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Lin P, Yan P, Zhu J, Huang S, Wang Z, Hu O, Jin H, Li Y, Zhang L, Zhao J, Chen L, Liu B, He J, Gan Y, Liu P. Spatially multicellular variability of intervertebral disc degeneration by comparative single-cell analysis. Cell Prolif 2023; 56:e13464. [PMID: 37025067 PMCID: PMC10542621 DOI: 10.1111/cpr.13464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
Previous studies have revealed cellular heterogeneity in intervertebral discs (IVDs). However, the cellular and molecular alteration patterns of cell populations during degenerative progression remain to be fully elucidated. To illustrate the cellular and molecular alteration of cell populations in intervertebral disc degeneration (IDD), we perform single cell RNA sequencing on cells from four anatomic sites of healthy and degenerative goat IVDs. EGLN3+ StressCs, TGFBR3+ HomCs and GPRC5A+ RegCs exhibit the characteristics associated with resistance to stress, maintaining homeostasis and repairing, respectively. The frequencies and signatures of these cell clusters fluctuate with IDD. Notably, the chondrogenic differentiation programme of PROCR+ progenitor cells is altered by IDD, while notochord cells turn to stemness exhaustion. In addition, we characterise CAV1+ endothelial cells that communicate with chondrocytes through multiple signalling pathways in degenerative IVDs. Our comprehensive analysis identifies the variability of key cell clusters and critical regulatory networks responding to IDD, which will facilitate in-depth investigation of therapeutic strategies for IDD.
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Affiliation(s)
- Peng Lin
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Pulin Yan
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Jun Zhu
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Sha Huang
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Zhong Wang
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Ou Hu
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Huaijian Jin
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Yangyang Li
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Liang Zhang
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Jianhua Zhao
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Lin Chen
- Center of Bone Metabolism and Repair, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Laboratory for the Prevention and Rehabilitation of Military Training Related Injuries, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Bing Liu
- State Key Laboratory of Proteomics, Academy of Military Medical SciencesAcademy of Military SciencesBeijing100071China
- State Key Laboratory of Experimental Hematology, Institute of HematologyFifth Medical Center of Chinese PLA General HospitalBeijing100071China
- Key Laboratory for Regenerative Medicine of Ministry of EducationInstitute of Hematology, School of Medicine, Jinan UniversityGuangzhou510632China
- State Key Laboratory of Experimental HematologyInstitute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical SciencesTianjin300020China
| | - Jian He
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
- Laboratory of Basic MedicineThe General Hospital of Western Theater CommandChengdu610031China
| | - Yibo Gan
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
| | - Peng Liu
- Department of Spine Surgery, Center of Orthopedics, State Key Laboratory of Trauma, Burns and Combined Injury, Daping HospitalArmy Medical University (Third Military Medical University)Chongqing400042China
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Liu XW, Xu HW, Yi YY, Zhang SB, Wang SJ. Role of ferroptosis and immune infiltration in intervertebral disc degeneration: novel insights from bioinformatics analyses. Front Cell Dev Biol 2023; 11:1170758. [PMID: 37736497 PMCID: PMC10509768 DOI: 10.3389/fcell.2023.1170758] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023] Open
Abstract
Background: Intervertebral disc degeneration (IVDD), which contributes to stenosis of the spinal segment, commonly causes lower back pain. The process of IVDD degradation entails gradual structural adjustments accompanied by extreme transformations in metabolic homeostasis. However, the molecular and cellular mechanisms associated with IVDD are poorly understood. Methods: The RNA-sequencing datasets GSE34095 and GSE56081 were obtained from the Gene Expression Omnibus (GEO) database. Ferroptosis-related differentially expressed genes (DEGs) were identified from these gene sets. The protein-protein interaction (PPI) network was established and visualized using the STRING database and Cytoscape software, and the key functional modules of ferroptosis-related genes were identified. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed on the DEGs. Weighted gene co-expression network analysis (WGCNA), immune infiltration analysis in the GEO database, and other GSE series were used as validation datasets. The xCELL algorithm was performed to investigate the immune cell infiltration differences between the degenerated IVDD and control groups. Results: The major genes involved in nucleus pulposus tissue immune infiltration and ferroptosis-related genes were mined by bioinformatics analysis. A total of 3,056 DEGs were obtained between the IVDD tissue and control groups. The DEGs were enriched in the cell cycle; apoptosis; necroptosis; and the PI3K-Akt, Hippo, and HIF-1 signaling pathways. PCR and Western blot techniques were utilized to confirm the differential ferroptosis-related genes. The results indicated that the protein expression levels of NCOA4 and PCBP1 were elevated, while the protein expression level of GPX4 was reduced in NPCs following IL-1β treatment. Our study has found that severe disc tissue degeneration leads to a noteworthy increase in the expression of CD8A in naive T cells, CCR7 in memory CD4+ cells, GZMB in natural killer (NK) cells, and CD163 and CD45 in macrophages. Conclusion: Our data demonstrate that ferroptosis occurs in IVDD, suggesting that ferroptosis may also increase IVDD improvement by triggering immune infiltration. This work was conducted to further understand IVDD pathogenesis and identify new treatment strategies.
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Affiliation(s)
- Xiao-Wei Liu
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hao-Wei Xu
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yu-Yang Yi
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shu-Bao Zhang
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shan-Jin Wang
- Department of Spinal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Orthopedic, East Hospital, Ji’an Hospital, Jinggangshan University School of Medicine, Jiangxi, China
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Xu H, Li J, Fei Q, Jiang L. Contribution of immune cells to intervertebral disc degeneration and the potential of immunotherapy. Connect Tissue Res 2023; 64:413-427. [PMID: 37161923 DOI: 10.1080/03008207.2023.2212051] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/11/2023]
Abstract
Substantial evidence supports that chronic low back pain is associated with intervertebral disc degeneration (IDD), which is accompanied by decreased cell activity and matrix degradation. The role of immune cells, especially macrophages, in a variety of diseases has been extensively studied; therefore, their role in IDD has naturally attracted widespread scholarly interest. The IVD is considered to be an immunologically-privileged site given the presence of physical and biological barriers that include an avascular microenvironment, a high proteoglycan concentration, high physical pressure, the presence of apoptosis inducers such as Fas ligand, and the presence of notochordal cells. However, during IDD, immune cells with distinct characteristics appear in the IVD. Some of these immune cells release factors that promote the inflammatory response and angiogenesis in the disc and are, therefore, important drivers of IDD. Although some studies have elucidated the role of immune cells, no specific strategies related to systemic immunotherapy have been proposed. Herein, we summarize current knowledge of the presence and role of immune cells in IDD and consider that immunotherapy targeting immune cells may be a novel strategy for alleviating IDD symptoms.
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Affiliation(s)
- Hao Xu
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Juan Li
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qinming Fei
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Libo Jiang
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Orthopedic Surgery, Zhongshan Hospital, Fudan University, Xiamen, Fujian Province, China
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Feng P, Che Y, Gao C, Zhu L, Gao J, Vo NV. Immune exposure: how macrophages interact with the nucleus pulposus. Front Immunol 2023; 14:1155746. [PMID: 37122738 PMCID: PMC10140429 DOI: 10.3389/fimmu.2023.1155746] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/31/2023] [Indexed: 05/02/2023] Open
Abstract
Intervertebral disc degeneration (IDD) is a primary contributor to low back pain. Immune cells play an extremely important role in modulating the progression of IDD by interacting with disc nucleus pulposus (NP) cells and extracellular matrix (ECM). Encased within the annulus fibrosus, healthy NP is an avascular and immune-privileged tissue that does not normally interact with macrophages. However, under pathological conditions in which neovascularization is established in the damaged disc, NP establishes extensive crosstalk with macrophages, leading to different outcomes depending on the different microenvironmental stimuli. M1 macrophages are a class of immune cells that are predominantly pro-inflammatory and promote inflammation and ECM degradation in the NP, creating a vicious cycle of matrix catabolism that drives IDD. In contrast, NP cells interacting with M2 macrophages promote disc tissue ECM remodeling and repair as M2 macrophages are primarily involved in anti-inflammatory cellular responses. Hence, depending on the crosstalk between NP and the type of immune cells (M1 vs. M2), the overall effects on IDD could be detrimental or regenerative. Drug or surgical treatment of IDD can modulate this crosstalk and hence the different treatment outcomes. This review comprehensively summarizes the interaction between macrophages and NP, aiming to highlight the important role of immunology in disc degeneration.
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Affiliation(s)
- Peng Feng
- School of Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- Department of Spine, Wangjing Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Ying Che
- School of Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chunyu Gao
- Department of Spine, Wangjing Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Liguo Zhu
- Department of Spine, Wangjing Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
- Beijing Key Laboratory of Bone Setting Technology of Traditional Chinese Medicine, Wangjing Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
| | - Jinghua Gao
- Department of Spine, Wangjing Hospital Affiliated to China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Jinghua Gao, ; Nam V. Vo,
| | - Nam V. Vo
- Ferguson Laboratory for Orthopedic and Spine Research, Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, United States
- *Correspondence: Jinghua Gao, ; Nam V. Vo,
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Role of Advanced Glycation End Products in Intervertebral Disc Degeneration: Mechanism and Therapeutic Potential. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:7299005. [PMID: 36573114 PMCID: PMC9789911 DOI: 10.1155/2022/7299005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
The incidence of low back pain caused by lumbar disc degeneration is high, and it can lead to loss of work ability and impose heavy social and economic burdens. The pathogenesis of low back pain is unclear, and there are no effective treatments. With age, the deposition of advanced glycation end products (AGEs) in intervertebral disc (IVD) gradually increases and is accelerated by diabetes and a high-AGEs diet, leading to destruction of the annulus fibrosus (AF), nucleus pulposus (NP), and cartilage endplate (CEP) and finally intervertebral disc degeneration (IDD). Reducing the accumulation of AGEs in IVD and blocking the transmission of downstream signals caused by AGEs have a significant effect on alleviating IDD. In this review, we summarize the mechanism by which AGEs induce IDD and potential treatment strategies.
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Hydroxytyrosol Ameliorates Intervertebral Disc Degeneration and Neuropathic Pain by Reducing Oxidative Stress and Inflammation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:2240894. [PMID: 36388163 PMCID: PMC9646310 DOI: 10.1155/2022/2240894] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/27/2022] [Accepted: 09/22/2022] [Indexed: 12/01/2022]
Abstract
Low back pain (LBP) seriously affects human quality of life. Intervertebral disc degeneration (IVDD) is the main pathological factor that leads to LBP, but the pathological mechanism underlying IVDD has not been fully elucidated. Neuropathic pain caused by IVDD is an important pathological factor affecting people's daily lives. Therefore, it is very important to identify therapeutic drugs to ameliorate IVDD and secondary neuropathic pain. Hydroxytyrosol (HT) is a natural compound derived from olive leaves and oil and has anti-inflammatory, antioxidant, and antitumor activities and other properties. In this study, TNF-α-stimulated human nucleus pulposus cells (HNPCs) were used to simulate the local inflammatory microenvironment observed in IVDD in vitro to explore the role of HT in alleviating various pathological processes associated with IVDD. A rat needle puncture model was used to further explore the role of HT in alleviating IVDD. Lipopolysaccharide (LPS) was used to stimulate microglia in vitro to comprehensively explore the role of HT in alleviating neuropathic pain, and a rat model involving chronic compression of the dorsal root ganglion (CCD) was established to simulate the neuropathic pain caused by IVDD. This study suggests that HT reduces the expression of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), the NOD-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4) and matrix metalloproteinase-13 (MMP-13); inhibits the production of mitochondrial reactive oxygen species (ROS); and maintains mitochondrial homeostasis. Thus, HT appears to reduce the rate of apoptosis and mitigate the loss of major intervertebral disc components by inhibiting the nuclear factor kappa-B (NF-κB) signaling pathway. Moreover, HT inhibited the secretion of COX-2, tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-1β, and iNOS and activation of the NLRP3 inflammasome in microglia by inhibiting the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) and extracellular regulated protein kinase (ERK) signaling pathways. In conclusion, HT plays a protective role against IVDD and secondary neuropathic pain by inhibiting the NF-κB, PI3K/AKT, and ERK signaling pathways.
