studies which evaluated disc cells seeded into collagen sponge, collagen gel, agarose, alginate or fibrin gel three-dimensional (3D) cell carriers, collagen sponge and agarose were found to provide superior microenvironments for formation of extracellular matrix (ECM). A standardized test design was used to evaluate ECM formed after 14 days of culture using the 1,9-dimethylmethylene blue (DMB) assay to assess sulfated glycosaminoglycan (S-GAG) production. Although agarose culture showed higher S-GAG levels compared to collagen sponge (2.94+/-2.20 (19) microg/ml S-GAG (mean+/-S.D. (n)) vs. 0.94+/-0.77 (22), respectively, p=0.0003), this is off-set by the significantly lower proliferation rate associated with culture of disc cells in agarose.

A three-dimensional collagen matrix as a suitable culture system for the comparison of cyclic strain and hydrostatic pressure effects on intervertebral disc cells

OBJECT

To study intervertebral disc cell mechanobiology, the authors developed experimental systems that allow the application of cyclic strain and intermittent hydrostatic pressure (IHP) on isolated disc cells under equal three-dimensional (3D) culture conditions. The purpose of the study was to characterize disc cell proliferation, viability, morphology, and gene expression in 3D collagen matrices.

METHODS

The effects of cyclic strain (1, 2, 4, and 8% strain; 1 Hz) and IHP (0.25 MPa, 0.1 Hz) on gene expression (real-time polymerase chain reaction) of anabolic and catabolic matrix proteins were investigated and compared with those derived from mechanically unstimulated controls. Intervertebral disc cells proliferated in the collagen gels (mean viability 91.6%) and expressed messenger RNA for collagen I, collagen II, aggrecan, matrix metalloproteinase (MMP)-2, and MMP-3. Morphologically, both spindle-shaped cells with longer processes and rounded cells were detected in the collagen scaffolds. Cyclic strain increased collagen II and aggrecan expression and decreased MMP-3 expression of anulus fibrosus cells. No significant difference between the four strain magnitudes was found. Intermittent hydrostatic pressure tended to increase collagen I and aggrecan expression of nucleus cells and significantly decreased MMP-2 and -3 expression of nucleus cells, whereas aggrecan expression of anulus cells tended to decrease.

CONCLUSIONS

Based on these results, the collagen matrix appeared to be a suitable substrate to apply both cyclic strain and IHP to intervertebral disc cells under 3D culture conditions. Individual variations may be influenced by the extent of degeneration of the disc specimens from which the cells were isolated. This experimental setup may be suitable for studying the influence of degeneration on the disc cell response to mechanical stimuli.

Colony formation and matrix production by human anulus cells: modulation in three-dimensional culture

STUDY DESIGN

Human intervertebral disc cells from the anulus were tested in a study of colony formation and extracellular matrix (ECM) production during long-term three-dimensional culture with exposure to selected cytokines. Experimental studies were approved by the authors' Human Subjects Institutional Review Board.

OBJECTIVES

To quantitatively evaluate colony formation and qualitatively assess ECM production (using immunohistochemistry and in situ hybridization) in cells derived from Thompson Grades I to V discs and tested in culture with cytokines and nutrient supplementation.

SUMMARY OF THE BACKGROUND DATA

Human intervertebral disc cells offer special in vitro challenges because of the slow-growing nature of these cells and their need for specialized three-dimensional in vitro conditions, which permit the expression and production of proteoglycans and Type II collagen, two ECM products that are important for disc cell biology.

METHODS

Discs from 9 human subjects (2 control donors and 7 surgical patients, Thompson Grades I-V), mean age 35.8 years, were used to obtain anulus cells to be tested in three-dimensional agarose culture. Tests of specialized growth conditions included treatment with ITS (insulin-transferrin-sodium selenite supplement), insulin-like growth factor I (IGF-I), and transforming growth factor-beta1 (TGF-beta1). Cultures were evaluated after 14 to 36 days of culture for % colony formation and cell numbers/colony; immunocytochemistry, in situ hybridization, and quantitative histology were used to evaluate colony formation and ECM production.

RESULTS

: Data showed that compared with the average 17.5% colony formation observed in controls, ITS, TGF-beta1 and ITS with IGF-I significantly increased colony formation (28.4%, 30.4%, and 30.4%, respectively, P < or = 0.04). Even cells derived from Thompson Grade V disc showed responsiveness to cytokines and improved production of ECM in vitro.

CONCLUSIONS

: Findings indicated that cells derived from discs with advanced degeneration were still responsive to cytokines and could be modulated to produce Type II collagen and proteoglycans in three-dimensional culture by the addition of enriched media and selected cytokines. Such findings are important since they advance our understanding of how to modulate disc cell behavior in vitro, and may have application to potential future biologic therapies for disc degeneration.