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DPSCs Protect Architectural Integrity and Alleviate Intervertebral Disc Degeneration by Regulating Nucleus Pulposus Immune Status. Stem Cells Int 2022; 2022:7590337. [PMID: 36299466 PMCID: PMC9590116 DOI: 10.1155/2022/7590337] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Abstract
Intervertebral disc (IVD) degeneration is the primary cause for low back pain that has a high prevalence in modern society and poses enormous economic burden on patients. Few effective therapeutic strategies are available for IVD degeneration treatment. To understand the biological effects of dental pulp stem cells (DPSCs) on nucleus pulposus (NP) cells, we carried out RNA sequencing, bioinformatic analysis which unveiled gene expression differences, and pathway variation in primarily isolated patients' NP cells after treatment with DPSCs supernatant. Western blot and immunofluorescence were used to verify these molecular alterations. Besides, to evaluate the therapeutic effect of DPSCs in IVD degeneration treatment, DPSCs were injected into a degeneration rat model in situ, with treatment outcome measured by micro-CT and histological analysis. RNA sequencing and in vitro experiments demonstrated that DPSCs supernatant could downregulate NP cells' inflammation-related NF-κB and JAK-STAT pathways, reduce IL-6 production, increase collagen II expression, and mitigate apoptosis. In vivo results showed that DPSCs treatment protected the integrity of the disc structure, alleviated extracellular matrix degradation, and increased collagen fiber expression. In this study, we verified the therapeutic effect of DPSCs in an IVD degeneration rat model and elucidated the underlying molecular mechanism of DPSCs treatment, which provides a foundation for the application of DPSCs in IVD degeneration treatment.
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Karamian BA, Levy HA, Boere P, Yalla GR, Canseco JA, Chang M, Divi SN, Fang T, Millhouse PW, Lendner M, Hilibrand AS, Vaccaro AR, Kepler CK, Markova DZ, Schroeder GD. Do Inflammatory Cytokines Affect Patient Outcomes After ACDF? Clin Spine Surg 2022; 35:137-143. [PMID: 35351842 DOI: 10.1097/bsd.0000000000001318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/01/2022] [Indexed: 11/26/2022]
Abstract
STUDY DESIGN Prospective cohort study. OBJECTIVE The aim was to determine the relationship between serum inflammatory mediators, preoperative cervical spine disease severity, and clinical outcomes after anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA Given the role of the inflammatory cascade in spinal degenerative disease, it has been hypothesized that inflammatory markers may serve as a predictor of patient outcomes after surgery. MATERIALS AND METHODS All patients over age 18 who underwent ACDF for cervical spondylosis with associated radiculopathy and/or myelopathy between 2015 and 2017 from a single institution were prospectively recruited. Preoperative serum inflammatory markers including interleukin (IL)-6, IL-8, tumor necrosis factor-α, high-mobility group box-1 (HMGB1), and white blood cells were measured and correlated to patient demographics, surgical characteristics, duration of symptoms, previous opioid use, and preoperative and 1-year postoperative patient-reported outcomes measures (PROMs) including the neck disability index (NDI), visual analog scale neck pain, visual analog scale arm pain, and Physical and Mental Component Scores of the Short Form-12 (PCS and MCS, respectively) using spearman's rho coefficient. RESULTS A total of 77 patients were enrolled with follow-up PROMs available for 62% (n=48) of patients at a minimum of 1-year after ACDF. The absolute concentrations of IL-6 and tumor necrosis factor-α were found to be weakly correlated with one another (ρ=0.479). Preoperative symptoms lasting <1-year were weakly correlated with elevation in HMGB1 (ρ=0.421). All other patient demographics exhibited negligible correlation with the preoperative inflammatory markers. Lower preoperative PCS (ρ=0.355) and higher preoperative NDI (ρ=0.336) were weakly correlated with elevated HMGB1. Lower MCS (ρ=0.395) and higher NDI (ρ=0.317) preoperatively were weakly correlated with elevated white blood cells. Postoperative improvement in MCS (ρ=0.306) and MCS recovery ratio (ρ=0.321) exhibited a weakly positive correlation with IL-6. CONCLUSION Preoperative cytokine levels demonstrated minimal correlation with preoperative symptoms or clinical improvement, suggesting that profiling of patient cytokines has limited utility in predicting outcomes after ACDF. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Brian A Karamian
- Department of Orthopaedic Surgery, Rothman Institute
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Hannah A Levy
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Payton Boere
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Goutham R Yalla
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Jose A Canseco
- Department of Orthopaedic Surgery, Rothman Institute
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Michael Chang
- Department of Orthopaedic Surgery, Rothman Institute
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Srikanth N Divi
- Department of Orthopaedic Surgery, Rothman Institute
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Taolin Fang
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Paul W Millhouse
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Mayan Lendner
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Alan S Hilibrand
- Department of Orthopaedic Surgery, Rothman Institute
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Alexander R Vaccaro
- Department of Orthopaedic Surgery, Rothman Institute
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Christopher K Kepler
- Department of Orthopaedic Surgery, Rothman Institute
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Dessislava Z Markova
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
| | - Gregory D Schroeder
- Department of Orthopaedic Surgery, Rothman Institute
- Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, PA
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Mesenchymal Stem Cell-Derived Extracellular Vesicles: Immunomodulatory Effects and Potential Applications in Intervertebral Disc Degeneration. Stem Cells Int 2022; 2022:7538025. [PMID: 35222648 PMCID: PMC8881131 DOI: 10.1155/2022/7538025] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 11/25/2021] [Accepted: 01/05/2022] [Indexed: 02/06/2023] Open
Abstract
Intervertebral disc (IVD) degenerative disease is a common health problem worldwide. Administration of mesenchymal stem cells (MSCs) in intervertebral disc degeneration (IVDD) has been widely explored in recent years. However, transplantation of MSCs is restricted by several factors. Currently, paracrine signaling is one of the main mechanisms by which MSCs play a therapeutic role in disc regeneration. Extracellular vehicles (EVs) are the main paracrine products of MSCs. They show great potential as an effective alternative to MSCs and play immunomodulation roles such as anti-inflammatory effects, antioxidative stress, antiapoptosis, and antiextracellular matrix (ECM) degradation during treatment of IVDD. This review focuses on the immunomodulatory effect of MSC EVs and their potential applications.
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The Role of Oxidative Stress in Intervertebral Disc Degeneration. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:2166817. [PMID: 35069969 PMCID: PMC8769842 DOI: 10.1155/2022/2166817] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/21/2021] [Accepted: 12/04/2021] [Indexed: 12/22/2022]
Abstract
Intervertebral disc degeneration is a very common type of degenerative disease causing severe socioeconomic impact, as well as a major cause of discogenic low back pain and herniated discs, placing a heavy burden on patients and the clinicians who treat them. IDD is known to be associating with a complex process involving in extracellular matrix and cellular damage, and in recent years, there is increasing evidence that oxidative stress is an important activation mechanism of IDD and that reactive oxygen and reactive nitrogen species regulate matrix metabolism, proinflammatory phenotype, autophagy and senescence in intervertebral disc cells, apoptosis, autophagy, and senescence. Despite the tremendous efforts of researchers within the field of IDD pathogenesis, the proven strategies to prevent and treat this disease are still very limited. Up to now, several antioxidants have been proved to be effective for alleviating IDD. In this article, we discussed that oxidative stress accelerates disc degeneration by influencing aging, inflammation, autophagy, and DNA methylation, and summarize some antioxidant therapeutic measures for IDD, indicating that antioxidant therapy for disc degeneration holds excellent promise.
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Mangiferin Alleviates Mitochondrial ROS in Nucleus Pulposus Cells and Protects against Intervertebral Disc Degeneration via Suppression of NF- κB Signaling Pathway. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6632786. [PMID: 34234886 PMCID: PMC8216826 DOI: 10.1155/2021/6632786] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/15/2021] [Accepted: 04/23/2021] [Indexed: 01/07/2023]
Abstract
Intervertebral disc degeneration (IVDD), one of the most common clinical diseases worldwide, causes disc herniation and sciatica. Recent studies have identified the involvement of mitochondrial dysfunction, inflammatory responses, and extracellular matrix degradation in IVDD. Mangiferin is known to protect against various diseases by inhibiting oxidative stress, suppressing inflammation reaction, and relieving mitochondrial dysfunction. Whether mangiferin can alleviate IVDD remains to be elucidated. In the present study, human nucleus pulposus cells (HNPCs) and mouse intervertebral discs were cultured and stimulated with TNF-α, with or without treatment of mangiferin. Moreover, we established a rat needle puncture model and injected mangiferin into the intervertebral discs to verify its protective effect on IVDD. Furthermore, the activity of the NF-κB signaling pathway was tested in vitro. Our results indicated that mangiferin alleviated the inflammatory response and reversed the loss of major intervertebral disc components. Besides, mangiferin reduced reactive oxygen species production, ameliorated mitochondrial damage, and decreased the expression of apoptosis-related parameters in stimulation of TNF-α. In addition, mangiferin antagonized the activation of the NF-κB signaling pathway induced by TNF-α. Collectively, mangiferin antagonized mitochondrial ROS in NP cells and protected against IVDD by suppressing the activation of the NF-κB signaling pathway, which might provide a potential therapeutic instrument for IVDD.
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Aripaka SS, Bech-Azeddine R, Jørgensen LM, Chughtai SA, Gaarde C, Bendix T, Mikkelsen JD. Low back pain scores correlate with the cytokine mRNA level in lumbar disc biopsies: a study of inflammatory markers in patients undergoing lumbar spinal fusion. 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 2021; 30:2967-2974. [PMID: 34023967 DOI: 10.1007/s00586-021-06868-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/26/2021] [Accepted: 05/02/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE The molecular mechanism behind pain in degenerative disc disease (DDD) and chronic low back pain (LBP) patients is largely unknown. This present study examines the association of LBP and disability to mediators of the inflammatory cascade, as indexed by mRNA gene expression of pro-inflammatory cytokine markers in the intervertebral disc (IVD). METHODS Biopsies of the annulus fibrosus (AF) and the nucleus pulposes (NP) from patients with DDD undergoing 1-2 level fusion surgery at L4/L5 or L5/S1 were obtained from total of 34 patients [9 M, 25 F] with average age of 53 [32-63]. The mRNA expression of TNF-α, IL-1β, and IL-6 in the AF and NP was analyzed using quantitative real-time polymerase chain reaction (RT-qPCR), and the expression level of these markers was correlated to the visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores (0-100) for pain and disability. RESULTS We report a statistically significant positive correlation between pain intensity (VAS score) and the expression of TNF-α in both the AF (r = 0.54, p = 0.001) and NP (r = 0.40, p = 0.02), similarly with IL-1β in AF (r = 0.37, p = 0.02) and IL-6 in NP (r = 0.40, p = 0.02). In addition, we found significant positive correlation observed between disability score (ODI) and expression of IL-6 in both AF (r = 0.36, p = 0.03) and NP (r = 0.41, p = 0.01). CONCLUSION We conclude that the intensity of LBP and disability is associated with the level of inflammation in the disc.
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Affiliation(s)
- Sanjay S Aripaka
- Neurobiology Research Unit, University Hospital Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - R Bech-Azeddine
- Copenhagen Spine Research Unit, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L M Jørgensen
- Neurobiology Research Unit, University Hospital Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Copenhagen Spine Research Unit, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S A Chughtai
- Copenhagen Spine Research Unit, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - C Gaarde
- Copenhagen Spine Research Unit, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - T Bendix
- Copenhagen Spine Research Unit, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark
| | - J D Mikkelsen
- Neurobiology Research Unit, University Hospital Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Network Analysis Identifies Gene Regulatory Network Indicating the Role of RUNX1 in Human Intervertebral Disc Degeneration. Genes (Basel) 2020; 11:genes11070771. [PMID: 32659941 PMCID: PMC7397129 DOI: 10.3390/genes11070771] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 06/29/2020] [Accepted: 07/07/2020] [Indexed: 12/31/2022] Open
Abstract
Intervertebral disc (IVD) degeneration (IDD) is a multifactorial physiological process which is often associated with lower back pain. Previous studies have identified some molecular markers associated with disc degeneration, which despite their significant contributions, have provided limited insight into the etiology of IDD. In this study, we utilized a network medicine approach to uncover potential molecular mediators of IDD. Our systematic analyses of IDD associated with 284 genes included functional annotation clustering, interaction networks, network cluster analysis and Transcription factors (TFs)-target gene network analysis. The functional enrichment and protein–protein interaction network analysis highlighted the role of inflammatory genes and cytokine/chemokine signaling in IDD. Moreover, sub-network analysis identified significant clusters possessing organized networks of 24 cytokine and chemokine genes, which may be considered as key modulators for IDD. The expression of these genes was validated in independent microarray datasets. In addition, the regulatory network analysis identified the role of multiple transcription factors, with RUNX1 being a master regulator in the pathogenesis of IDD. Our analyses highlighted the role of cytokine genes and interacting pathways in IDD and further improved our understanding of the genetic mechanisms underlying IDD.
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14
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Zhao Y, Qiu C, Wang W, Peng J, Cheng X, Shangguan Y, Xu M, Li J, Qu R, Chen X, Jia S, Luo D, Liu L, Li P, Guo F, Vasilev K, Liu L, Hayball J, Dong S, Pan X, Li Y, Guo L, Cheng L, Li W. Cortistatin protects against intervertebral disc degeneration through targeting mitochondrial ROS-dependent NLRP3 inflammasome activation. Theranostics 2020; 10:7015-7033. [PMID: 32550919 PMCID: PMC7295059 DOI: 10.7150/thno.45359] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/19/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Intervertebral disc (IVD) degeneration is a common degenerative disease that can lead to collapse or herniation of the nucleus pulposus (NP) and result in radiculopathy in patients. Methods: NP tissue and cells were isolated from patients and mice, and the expression profile of cortistatin (CST) was analysed. In addition, ageing of the NP was compared between 6-month-old WT and CST-knockout (CST-/-) mice. Furthermore, NP tissues and cells were cultured to validate the role of CST in TNF-α-induced IVD degeneration. Moreover, in vitro and in vivo experiments were performed to identify the potential role of CST in mitochondrial dysfunction, mitochondrial ROS generation and activation of the NLRP3 inflammasome during IVD degeneration. In addition, NF-κB signalling pathway activity was tested in NP tissues and cells from CST-/- mice. Results: The expression of CST in NP cells was diminished in the ageing- and TNF-α-induced IVD degeneration process. In addition, compared with WT mice, aged CST-/- mice displayed accelerated metabolic imbalance and enhanced apoptosis, and these mice showed a disorganized NP tissue structure. Moreover, TNF-α-mediated catabolism and apoptosis were alleviated by exogenous CST treatment. Furthermore, CST inhibited mitochondrial dysfunction in NP cells through IVD degeneration and suppressed activation of the NLRP3 inflammasome. In vitro and ex vivo experiments indicated that increased NF-κB pathway activity might have been associated with the IVD degeneration observed in CST-/- mice. Conclusion: This study suggests the role of CST in mitochondrial ROS and activation of the NLRP3 inflammasome in IVD degeneration, which might shed light on therapeutic targets for IVD degeneration.
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15
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Yu H, Liu Y, Xie W, Xie Q, Liu Q, Cheng L. IL-38 alleviates the inflammatory response and the degeneration of nucleus pulposus cells via inhibition of the NF-κB signaling pathway in vitro. Int Immunopharmacol 2020; 85:106592. [PMID: 32502922 DOI: 10.1016/j.intimp.2020.106592] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 12/14/2022]
Abstract
Previous studies have suggested that the inflammatory response contributes to the onset of intervertebral disc degeneration (IVDD). Interleukin (IL)-38, a newly discovered cytokine of the IL-1 family, has been demonstrated to play an anti-inflammatory role in autoimmune diseases, such as Crohn's disease, rheumatoid arthritis and psoriasis. However, whether IL-38 participates in the pathogenesis of IVDD remains unknown. In this study, human disc tissues from IVDD patients and rat disc tissues from an IVDD model were collected to measure the expression of IL-38 in the IVDD groups and the control groups by western blot and immunohistochemical staining. To further determine the role of IL-38 in IVDD, human nucleus pulposus cells (HNPCs) were stimulated with TNF-α to generate an in vitro model of inflammation to mimic the local inflammatory environment of the lumbar disc. The inflammatory response and HNPC degeneration markers were measured after stimulation with TNF-α and IL-38. IL-38 was upregulated in both the human and rat degenerated disc tissues compared with the control tissues. In vitro, IL-38 significantly decreased the TNF-α-induced expression of IL-1β, IL-6, COX-2, MMP-13 and ADAMTS-5 in the HNPCs, and IL-38 also alleviated the TNF-α-induced reductions in type II collagen and aggrecan. Moreover, IL-38 inhibited the activation of the NF-κB signaling pathway in the HNPC-based model of inflammation by reducing the expression level of the NF-κB P-P65 protein. In conclusion, IL-38 could alleviate the inflammatory response and HNPC degeneration in vitro via the inhibition of the NF-κB signaling pathway. These results suggest that IL-38 may be a new strategy for the treatment of IVDD.
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Affiliation(s)
- Haichao Yu
- Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, People's Republic of China
| | - Yi Liu
- Department of Orthopedics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, People's Republic of China
| | - Weiping Xie
- Department of Rehabilitation Medicine, People's Hospital of Dingtao District, Heze 274100, Shandong, People's Republic of China
| | - Qing Xie
- Department of Pharmacy, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, People's Republic of China
| | - Qiaohui Liu
- Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, People's Republic of China.
| | - Lei Cheng
- Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, People's Republic of China.
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16
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Zheng H, Wang T, Li X, He W, Gong Z, Lou Z, Wang B, Li X. LncRNA MALAT1 exhibits positive effects on nucleus pulposus cell biology in vivo and in vitro by sponging miR-503. BMC Mol Cell Biol 2020; 21:23. [PMID: 32228440 PMCID: PMC7106590 DOI: 10.1186/s12860-020-00265-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/18/2020] [Indexed: 12/17/2022] Open
Abstract
Background Intervertebral disc degeneration (IDD) is characterized by the loss of nucleus pulposus cells (NPCs) and phenotypic abnormalities. Accumulating evidence suggests that long noncoding RNAs (lncRNAs) are involved in the pathogenesis of IDD. In this study, we aimed to investigate the functional effects of lncRNA MALAT1 on NPCs in IDD and the possible mechanism governing these effects. Results We validated the decreased expression of MALAT1 in the IDD tissues, which was associated with decreased Collagen II and Aggrecan expression. In vitro, overexpressed MALAT1 could attenuate the effect of IL-1β on NPC proliferation, apoptosis, and Aggrecan degradation. In vivo, MALAT1 overexpression attenuated the severity of disc degeneration in IDD model rats. Our molecular study further demonstrated that MALAT1 could sponge miR-503, modulate the expression of miR-503, and activate downstream MAPK signaling pathways. The effects of MALAT1 on NPCs were partially reversed/aggregated by miR-503 mimics/inhibitor treatment. Conclusion Our data suggested that the MALAT1-miR-503-MAPK pathway plays a critical role in NPCs, which may be a potential strategy for alleviating IDD.
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Affiliation(s)
- Hongyu Zheng
- Department of Emergency Medical, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Tingting Wang
- Department of Geriatrics, Yan' An Hospital of Kunming City, Kunming, China
| | - Xiangmin Li
- Department of Panicaceae, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wei He
- Department of Orthopedics, Qianjiang Central Hospital, Qianjiang, China
| | - Zhiqiang Gong
- Department of Orthopedics, First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Kunming, Yunnan, China
| | - Zhenkai Lou
- Department of Orthopedics, First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Kunming, Yunnan, China
| | - Bing Wang
- Department of Orthopedics, First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Kunming, Yunnan, China
| | - Xingguo Li
- Department of Orthopedics, First Affiliated Hospital of Kunming Medical University, No. 295 Xichang Road, Kunming, Yunnan, China.
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Bydon M, Moinuddin FM, Yolcu YU, Wahood W, Alvi MA, Goyal A, Elminawy M, Galeano-Garces C, Dudakovic A, Nassr A, Larson AN, van Wijnen AJ. Lumbar intervertebral disc mRNA sequencing identifies the regulatory pathway in patients with disc herniation and spondylolisthesis. Gene 2020; 750:144634. [PMID: 32240779 DOI: 10.1016/j.gene.2020.144634] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 12/16/2022]
Abstract
Lumbar degenerative disc disease (DDD) is a multifaceted progressive condition and often accompanied by disc herniation (DH) and/or degenerative spondylolisthesis (DS). Given the high prevalence of the disease (up to 20% according to some estimates) and the high costs associated with its care, there is a need to explore novel therapies such as regenerative medicine. Exploring these novel therapies first warrants investigation of molecular pathways underlying these disorders. Here, we show results from next generation RNA sequencing (RNA-seq) on mRNA isolated from 10 human nucleus pulposus (NP) samples of lumbar degenerated discs (DH and DS; n = 5 for each tissue) and other musculoskeletal tissues (Bone, cartilage, growth plate, and muscle; n = 7 for each tissue). Pathway and network analyses based on gene ontology (GO) terms were used to identify the biological functions of differentially expressed mRNAs. A total of 701 genes were found to be significantly upregulated in lumbar NP tissue compared to other musculoskeletal tissues. These differentially expressed mRNAs were primarily involved in DNA damage, immunity and G1/S transition of mitotic cell cycle. Interestingly, DH-specific signaling genes showed major network in chemotactic (e.g., CXCL10, CXCL11, IL1RL2 and IL6) and matrix-degrading pathway (e.g., MMP16, ADAMTSL1, 5, 8, 12, and 15), while DS-specific signaling genes were found to be those involved in cell adhesion (e.g., CDH1, EPHA1 and EFNA2) and inflammatory cytokines (e.g., CD19, CXCL5, CCL24, 25 and XCL2). Our findings provide new leads for therapeutic drug discovery that would permit optimization of medical or pharmacological intervention for cases of lumbar DDD.
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Affiliation(s)
- Mohamad Bydon
- Mayo Clinic Neuro-Informatics Laboratory, Rochester, MN, United States; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States.
| | - F M Moinuddin
- Mayo Clinic Neuro-Informatics Laboratory, Rochester, MN, United States; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Yagiz U Yolcu
- Mayo Clinic Neuro-Informatics Laboratory, Rochester, MN, United States; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Waseem Wahood
- Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Mohammed Ali Alvi
- Mayo Clinic Neuro-Informatics Laboratory, Rochester, MN, United States; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Anshit Goyal
- Mayo Clinic Neuro-Informatics Laboratory, Rochester, MN, United States; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Mohammed Elminawy
- Mayo Clinic Neuro-Informatics Laboratory, Rochester, MN, United States; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Catalina Galeano-Garces
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Amel Dudakovic
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States; Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, MN, United States
| | - Ahmad Nassr
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States
| | - A Noelle Larson
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Andre J van Wijnen
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States; Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, MN, United States.
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18
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Ge J, Yan Q, Wang Y, Cheng X, Song D, Wu C, Yu H, Yang H, Zou J. IL-10 delays the degeneration of intervertebral discs by suppressing the p38 MAPK signaling pathway. Free Radic Biol Med 2020; 147:262-270. [PMID: 31883468 DOI: 10.1016/j.freeradbiomed.2019.12.040] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/15/2019] [Accepted: 12/24/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The degeneration of intervertebral discs (IVD) is a risk factor for chronic low back pain. Anti-inflammation therapy could alleviate IVD degeneration. IL-10 is an important anti-inflammatory cytokine. However, the effect of IL-10 on IVD has not been fully revealed. The current study is to reveal the effect of IL-10 on IVD and its underlying mechanism. METHODS IL-1β was used to induce the degeneration of nucleus pulposus cells (NPCs). mRNA expression level was determined by qPCR. Protein expression level was determined by western blotting. Methylene blue was used to determined the expression of aggrecan. Immunocytochemical staining was used to determined the expression of collagen II. A rat caudal IVD degeneration model was established and used to evaluate the effect of IL-10 on IVD in vivo. RESULTS IL10 could alleviated NPC degeneration in both morphology and extracellular matrix. IL-10 could increase the mRNA expression of Collagen II, Sox-9, but decrease the mRNA expression of IL-1β, TNFα and Collagen X. IL-10 could also increase the protein level of Collagen II and aggrecan, but decrease that of Collagen X. Western blotting futher revealed the mechanism of the positive effect of IL-10 on IVD. IL-10 reduces phosphorylation level of p38 MAPK effectively. Rat caudal IVD degeneration model futher confirmed the positive effect of IL-10 on IVD degeneration and its mechanism in vivo. CONCLUSION The current study demonstrates that exogenous IL-10 treatment can induce an anti-inflammatory response and inhibit p38 MAPK activation to delay IVD degeneration.
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Affiliation(s)
- Jun Ge
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China
| | - Qi Yan
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China
| | - Yingjie Wang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China
| | - Xiaoqiang Cheng
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China
| | - Dawei Song
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China
| | - Cenhao Wu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China
| | - Hao Yu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China
| | - Huilin Yang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China
| | - Jun Zou
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China.
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19
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Yang S, Zhang F, Ma J, Ding W. Intervertebral disc ageing and degeneration: The antiapoptotic effect of oestrogen. Ageing Res Rev 2020; 57:100978. [PMID: 31669486 DOI: 10.1016/j.arr.2019.100978] [Citation(s) in RCA: 183] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 10/20/2019] [Accepted: 10/22/2019] [Indexed: 02/07/2023]
Abstract
As an important part of the spinal column, the intervertebral disc (IVD) plays an important role in the intervertebral juncture and spinal movement in general. IVD degeneration (IVDD), which mimics disc ageing but at an accelerated rate, is a common and chronic process that results in severe spinal symptoms, such as lower back pain. It is generally assumed that lower back pain caused by IVDD can also develop secondary conditions, including spinal canal stenosis, spinal segmental instability, osteophyte formation, disc herniation and spinal cord and nerve root compression. Over the past few years, many researchers around the world have widely studied the relevance between oestrogen and IVDD, indicating that oestrogen can effectively alleviate IVDD development by inhibiting the apoptosis of IVD cells. Oestrogen can decrease IVD cell apoptosis in multiple ways, including the inhibition of the inflammatory cytokines IL-1β and TNF-α, reducing catabolism because of inhibition of matrix metalloproteinases, upregulating integrin α2β1 and IVD anabolism, activating the PI3K/Akt pathway, decreasing oxidative damage and promoting autophagy. In this article, we perform an overview of the literature regarding the antiapoptotic effect of oestrogen in IVDD.
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Affiliation(s)
- Sidong Yang
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139Ziqiang Rd, Shijiazhuang 050051, PR China.
| | - Feng Zhang
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, 139Ziqiang Rd, Shijiazhuang 050051, PR China.
| | - Jiangtao Ma
- Laboratory of Immunology, Hebei Provincial Institute of Orthopaedic Research, 139Ziqiang Rd, Shijiazhuang 050051, PR China.
| | - Wenyuan Ding
- Department of Spine Surgery, The Third Hospital of Hebei Medical University, 139Ziqiang Rd, Shijiazhuang 050051, PR China.
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Xie L, Huang W, Fang Z, Ding F, Zou F, Ma X, Tao J, Guo J, Xia X, Wang H, Yu Z, Lu F, Jiang J. CircERCC2 ameliorated intervertebral disc degeneration by regulating mitophagy and apoptosis through miR-182-5p/SIRT1 axis. Cell Death Dis 2019; 10:751. [PMID: 31582722 PMCID: PMC6776655 DOI: 10.1038/s41419-019-1978-2] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/04/2019] [Accepted: 09/16/2019] [Indexed: 12/21/2022]
Abstract
The molecular mechanism of intervertebral disc degeneration (IVDD) remains unclear. This study aimed to investigate the role of circular RNAs (circRNAs) in the pathogenesis of IVDD. We sued nucleus pulposus (NP) tissues of patients, tert-butyl hydroperoxide (TBHP) stimulated NP cells (NPCs), and IVDD rat model to explore the interaction between circERCC2 and miR-182-5p/SIRT1 axis. The results showed that downregulation of circERCC2 increased the level of miR-182-5p and decreased the level of SIRT1 in degenerative NP tissues in vivo as well as in TBHP-stimulated NPCs in vitro. Treatment of SIRT1-si activated apoptosis and inhibited mitophagy. Moreover, miR-182-5p-si could regulate the mitophagy and the apoptosis of NPCs by targeting SIRT1. The effects of circERCC2 on NPCs and IVDD rat model were mediated by miR-182-5p/SIRT1 axis. In conclusion, this study provides the first evidence that circERCC2 could ameliorate IVDD through miR-182-5p/SIRT1 axis by activating mitophagy and inhibiting apoptosis, and suggests that circERCC2 is a potentially effective therapeutic target for IVDD.
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Affiliation(s)
- Lin Xie
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi Road, Shanghai, 200040, China
| | - Weibo Huang
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi Road, Shanghai, 200040, China
| | - Zhenhua Fang
- Department of Orthopedic Surgery, Wuhan Fourth Hospital, Huazhong University of Science and Technology, 473 Hanzheng Street, Wuhan, 430000, China
| | - Fan Ding
- Department of Spinal Surgery, Wuhan Puren Hospital, Wuhan University of Science and Technology, 1 Benxi Street, Wuhan, 430080, China
| | - Fei Zou
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi Road, Shanghai, 200040, China
| | - Xiaosheng Ma
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi Road, Shanghai, 200040, China
| | - Jie Tao
- Laboratory of Neuropharmacology and Neurotoxicology, Shanghai University, 381 Nanchen Road, Shanghai, 200436, China
| | - Jingkang Guo
- Laboratory of Neuropharmacology and Neurotoxicology, Shanghai University, 381 Nanchen Road, Shanghai, 200436, China
| | - Xinlei Xia
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi Road, Shanghai, 200040, China
| | - Hongli Wang
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi Road, Shanghai, 200040, China.
| | - Zuochong Yu
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi Road, Shanghai, 200040, China
- Department of Orthopedic Surgery, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China
| | - Feizhou Lu
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi Road, Shanghai, 200040, China
- Department of Orthopedic Surgery, The Fifth People's Hospital of Shanghai, Fudan University, 128 Ruili Road, Shanghai, 201100, China
| | - Jianyuan Jiang
- Department of Orthopedics, Huashan Hospital, Fudan University, 12 Mid-Wulumuqi Road, Shanghai, 200040, China.
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Ge J, Yang H, Chen Y, Yan Q, Wu C, Zou J. PMMA Bone Cement Acts on the Hippo/YAP Pathway To Regulate CTGF and Induce Intervertebral Disc Degeneration. ACS Biomater Sci Eng 2019; 5:3293-3302. [PMID: 33405572 DOI: 10.1021/acsbiomaterials.9b00146] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Jun Ge
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
| | - Huilin Yang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
| | - Yufeng Chen
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
| | - Qi Yan
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
| | - Cenhao Wu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
| | - Jun Zou
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China
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22
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Hodgkinson T, Shen B, Diwan A, Hoyland JA, Richardson SM. Therapeutic potential of growth differentiation factors in the treatment of degenerative disc diseases. JOR Spine 2019; 2:e1045. [PMID: 31463459 PMCID: PMC6686806 DOI: 10.1002/jsp2.1045] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/16/2019] [Accepted: 02/04/2019] [Indexed: 02/06/2023] Open
Abstract
Intervertebral disc (IVD) degeneration is a major contributing factor to chronic low back pain and disability, leading to imbalance between anabolic and catabolic processes, altered extracellular matrix composition, loss of tissue hydration, inflammation, and impaired mechanical functionality. Current treatments aim to manage symptoms rather than treat underlying pathology. Therefore, IVD degeneration is a target for regenerative medicine strategies. Research has focused on understanding the molecular process of degeneration and the identification of various factors that may have the ability to halt and even reverse the degenerative process. One such family of growth factors, the growth differentiation factor (GDF) family, have shown particular promise for disc regeneration in in vitro and in vivo models of IVD degeneration. This review outlines our current understanding of IVD degeneration, and in this context, aims to discuss recent advancements in the use of GDF family members as anabolic factors for disc regeneration. An increasing body of evidence indicates that GDF family members are central to IVD homeostatic processes and are able to upregulate healthy nucleus pulposus cell marker genes in degenerative cells, induce mesenchymal stem cells to differentiate into nucleus pulposus cells and even act as chemotactic signals mobilizing resident cell populations during disc injury repair. The understanding of GDF signaling and its interplay with inflammatory and catabolic processes may be critical for the future development of effective IVD regeneration therapies.
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Affiliation(s)
- Tom Hodgkinson
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchester Academic Health Sciences CentreManchesterUK
- Centre for the Cellular Microenvironment, Institute of Molecular, Cell and Systems Biology, College of Medical, Veterinary and Life SciencesUniversity of GlasgowGlasgowUK
| | - Bojiang Shen
- St. George Clinical SchoolUniversity of New South WalesSydneyNew South WalesAustralia
| | - Ashish Diwan
- St. George Clinical SchoolUniversity of New South WalesSydneyNew South WalesAustralia
| | - Judith A. Hoyland
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchester Academic Health Sciences CentreManchesterUK
- NIHR Manchester Biomedical Research Centre, Manchester University Foundation TrustManchester Academic Health Sciences CentreManchesterUK
| | - Stephen M. Richardson
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of ManchesterManchester Academic Health Sciences CentreManchesterUK
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Yang S, Li L, Zhu L, Zhang C, Li Z, Guo Y, Nie Y, Luo Z. Aucubin inhibits IL‐1β‐ or TNF‐α‐induced extracellular matrix degradation in nucleus pulposus cell through blocking the miR‐140‐5p/CREB1 axis. J Cell Physiol 2019; 234:13639-13648. [PMID: 30637726 DOI: 10.1002/jcp.28044] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 12/03/2018] [Indexed: 01/04/2023]
Affiliation(s)
- Shaofeng Yang
- Department of Spine The First Hospital of Hunan University of Chinese Medicine Changsha China
| | - Linghui Li
- Department of General Orthopedics Wangjing Hospital, China Academy of Chinese Medical Sciences Beijing China
| | - Liguo Zhu
- Department of General Orthopedics Wangjing Hospital, China Academy of Chinese Medical Sciences Beijing China
| | - Chao Zhang
- Department of Spine The First Hospital of Hunan University of Chinese Medicine Changsha China
| | - Zhaoyong Li
- Department of Spine The First Hospital of Hunan University of Chinese Medicine Changsha China
| | - Yantao Guo
- Department of Spine The First Hospital of Hunan University of Chinese Medicine Changsha China
| | - Ying Nie
- Department of Spine The First Hospital of Hunan University of Chinese Medicine Changsha China
| | - Zhenhua Luo
- Department of Spine The First Hospital of Hunan University of Chinese Medicine Changsha China
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24
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Gao ST, Xu T, Xun CH, Liang WD, Cao R, Mao C, Sheng WB. Significant association of IL-6-572G/C, IL-6-597G/A, and IL-6-174G/C polymorphisms and susceptibility to lumbar degenerative disease: A meta-analysis. Clin Neurol Neurosurg 2018; 175:40-46. [PMID: 30326328 DOI: 10.1016/j.clineuro.2018.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/25/2018] [Accepted: 10/07/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To assess and synthesize the current evidence on the association of interleukin-6 (IL-6)-572 G/C, IL-6-597 G/A, and IL-6-174 G/C polymorphisms and risk of lumbar degenerative disease (LDD). PATIENTS AND METHODS Five electronic databases including PubMed, EMBASE, Web of Science, CNKI and Wanfang were systematically searched for potential studies previous to August 10, 2018. Summary odds ratio (OR) and corresponding 95% confidence interval (95%CI) were calculated to evaluate the association. RESULTS Nine case-control studies comprising 1519 cases and 1887 controls were obtained for the meta-analysis. For IL-6-572 G/C, IL-6-597 G/A, and IL-6-174 G/C polymorphisms, there were seven, six, and seven studies eventually included in the meta-analysis respectively. The findings indicated that the three polymorphisms had significant associations with risk of LDD: for IL-6-572 G/C, G vs. C, OR = 1.37, 95%CI 1.11-1.69, P = 0.004; for IL-6-597 G/A, G vs. A, OR = 1.38, 95 %CI 1.16-1.65, P = 0.000; for IL-6-174 G/C, G vs. C, OR = 1.63, 95%CI 1.15-2.29, P = 0.006. CONCLUSION The present meta-analysis found IL-6-572 G/C, IL-6-597 G/A, and IL-6-174 G/C polymorphisms were significantly associated with increased risk of LDD susceptibility.
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Affiliation(s)
- Shu-Tao Gao
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, Urumqi, 830054, China.
| | - Tao Xu
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, Urumqi, 830054, China.
| | - Chuan-Hui Xun
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, Urumqi, 830054, China.
| | - Wei-Dong Liang
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, Urumqi, 830054, China.
| | - Rui Cao
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, Urumqi, 830054, China.
| | - Cao Mao
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, Urumqi, 830054, China.
| | - Wei-Bin Sheng
- Department of Spine Surgery, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, Urumqi, 830054, China.
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Suyama K, Sakai D, Hirayama N, Nakamura Y, Matsushita E, Terayama H, Qu N, Tanaka O, Sakabe K, Watanabe M. Effects of interleukin-17A in nucleus pulposus cells and its small-molecule inhibitors for intervertebral disc disease. J Cell Mol Med 2018; 22:5539-5551. [PMID: 30207057 PMCID: PMC6201370 DOI: 10.1111/jcmm.13828] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/07/2018] [Indexed: 01/05/2023] Open
Abstract
Intervertebral discs (IVD) degeneration, which is caused by ageing or mechanical stress, leads to IVD disease, including back pain and sciatica. The cytokine interleukin (IL)-17A is elevated in NP cells during IVD disease. Here we explored the pharmacotherapeutic potential of IL-17A for the treatment of IVD disease using small-molecule inhibitors that block binding of IL-17A to the IL-17A receptor (IL-17RA). Treatment of NP cells with IL-17A increased expression of cyclooxygenase-2 (COX-2), IL-6, matrix metalloproteinase (MMP)-3 and MMP-13. These increases were suppressed by an IL-17A-neutralizing antibody, and small molecules that were identified as inhibitors by binding to the IL-17A-binding region of IL-17RA. IL-17A signalling also altered sulphated glycosaminoglycan deposition and spheroid colony formation, while treatment with small-molecule inhibitors of IL-17A attenuated this response. Furthermore, mitogen-activated protein kinase pathways were activated by IL-17A stimulation and induced IL-6 and COX-2 expression, while small-molecule inhibitors of IL-17A suppressed their expression. Taken together, these results show that IL-17A is a valid target for IVD disease therapy and that small-molecule inhibitors that inhibit the IL-17A-IL-17RA interaction may be useful for pharmacotherapy of IVD disease.
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Affiliation(s)
- Kaori Suyama
- Department of Anatomy and Cellular biology, Basic Medical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Daisuke Sakai
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Noriaki Hirayama
- Institute of Advanced Biosciences, Tokai University, Kanagawa, Japan
| | - Yoshihiko Nakamura
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Erika Matsushita
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Hayato Terayama
- Department of Anatomy and Cellular biology, Basic Medical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Ning Qu
- Department of Anatomy and Cellular biology, Basic Medical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Osamu Tanaka
- Department of Anatomy and Cellular biology, Basic Medical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Kou Sakabe
- Department of Anatomy and Cellular biology, Basic Medical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Masahiko Watanabe
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan
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Wang X, Wang B, Zou M, Li J, Lü G, Zhang Q, Liu F, Lu C. CircSEMA4B targets miR-431 modulating IL-1β-induced degradative changes in nucleus pulposus cells in intervertebral disc degeneration via Wnt pathway. Biochim Biophys Acta Mol Basis Dis 2018; 1864:3754-3768. [PMID: 30251693 DOI: 10.1016/j.bbadis.2018.08.033] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/09/2018] [Accepted: 08/27/2018] [Indexed: 12/11/2022]
Abstract
Intervertebral disc (IVD) degeneration (IDD), characterized by elevated levels of proinflammatory mediators, increased Aggrecan and collagen degradation, and increased degradation of extracellular matrix (ECM), has been widely regarded as a significant contributor to low back pain. Genetics are significant factors contribute to IDD. Based on previous data, circular RNA SEMA4B (circSEMA4B) is down-regulated in IDD specimens; herein, we demonstrated circSEMA4B overexpression could attenuate the effect of IL-1β on nucleus pulposus cell (NPC) proliferation, senescence, and ECM and Aggrecan degradation in IDD via Wnt signaling. Moreover, miR-431, a direct target of circSEMA4B, could bind to the 3'UTR of SFRP1 or GSK-3β, two inhibitory regulators of Wnt signaling, to inhibit their expression thus playing a role similar to the activator of Wnt signaling in NPCs. The effect of circSEMA4B knockdown on NPCs was partially reversed by miR-431 inhibition; circSEMA4B serves as a miR-431 sponge to compete with SFRP1 or GSK-3β for miR-431 binding, thus inhibiting IL-1β-induced degenerative process in NPCs through Wnt signaling. Rescuing circSEMA4B expression in NPCs in IDD might present a potential strategy for IDD improvement.
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Affiliation(s)
- Xiaobin Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China
| | - Bing Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China
| | - Mingxiang Zou
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China
| | - Jing Li
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
| | - Guohua Lü
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China.
| | - Qianshi Zhang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China
| | - Fubin Liu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China
| | - Chang Lu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China
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Niu T, Lv C, Yi G, Tang H, Gong C, Niu S. Therapeutic Effect of Medical Ozone on Lumbar Disc Herniation. Med Sci Monit 2018; 24:1962-1969. [PMID: 29611536 PMCID: PMC5896688 DOI: 10.12659/msm.903243] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/24/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study aimed to investigate the therapeutic effect of low, medium, and high concentrations of medical ozone on trauma-induced lumbar disc herniation. MATERIAL AND METHODS A total of 80 patients were included and were grouped into a control group, a low medical ozone (20 μg/ml) group, a medium medical ozone (40 μg/ml) group, and a high medical ozone (60 μg/ml) group. The CT scan and enzyme-linked immunosorbent assay (ELISA) were used to detect IL-6 level, SOD activity, IgM, and IgG levels upon admission and at 6 and 12 months after follow-up. The area under the ROC curve (AUC) was calculated for visual analogue scale (VAS) and efficiency rate. RESULTS All patients showed disc retraction at 6- and 12-month follow-up; while patients in the medium medical ozone (40 μg/ml) group showed the greatest disc retraction rate. The IL-6, IgM, IgG, and VAS levels significantly decreased while SOD activity increased among all groups over time (p<0.05). The AUCIL-6, AUCIgG, AUCIgM, and AUCSOD was closest to 1 in the medium medical ozone (40 μg/ml) group compared with other groups (p<0.01), with the highest efficacy at 6 (35%) and 12 (85%) months during follow-up. CONCLUSIONS Low concentrations of medical ozone (20 μg/ml and 40 μg/ml) reduced the serum IL-6, IgG, and IgM expression, presenting as analgesic and anti-inflammatory effects, while high concentrations of medical ozone (60 μg/ml) increased the serum IL-6, IgG, IgM expression, presenting as pain and pro-inflammatory effects. The medical ozone concentration of 40 μg/ml showed the optimal treatment efficacy.
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Affiliation(s)
- Tong Niu
- Department of Spine Surgery, Jining First People’s Hospital, Jining, Shandong, P.R. China
| | - Chaoliang Lv
- Department of Spine Surgery, Jining First People’s Hospital, Jining, Shandong, P.R. China
| | - Guangkun Yi
- Department of Spine Surgery, Jining First People’s Hospital, Jining, Shandong, P.R. China
| | - Huamin Tang
- Department of Emergency Medicine, Guangxi Medical College, Nanning, Guangxi, P.R. China
| | - Cunji Gong
- Department of Laboratory Medicine, Jining First People’s Hospital, Jining, Shandong, P.R. China
| | - Shizhen Niu
- School of Clinical Medicine, Jining Medical University, Jining, Shandong, P.R. China
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Wang X, Zou M, Li J, Wang B, Zhang Q, Liu F, Lü G. LncRNA H19 targets miR-22 to modulate H 2 O 2 -induced deregulation in nucleus pulposus cell senescence, proliferation, and ECM synthesis through Wnt signaling. J Cell Biochem 2018. [PMID: 29520849 DOI: 10.1002/jcb.26738] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Intervertebral disc (IVD) degeneration (IDD) is a major contributor to low back pain. During IDD progression, ROS can be produced in the form of H2 O2 in nucleus pulposus cells (NPCs) in response to elevated cytokines, leading to subsequent alternations of cell fate and metabolic processes. Genetic factors are considered as main contributors to IDD pathopoiesis. Herein, we investigated the detailed function and mechanism of H19, one of the most up-regulated lncRNAs in IDD specimens, in H2 O2 -induced cell senescence model in NPCs. H19 could accelerate H2 O2 -induced degenerative changes by promoting cell senescence, increasing ADAMTS-5 and MMPs protein levels and Collagen I content, as well as suppressing NPC proliferation through activating Wnt/β-catenin signaling. Moreover, miR-22, a direct target of H19, could bind to the 3'UTR of LEF1 to inhibit its expression and reverse the effect of H19 on NPCs, thus inhibiting Wnt/β-catenin signaling. Taken together, H19 acts as a ceRNA to compete with LEF1 for miR-22, thus modulating downstream Wnt/β-catenin signaling in NPCs; H19/miR-22/LEF1 might be a novel target for improving H2 O2 -induced NPC senescence and treatment for IDD.
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Affiliation(s)
- Xiaobin Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mingxiang Zou
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jing Li
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bing Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qianshi Zhang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fubin Liu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guohua Lü
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Miguélez-Rivera L, Pérez-Castrillo S, González-Fernández ML, Prieto-Fernández JG, López-González ME, García-Cosamalón J, Villar-Suárez V. Immunomodulation of mesenchymal stem cells in discogenic pain. Spine J 2018; 18:330-342. [PMID: 28939169 DOI: 10.1016/j.spinee.2017.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 08/09/2017] [Accepted: 09/11/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Back pain is a highly prevalent health problem in the world today and has a great economic impact on health-care budgets. Intervertebral disc (IVD) degeneration has been identified as a main cause of back pain. Inflammatory cytokines produced by macrophages or disc cells in an inflammatory environment play an important role in painful progressive degeneration of IVD. Mesenchymal stem cells (MSCs) have shown to have immunosuppressive and anti-inflammatory properties. Mesenchymal stem cells express a variety of chemokines and cytokines receptors having tropism to inflammation sites. PURPOSE This study aimed to develop an in vitro controlled and standardized model of inflammation and degeneration of IVD with rat cells and to evaluate the protective and immunomodulatory effect of conditioned medium (CM) from the culture of MSCs to improve the conditions presented in herniated disc and discogenic pain processes. STUDY DESIGN This is an experimental study. METHODS In this study, an in vitro model of inflammation and degeneration of IVD has been developed, as well as the effectiveness of CM from the culture of MSCs. RESULTS Conditioned medium from MSCs downregulated the expression of various proinflammatory cytokines produced in the pathogenesis of discogenic pain such as interleukin (IL)-1β, IL-6, IL-17, and tumor necrosis factor (TNF). CONCLUSION Mesenchymal stem cells represent a promising alternative strategy in the treatment of IVD degeneration inasmuch as there is currently no treatment which leads to a complete remission of long-term pain in the absence of drugs.
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Affiliation(s)
- Laura Miguélez-Rivera
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana s/n, University of León, 24071, Spain
| | - Saúl Pérez-Castrillo
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana s/n, University of León, 24071, Spain
| | | | - Julio Gabriel Prieto-Fernández
- Institute of Biomedicine (IBIOMED), Faculty of Veterinary Sciences, Campus de Vegazana s/n, Universidad de León, 24071, Spain
| | - María Elisa López-González
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana s/n, University of León, 24071, Spain
| | - José García-Cosamalón
- Institute of Biomedicine (IBIOMED), Faculty of Veterinary Sciences, Campus de Vegazana s/n, Universidad de León, 24071, Spain
| | - Vega Villar-Suárez
- Department of Anatomy, Faculty of Veterinary Sciences, Campus de Vegazana s/n, University of León, 24071, Spain; Institute of Biomedicine (IBIOMED), Faculty of Veterinary Sciences, Campus de Vegazana s/n, Universidad de León, 24071, Spain.
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Shim EK, Lee JS, Kim DE, Kim SK, Jung BJ, Choi EY, Kim CS. Autogenous Mesenchymal Stem Cells from the Vertebral Body Enhance Intervertebral Disc Regeneration via Paracrine Interaction: An in Vitro Pilot Study. Cell Transplant 2018; 25:1819-1832. [PMID: 27075568 DOI: 10.3727/096368916x691420] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Several in vivo studies have found that transplanting mesenchymal stem cells (MSCs) into degenerative intervertebral discs (IVDs) leads to regeneration of disc cells. Since the exact underlying mechanisms are not understood, we investigated the mechanisms of action of MSCs in regeneration of degenerative IVDs via paracrine actions. Human MSCs and degenerative disc cells from the same donor vertebrae were directly or indirectly cocultured. The multidifferentiation potential, cell proliferation, collagen synthesis, and mRNA expression levels were assessed. The proliferation rates of MSCs and degenerative disc cells were higher in the coculture system than in the monolayer cultures or in the conditioned medium of each cell type. During coculturing with nucleus pulposus (NP) cells, mRNA expression of the extracellular matrix (ECM) components aggrecan, versican (VCAN), SOX9, and type II and type VI collagen was significantly increased in MSCs, whereas mRNA expression for type V collagen was increased in MSCs cocultured with annulus fibrosus (AF) cells. In addition, the accumulation of total ECM collagen was greater in cocultured degenerative disc cells than in monocultured cells. During coculturing, MSCs downregulated the expression levels of various proinflammatory cytokine genes in degenerative NP [interleukin-1α ( IL-1α), IL-1β, IL-6, and tumor necrosis factor-α ( TNF-α)] and AF cells ( IL-1α and IL-6), which are involved in the degradation of ECM molecules. In association with the trophic effect of MSCs on degenerative disc cells, upregulation of growth factor mRNA expression was shown in MSCs cocultured with degenerative NP cells [epidermal growth factor ( EGF), insulin-like growth factor-1 ( IGF-1), osteogenic protein-1 ( OP-1), growth and differentiation factor-7 ( GDF-7), and transforming growth factor-β ( TGF-β)] or degenerative AF cells ( IGF-1, OP-1, and GDF-7). In terms of MSC-based clinical approaches to IVD regeneration, implanting MSCs into a degenerative IVD may both stimulate MSC differentiation into an NP- or AF-like phenotype and stimulate the biological activation of degenerative disc cells for self-repair.
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Affiliation(s)
- Eun-Kyung Shim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Department of Applied Life Science, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Dong-Eun Kim
- Biomedical Research Institute, iBMT, Anyang, South Korea
| | - Seul Ki Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Byung-Joo Jung
- Department of Neurosurgery, Naeun Hospital, Anyang, South Korea
| | - Eun-Young Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Department of Applied Life Science, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, South Korea
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31
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Proinflammatory Cytokines IL-1β and TNF-α Influence Human Annulus Cell Signaling Cues for Neurite Growth: In Vitro Coculture Studies. Spine (Phila Pa 1976) 2017; 42:1529-1537. [PMID: 28306638 DOI: 10.1097/brs.0000000000002155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Institutional review board-approved research using human annulus cells cocultured with F11 nerve cells. OBJECTIVE To perform functional, kinetic assays of neurite dynamics and media neurotrophin measurements to test whether proinflammatory cytokines influence annulus cells' signaling cues for neurite growth/repulsion. SUMMARY OF BACKGROUND DATA Nerves grow in response to signaling molecules called neurotrophins, which disc cells produce (e.g., brain-derived neurotrophic factor [BDNF], glial cell line-derived neurotrophic factor [GDNF], and neurotrophin 3 [NT3]) and which influence neuron survival, differentiation, and migration. How proinflammatory cytokines influence disc signaling cues for neurite growth/repulsion is poorly understood. METHODS Studies used our previous model of 4-day human annulus cell-F11 nerve cell coculture to assess effects of added proinflammatory cytokines interleukin 1 beta (IL-1β; 10 pmol/L) or tumor necrosis factor alpha (TNF-α) (10 pmol/L). Annulus cells were cultured from 6 Thompson grade I, 9 grade II, 8 grade III, 11 grade IV, and 7 grade V discs. Neurite lengths were measured following control conditions or with added IL-1β or TNF-α, and conditioned media assayed with RayBiotech Growth Factor Arrays. Standard statistical methods used analysis of variance and Spearman correlation coefficient testing associations of neurite length with neurotrophin levels. RESULTS IL-1-β or TNF-α significantly increased neurite lengths (P < 0.001) and BDNF, NT3, and GDNF media levels (P ≤ 0.01) versus controls. Significant positive correlations were present between media neurotrophin levels for BDNF, NT3, and GDNF and neurite lengths under control conditions, following addition of IL-1β, and following addition of TNF-α. Novel data showed production of the neurotrophin amphiregulin. CONCLUSION In vitro data supported the hypothesis that nerve-disc cell interactions may be influenced by the heightened proinflammatory milieu present in degenerating discs, leading to increased nerve migration. Data may have direct clinical relevance/implications for nerve ingrowth and pain in the outer annulus (where disc cell numbers are high), and in regions where nerves penetrate into the disc via annular tears. LEVEL OF EVIDENCE N/A.
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32
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Chen Y, Huang J, Tang C, Chen X, Yin Z, Heng BC, Chen W, Shen W. Small molecule therapeutics for inflammation-associated chronic musculoskeletal degenerative diseases: Past, present and future. Exp Cell Res 2017; 359:1-9. [PMID: 28739444 DOI: 10.1016/j.yexcr.2017.07.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 12/13/2022]
Abstract
Inflammation-associated chronic musculoskeletal degenerative diseases (ICMDDs) like osteoarthritis and tendinopathy often results in morbidity and disability, with consequent heavy socio-economic burden. Current available therapies such as NSAIDs and glucocorticoid are palliative rather than disease-modifying. Insufficient systematic research data on disease molecular mechanism also makes it difficult to exploit valid therapeutic targets. Small molecules are designed to act on specific signaling pathways and/or mechanisms of cellular physiology and function, and have gradually shown potential for treating ICMDDs. In this review, we would examine and analyze recent developments in small molecule drugs for ICMDDs, suggest possible feasible improvements in treatment modalities, and discuss future research directions.
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Affiliation(s)
- Yangwu Chen
- Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China; Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Zhejiang 310000, China; Orthopaedics Research Institute of Zhejiang Univerisity, China; Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; China Orthopaedic Regenerative Medicine (CORMed), Hangzhou, China
| | - Jiayun Huang
- Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China; Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Zhejiang 310000, China; Orthopaedics Research Institute of Zhejiang Univerisity, China; Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; China Orthopaedic Regenerative Medicine (CORMed), Hangzhou, China
| | - Chenqi Tang
- Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China; Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Zhejiang 310000, China; Orthopaedics Research Institute of Zhejiang Univerisity, China; Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; China Orthopaedic Regenerative Medicine (CORMed), Hangzhou, China
| | - Xiao Chen
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Zhejiang 310000, China; Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; China Orthopaedic Regenerative Medicine (CORMed), Hangzhou, China
| | - Zi Yin
- Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Zhejiang 310000, China; Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China
| | - Boon Chin Heng
- Faculty of Dentistry, Department of Endodontology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Weishan Chen
- Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China; Orthopaedics Research Institute of Zhejiang Univerisity, China.
| | - Weiliang Shen
- Department of Orthopedic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang 310009, China; Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cell and Regenerative Medicine, Zhejiang University, Zhejiang 310000, China; Orthopaedics Research Institute of Zhejiang Univerisity, China; Department of Sports Medicine, School of Medicine, Zhejiang University, Zhejiang 310000, China; China Orthopaedic Regenerative Medicine (CORMed), Hangzhou, China.
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Gruber HE, Marrero E, Ingram JA, Hoelscher GL, Hanley EN. Constitutive expression of IL-22 in the human intervertebral disc and its reduction by exposure to pro-inflammatory cytokines in vitro. Biotech Histochem 2017; 92:222-229. [PMID: 28409653 DOI: 10.1080/10520295.2017.1300834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The importance of cytokines in disc degeneration is well recognized. Little is known about IL-22 expression in the human intervertebral disc. We investigated IL-22 immuno-localization in disc tissue, and molecular expression and production of IL-22 by annulus cells cultured in three-dimensional (3D) culture. We examined human disc tissue using immunohistochemistry and we cultured isolated annulus cells in 3D to analyze IL-22 expression and production, and its receptor, IL-22R, in conditioned media. Ingenuity pathway analysis (IPA) also was used to identify significant gene expression networks within the molecular data. IL-22 and IL-22R were immunolocalized in many cells in the human outer and inner annulus; fewer cells exhibited localization in the nucleus. Three-dimensional culture of annulus cells demonstrated production of IL-22 in conditioned media; exposure to IL-1ß or TNF-α significantly reduced IL-22 levels. Significant decreases also were identified in conditioned media assayed for IL-22R in TNF-α treated cells. IPA analysis showed that IL-22 ranked among the top canonical pathways. We found constitutive expression and production of IL-22 and IL-22R in the disc, which expands our understanding of the effect of pro-inflammatory cytokines on IL-22 expression and production. Three-dimensional cultured annulus cells exposed to IL-1ß or TNF produced significantly lower levels of IL-22 into their conditioned media compared to levels produced by control cells. Our findings have clinical relevance because of the elevated pro-inflammatory milieu within the degenerating human disc.
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Affiliation(s)
- H E Gruber
- a Department of Orthopaedic Surgery , Carolinas Medical Center , Charlotte , North Carolina
| | - E Marrero
- a Department of Orthopaedic Surgery , Carolinas Medical Center , Charlotte , North Carolina
| | - J A Ingram
- a Department of Orthopaedic Surgery , Carolinas Medical Center , Charlotte , North Carolina
| | - G L Hoelscher
- a Department of Orthopaedic Surgery , Carolinas Medical Center , Charlotte , North Carolina
| | - E N Hanley
- a Department of Orthopaedic Surgery , Carolinas Medical Center , Charlotte , North Carolina
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Beyaz SG, İnanmaz ME, Ergönenç T, Palabıyık O, Tomak Y, Tuna AT. Comparison of the Intravenous and Epidural Administration of Tumor Necrosis Factor-alpha Antagonists in an Experimental Rat Pain Model. Anesth Essays Res 2017; 11:898-901. [PMID: 29284846 PMCID: PMC5735485 DOI: 10.4103/aer.aer_160_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Inflammatory cytokines secreted from the nucleus pulposus are thought to lead to lumbar nerve root compression-like symptoms. Tumor necrosis factor-alpha (TNF-α), an inflammatory cytokine, likely plays an important role in lumbar disc hernia-related leg pain. In this experimental study, we compared the effectiveness of TNF-α antagonists administered through the intravenous or epidural route in lumbar spine pathologies. Materials and Methods After ethics committee approval had been obtained, 24 Sprague Dawley male rats aged 70-90 days and weighing 250-300 g each were allocated to four groups. In Group I, only the surgical procedure was performed; in Group II, 1 ml of saline solution was administered into the epidural field; in Group III, 10 mg/kg of infliximab was administered into the coccygeal vein; and in Group IV (epidural group), 25 mg of etanercept was administered into the epidural region. Results When the left leg pull values were analyzed on day 14, whereas there was not a significant difference among the three groups, a decreasing difference was observed in Group IV (P < 0.05). When the 21st and 28th day left leg pull values were compared between groups, the values from Groups II, III, and IV were significantly lower than those of Group I (P < 0.05). Conclusion The absence of a difference between the baseline values and left leg pull values on days 14, 21, and 28 in Group IV indicates that recovery began on day 21 with the epidural administration of etanercept. There was no difference between intravenous saline administration and intravenous infliximab administration with regard to the start of the recovery. In the present study of rats with discopathy, TNF-α antagonists administered epidurally led to earlier recovery from radiculopathy-related allodynia compared to intravenous administration.
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Affiliation(s)
- Serbülent Gökhan Beyaz
- Department of Anesthesiology and Pain Medicine, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Mustafa Erkan İnanmaz
- Department of Orthopedics and Traumatology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Tolga Ergönenç
- Department of Anesthesiology and Reanimation, Sakarya University Training Research, Sakarya, Turkey
| | - Onur Palabıyık
- Department of Anesthesiology and Reanimation, Sakarya University Training Research, Sakarya, Turkey
| | - Yakup Tomak
- Department of Anesthesiology and Reanimation, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Ayça Taş Tuna
- Department of Anesthesiology and Reanimation, Sakarya University Faculty of Medicine, Sakarya, Turkey
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Karabag H, Yetisgin A, Savik E, Kilic M, Aridici R, Taskin A, Ulas T. Evaluation of ceruloplasmin levels in patients with lumbar disc herniation. J Back Musculoskelet Rehabil 2016; 30:BMR712. [PMID: 27257979 DOI: 10.3233/bmr-160712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Chronic inflammation is believed to have a role in the development of lumbar disc herniation (LDH). Ceruloplasmin (CP), an acute phase protein, is known to limit inflammation. OBJECTIVE To evaluate CP levels in patients with LDH. METHODS Thirty-five patients with LDH and 35 healthy individuals were enrolled in the study. Participants were divided into two groups; group 1 (n = 35) consisted of patients with LDH, and group 2 (n = 35) consisted of healthy subjects. Surgery specimens were taken from all patients who underwent LDH-related surgery. CP levels were measured in both blood and tissue samples. Pain intensity was evaluated using a visual analog scale (VAS). RESULTS There were no significant differences in gender, age, or body mass index between the control and LDH patients (p > 0.05 for all). Compared with the control patients, LDH patients had significantly higher serum CP levels (p < 0.001). In LDH patients, tissue CP levels were significantly higher than serum levels (p < 0.001). According to bivariate analysis, the serum CP levels were significantly correlated with the VAS score in group 1 (r = 0.491, p = 0.003). CONCLUSIONS The present study showed that CP levels increased in both the serum and the tissues of patients with LDH compared to patients without LDH, possibly as a consequence of LDH-associated inflammation.
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Affiliation(s)
- Hamza Karabag
- Department of Neurosurgery, Harran University Faculty of Medicine, Sanliurfa, Turkey
| | - Alparslan Yetisgin
- Department of Physical Medicine and Rehabilitation, Harran University Faculty of Medicine, Sanliurfa, Turkey
| | - Emin Savik
- Department of Clinical Biochemistry, Harran University Faculty of Medicine, Sanliurfa, Turkey
| | - Mustafa Kilic
- Department of Neurosurgery, Malatya State Hospital, Malatya, Turkey
| | - Rifat Aridici
- Department of Physical Medicine and Rehabilitation, Harran University Faculty of Medicine, Sanliurfa, Turkey
- Department of Physical Medicine and Rehabilitation, Nusaybin State Hospital, Mardin, Turkey
| | - Abdullah Taskin
- Department of Clinical Biochemistry, Harran University Faculty of Medicine, Sanliurfa, Turkey
| | - Turgay Ulas
- Department of Internal Medicine, Harran University Faculty of Medicine, Sanliurfa, Turkey
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Cho HK, Kim SY, Choi MJ, Baek SO, Kwak SG, Ahn SH. The Effect of GCSB-5 a New Herbal Medicine on Changes in Pain Behavior and Neuroglial Activation in a Rat Model of Lumbar Disc Herniation. J Korean Neurosurg Soc 2016; 59:98-105. [PMID: 26962414 PMCID: PMC4783491 DOI: 10.3340/jkns.2016.59.2.98] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 09/24/2015] [Accepted: 02/10/2016] [Indexed: 01/02/2023] Open
Abstract
Objective Lumbar disc herniation can induce sciatica by mechanical compression and/or chemical irritation. The aim of this study was to compare the effects of GCSB-5 (Shinbaro®) and NSAIDs on pain-related behavior and on the expressions of microglia, astrocytes, CGRP, TRPV1, IL-6, and CX3CL1 in a rat model of lumbar disc herniation. Methods 112 male Sprague-Dawley rats underwent implantation of nucleus pulposus to a dorsal root ganglion (DRG). Rats were divided into five groups as follows; a saline group (the vehicle control group) (n=27), a 10 mg/kg aceclofenac group (the aceclofenac group) (n=22), and 100, 300 or 600 mg/kg GCSB-5 groups (the GCSB-5 100, 300, or 600 groups) (n=21 for each group). Rats were tested for mechanical allodynia at 3 days after surgery and at 1 day, 3 days, 7 days, 14 days, 21 days, 28 days, 35 days, 42 days, 49 days, and 56 days after treatment commencement. Immunohistochemical staining of microglia (Iba1), astrocytes (GFAP), CGRP, and TRPV1, and PCR for IL-6 and CX3CL1 were performed on spinal dorsal horns and DRGs at 56 days after medication commencement. Results After 56 days of GCSB-5 300 administration, mechanical withdrawal thresholds were significantly increased (p<0.05), and immunohisto-chemical expressions of Iba1, GFAP, CGRP, and TRPV1 were reduced than other groups, but this difference was not statistically significant. Conclusion These results indicate GCSB-5 reduces mechanical allodynia and downregulates neuroglial activity and the expressions of CGRP and TRPV1 in the spinal segments of a rat model of lumbar disc herniation.
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Affiliation(s)
- Hee Kyung Cho
- Department of Physical Medicine and Rehabilitation, College of Medicine, Catholic University of Daegu, Daegu, Korea
| | - So-Yeon Kim
- Medical Devices Clinical Trial Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Mi Jung Choi
- Medical Devices Clinical Trial Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Seung Ok Baek
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sang Gyu Kwak
- Department of Medical Statistics, College of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Sang Ho Ahn
- Medical Devices Clinical Trial Center, College of Medicine, Yeungnam University, Daegu, Korea.; Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Korea
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Weber KT, Alipui DO, Sison CP, Bloom O, Quraishi S, Overby MC, Levine M, Chahine NO. Serum levels of the proinflammatory cytokine interleukin-6 vary based on diagnoses in individuals with lumbar intervertebral disc diseases. Arthritis Res Ther 2016; 18:3. [PMID: 26743937 PMCID: PMC4718017 DOI: 10.1186/s13075-015-0887-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 12/03/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Many intervertebral disc diseases cause low back pain (LBP). Proinflammatory cytokines and matrix metalloproteinases (MMPs) participate in disc pathology. In this study, we examined levels of serum cytokines and MMPs in human subjects with diagnoses of disc herniation (DH), spinal stenosis (SS), or degenerative disc disease (DDD) relative to levels in control subjects. Comparison between subjects with DH and those with other diagnoses (Other Dx, grouped from SS and DDD) was performed to elaborate a pathological mechanism based on circulating cytokine levels. METHODS Study participants were recruited from a spine neurosurgery practice (n = 80), a back pain management practice (n = 27), or a control cohort (n = 26). Serum samples were collected before treatment and were assayed by multiplex assays for levels of interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-13, interferon-γ, tumor necrosis factor-α, MMP-1, MMP-3, and MMP-9. Inflammatory and degradative mediator levels were compared for subjects with LBP and control subjects, by diagnosis and by treatment groups, controlling for effects of sex, age, and reported history of osteoarthritis. Spearman's correlation coefficient was used to examine relationships with age, body mass index (BMI), symptom duration, and smoking history. RESULTS Serum levels of IL-6 were significantly higher in subjects with LBP compared with control subjects. Participants with LBP due to Other Dx had significantly higher levels of IL-6 than DH and controls. Serum levels of MMP-1 were significantly lower in LBP subjects, specifically those with DH, than in control subjects. Positive correlations were found between IL-6 levels and BMI, symptom duration, and age. MMP-1 levels were positively correlated with age. CONCLUSIONS The findings of the present clinical study are the results of the first examination of circulating cytokine levels in DDD and SS and provide evidence for a more extensive role of IL-6 in disc diseases, where patients with DDD or SS have higher serum cytokine levels than those with DH or control subjects. These findings suggest that LBP subjects have low-grade systemic inflammation, and biochemical profiling of circulating cytokines may assist in refining personalized diagnoses of disc diseases.
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Affiliation(s)
- Kathryn T Weber
- The Feinstein Institute for Medical Research, North Shore-LIJ Health System, Manhasset, NY, USA.
| | - D Olivier Alipui
- The Feinstein Institute for Medical Research, North Shore-LIJ Health System, Manhasset, NY, USA.
| | - Cristina P Sison
- The Feinstein Institute for Medical Research, North Shore-LIJ Health System, Manhasset, NY, USA. .,Department of Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. .,Department of Population Health, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
| | - Ona Bloom
- The Feinstein Institute for Medical Research, North Shore-LIJ Health System, Manhasset, NY, USA. .,Department of Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. .,Department of Physical Medicine and Rehabilitation, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
| | - Shaheda Quraishi
- Department of Physical Medicine and Rehabilitation, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. .,Department of Neurosurgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
| | - M Chris Overby
- Department of Neurosurgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
| | - Mitchell Levine
- Department of Neurosurgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
| | - Nadeen O Chahine
- The Feinstein Institute for Medical Research, North Shore-LIJ Health System, Manhasset, NY, USA. .,Department of Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. .,Department of Neurosurgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA. .,Department of Orthopedic Surgery, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
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Chan SCW, Tekari A, Benneker LM, Heini PF, Gantenbein B. Osteogenic differentiation of bone marrow stromal cells is hindered by the presence of intervertebral disc cells. Arthritis Res Ther 2015; 18:29. [PMID: 26809343 PMCID: PMC4727301 DOI: 10.1186/s13075-015-0900-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 12/14/2015] [Indexed: 02/04/2023] Open
Abstract
Background Clinical observations indicate that the presence of nucleus pulposus (NP) tissue during spinal fusion hinders the rate of disc ossification. While the underlying mechanism remains unknown, this observation could be due to incomplete removal of NP cells (NPCs) that secrete factors preventing disc calcification, such as bone morphogenetic protein (BMP) antagonists including noggin and members of the DAN (differential screening selected gene aberrative in neuroblastoma) family. Methods Monolayer human bone marrow-derived mesenchymal stem cells (MSCs) were cocultured withNPCs and annulus fibrosus cells (AFCs) embedded in alginate for 21 days. At the end of coculture, MSCs were stained for mineral deposition by alizarin red, and relative expression of bone-related genes [Runt-related transcription factor 2, (RUNX2), Osteopontin (OPN), and Alkaline phosphatase (ALP)] and ALP activity were analyzed. Relative expression of three BMP antagonists, chordin (CHRD), gremlin (GREM1), and noggin (NOG), was determined in primary human NPCs and AFCs. These cells were also stained for Gremlin and Noggin by immunocytochemistry. Results Alizarin red staining showed that MSC osteogenesis in monolayer cultures was inhibited by coculture with NPCs or AFCs. ALP activity and RT-PCR analyses confirmed these results and demonstrated inhibition of osteogenesis of MSC in the presence of disc cells. NOG was significantly up-regulated in MSCs after coculture. Relative gene expression of intervertebral disc (IVD) cells showed higher expression of GREM1 in NPCs than in AFCs. Conclusions We show that primary IVD cells inhibit osteogenesis of MSCs. BMP inhibitors NOG, GREM1 and CHRD were expressed in IVD cells. GREM1 appears to be differentially expressed in NPCs and AFCs. Our results have implications for the design and development of treatments for non-union in spinal fusion.
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Affiliation(s)
- Samantha C W Chan
- Tissue and Organ Mechanobiology, Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, Bern, CH-3014, Switzerland. .,Biointerfaces, EMPA, Swiss Federal Laboratories for Materials Science and Technology, Lerchenfeldstrasse 5, St Gallen, CH-9014, Switzerland.
| | - Adel Tekari
- Tissue and Organ Mechanobiology, Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, Bern, CH-3014, Switzerland.
| | - Lorin M Benneker
- Department for Orthopedic Surgery and Traumatology, Inselspital, University of Bern, Freiburgstrasse 4, Bern, CH-3010, Switzerland. .,AOSpine Research Network, Stettbachstrasse 6, Dübendorf, CH-8600, Switzerland.
| | - Paul F Heini
- Orthopedic Department, Sonnenhof Clinic, Buchserstrasse 30, Bern, CH-3006, Switzerland.
| | - Benjamin Gantenbein
- Tissue and Organ Mechanobiology, Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, Bern, CH-3014, Switzerland. .,AOSpine Research Network, Stettbachstrasse 6, Dübendorf, CH-8600, Switzerland.
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Feng C, Zhang Y, Yang M, Huang B, Zhou Y. Collagen-DerivedN-Acetylated Proline-Glycine-Proline in Intervertebral Discs Modulates CXCR1/2 Expression and Activation in Cartilage Endplate Stem Cells to Induce Migration and Differentiation Toward a Pro-Inflammatory Phenotype. Stem Cells 2015; 33:3558-68. [PMID: 26302999 DOI: 10.1002/stem.2200] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 07/05/2015] [Accepted: 07/25/2015] [Indexed: 01/07/2023]
Affiliation(s)
- Chencheng Feng
- Department of Orthopedics, Xinqiao Hospital; Third Military Medical University; Chongqing People's Republic of China
| | - Yang Zhang
- Department of Orthopedics, Xinqiao Hospital; Third Military Medical University; Chongqing People's Republic of China
| | - Minghui Yang
- Department of Orthopedics, Xinqiao Hospital; Third Military Medical University; Chongqing People's Republic of China
| | - Bo Huang
- Department of Orthopedics, Xinqiao Hospital; Third Military Medical University; Chongqing People's Republic of China
| | - Yue Zhou
- Department of Orthopedics, Xinqiao Hospital; Third Military Medical University; Chongqing People's Republic of China
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Teixeira GQ, Boldt A, Nagl I, Pereira CL, Benz K, Wilke HJ, Ignatius A, Barbosa MA, Gonçalves RM, Neidlinger-Wilke C. A Degenerative/Proinflammatory Intervertebral Disc Organ Culture: An Ex Vivo Model for Anti-inflammatory Drug and Cell Therapy. Tissue Eng Part C Methods 2015; 22:8-19. [PMID: 26565141 DOI: 10.1089/ten.tec.2015.0195] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Resolution of intervertebral disc (IVD) degeneration-associated inflammation is a prerequisite for tissue regeneration and could possibly be achieved by strategies ranging from pharmacological to cell-based therapies. In this study, a proinflammatory disc organ culture model was established. Bovine caudal disc punches were needle punctured and additionally stimulated with lipopolysaccharide (10 μg/mL) or interleukin-1β (IL-1β, 10-100 ng/mL) for 48 h. Two intradiscal therapeutic approaches were tested: (i) a nonsteroidal anti-inflammatory drug, diclofenac (Df) and (ii) human mesenchymal stem/stromal cells (MSCs) embedded in an albumin/hyaluronan hydrogel. IL-1β-treated disc organ cultures showed a statistically significant upregulation of proinflammatory markers (IL-6, IL-8, prostaglandin E2 [PGE2]) and metalloproteases (MMP1, MMP3) expression, while extracellular matrix (ECM) proteins (collagen II, aggrecan) were significantly downregulated. The injection of the anti-inflammatory drug, Df, was able to reduce the levels of proinflammatory cytokines and MMPs and surprisingly increase ECM protein levels. These results point the intradiscal application of anti-inflammatory drugs as promising therapeutics for disc degeneration. In parallel, the immunomodulatory role of MSCs on this model was also evaluated. Although a slight downregulation of IL-6 and IL-8 expression could be found, the variability among the five donors tested was high, suggesting that the beneficial effect of these cells on disc degeneration needs to be further evaluated. The proinflammatory/degenerative IVD organ culture model established can be considered a suitable approach for testing novel therapeutic drugs, thus reducing the number of animals in in vivo experimentation. Moreover, this model can be used to address the cellular and molecular mechanisms that regulate inflammation in the IVD and their implications in tissue degeneration.
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Affiliation(s)
- Graciosa Q Teixeira
- 1 Institute of Orthopaedic Research and Biomechanics, Center for Musculoskeletal Research, University of Ulm , Ulm, Germany .,2 Instituto de Investigação e Inovação em Saúde, Universidade do Porto , Porto, Portugal .,3 Instituto de Engenharia Biomédica (INEB), Universidade do Porto , Porto, Portugal .,4 Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto , Porto, Portugal
| | - Antje Boldt
- 1 Institute of Orthopaedic Research and Biomechanics, Center for Musculoskeletal Research, University of Ulm , Ulm, Germany
| | - Ines Nagl
- 1 Institute of Orthopaedic Research and Biomechanics, Center for Musculoskeletal Research, University of Ulm , Ulm, Germany
| | - Catarina Leite Pereira
- 2 Instituto de Investigação e Inovação em Saúde, Universidade do Porto , Porto, Portugal .,3 Instituto de Engenharia Biomédica (INEB), Universidade do Porto , Porto, Portugal .,4 Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto , Porto, Portugal
| | - Karin Benz
- 5 Natural and Medical Sciences Institute (NMI), University of Tuebingen , Reutlingen, Germany
| | - Hans-Joachim Wilke
- 1 Institute of Orthopaedic Research and Biomechanics, Center for Musculoskeletal Research, University of Ulm , Ulm, Germany
| | - Anita Ignatius
- 1 Institute of Orthopaedic Research and Biomechanics, Center for Musculoskeletal Research, University of Ulm , Ulm, Germany
| | - Mário A Barbosa
- 2 Instituto de Investigação e Inovação em Saúde, Universidade do Porto , Porto, Portugal .,3 Instituto de Engenharia Biomédica (INEB), Universidade do Porto , Porto, Portugal .,4 Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto , Porto, Portugal
| | - Raquel M Gonçalves
- 2 Instituto de Investigação e Inovação em Saúde, Universidade do Porto , Porto, Portugal .,3 Instituto de Engenharia Biomédica (INEB), Universidade do Porto , Porto, Portugal
| | - Cornelia Neidlinger-Wilke
- 1 Institute of Orthopaedic Research and Biomechanics, Center for Musculoskeletal Research, University of Ulm , Ulm, Germany
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Tian P, Li ZJ, Fu X, Ma XL. Role of interleukin-17 in chondrocytes of herniated intervertebral lumbar discs. Exp Ther Med 2015; 10:81-87. [PMID: 26170916 DOI: 10.3892/etm.2015.2449] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 03/20/2015] [Indexed: 12/12/2022] Open
Abstract
Lumbar disc herniation (LDH) is a common cause of lumbosacral radiculopathy. An autoimmune response to a herniated nucleus pulposus (NP) has been suggested to play an important role in the initiation of radiculopathy. Interleukin-17 (IL-17) is a cytokine associated with inflammation and autoimmunity. The presence of IL-17 has been studied in patients with LDH; however, extensive investigation into the expression of IL-17 in different disc pathologies of LDH has not yet been conducted. The aim of the present study was to investigate the role of neovascularization and hypertrophic chondrocytes in herniated intervertebral lumbar discs. Fifty-two intervertebral lumbar disc specimens were extracted from 46 patients with LDH and were subsequently classified as either contained or non-contained disc herniation (CDH and NCDH, respectively). The specimens were stained with hematoxylin and eosin or toluidine blue, or were immunostained with polyclonal antibodies to IL-17 using the streptavidin-peroxidase method. The neovascular tissue and staining results were graded to establish the histological differences between the two herniation types. The intervertebral discs (IVDs) obtained from patients with NCDH showed significantly more neovascularization and granulation tissue than the discs obtained from patients with CDH (P<0.05). Furthermore, hypertrophic chondrocytes were more abundant in the NCDH specimens than in the CDH specimens (P<0.05). Similarly, the number of IL-17-immunoreactive cells was significantly higher in the NCDH specimens than that in the CDH specimens (P<0.01). In conclusion, local inflammation and autoreactive immune activation may play an important role in the pathogenesis of LDH. These results also suggest a role of chondrocytes in the repair of herniated IVDs.
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Affiliation(s)
- Peng Tian
- Department of Orthopedics, Tianjin Hospital, Tianjin 300211, P.R. China
| | - Zhi-Jun Li
- Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin 300052, P.R. China
| | - Xin Fu
- Department of Orthopedics, Tianjin Hospital, Tianjin 300211, P.R. China
| | - Xin-Long Ma
- Department of Orthopedics, Tianjin Hospital, Tianjin 300211, P.R. China ; Department of Orthopedics, General Hospital of Tianjin Medical University, Tianjin 300052, P.R. China
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Hwang MH, Shin JH, Kim KS, Yoo CM, Jo GE, Kim JH, Choi H. Low Level Light Therapy Modulates Inflammatory Mediators Secreted by Human Annulus Fibrosus Cells during Intervertebral Disc DegenerationIn Vitro. Photochem Photobiol 2015; 91:403-10. [DOI: 10.1111/php.12415] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/09/2014] [Indexed: 01/05/2023]
Affiliation(s)
- Min Ho Hwang
- Department of Medical Sciences; Graduate School of Medicine; Korea University; Seoul South Korea
| | - Jae Hee Shin
- Department of Medical Sciences; Graduate School of Medicine; Korea University; Seoul South Korea
| | - Kyoung Soo Kim
- Department of Medical Sciences; Graduate School of Medicine; Korea University; Seoul South Korea
| | - Chang Min Yoo
- Department of Medical Sciences; Graduate School of Medicine; Korea University; Seoul South Korea
| | - Ga Eun Jo
- Department of Medical Sciences; Graduate School of Medicine; Korea University; Seoul South Korea
| | - Joo Han Kim
- Department of Neurosurgery; Guro Hospital; College of Medicine; Korea University; Seoul South Korea
| | - Hyuk Choi
- Department of Medical Sciences; Graduate School of Medicine; Korea University; Seoul South Korea
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Wang XH, Hong X, Zhu L, Wang YT, Bao JP, Liu L, Wang F, Wu XT. Tumor necrosis factor alpha promotes the proliferation of human nucleus pulposus cells via nuclear factor-κB, c-Jun N-terminal kinase, and p38 mitogen-activated protein kinase. Exp Biol Med (Maywood) 2014; 240:411-7. [PMID: 25304312 DOI: 10.1177/1535370214554533] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 09/03/2014] [Indexed: 11/17/2022] Open
Abstract
Although tumor necrosis factor alpha (TNF-α) is known to play a critical role in intervertebral disc (IVD) degeneration, the effect of TNF-α on nucleus pulposus (NP) cells has not yet been elucidated. The aim of this study was to explore the effect of TNF-α on proliferation of human NP cells. NP cells were treated with different concentrations of TNF-α. Cell proliferation was determined by cell counting kit-8 (CCK-8) analysis and Ki67 immunofluorescence staining, and expression of cyclin B1 was studied by quantitative real-time RT-PCR. Cell cycle was measured by flow cytometry and cell apoptosis was analyzed using an Annexin V-fluorescein isothiocyanate (FITC) & propidium iodide (PI) apoptosis detection kit. To identify the mechanism by which TNF-α induced proliferation of NP cells, selective inhibitors of major signaling pathways were used and Western blotting was carried out. Treatment with TNF-α increased cell viability (as determined by CCK-8 analysis) and expression of cyclin B1 and the number of Ki67-positive and S-phase NP cells, indicating enhancement of proliferation. Consistent with this, NP cell apoptosis was suppressed by TNF-α treatment. Moreover, inhibition of NF-κB, c-Jun N-terminal kinase (JNK), and p38 mitogen-activated protein kinase (MAPK) blocked TNF-α-stimulated proliferation of NP cells. In conclusion, the current findings suggest that the effect of TNF-α on IVD degeneration involves promotion of the proliferation of human NP cells via the NF-κB, JNK, and p38 MAPK pathways.
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Affiliation(s)
- Xiao-Hu Wang
- Medical School of Southeast University, Nanjing 210009, Jiangsu, China
| | - Xin Hong
- Department of Orthopaedics, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu, China
| | - Lei Zhu
- Department of Orthopaedics, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu, China
| | - Yun-Tao Wang
- Department of Orthopaedics, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu, China
| | - Jun-Ping Bao
- Department of Orthopaedics, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu, China
| | - Lei Liu
- Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich D-81675, Germany
| | - Feng Wang
- Department of Orthopaedics, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu, China
| | - Xiao-Tao Wu
- Medical School of Southeast University, Nanjing 210009, Jiangsu, China Department of Orthopaedics, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu, China
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Sedighi M, Haghnegahdar A. Role of vitamin D3 in treatment of lumbar disc herniation--pain and sensory aspects: study protocol for a randomized controlled trial. Trials 2014; 15:373. [PMID: 25257359 PMCID: PMC4190421 DOI: 10.1186/1745-6215-15-373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 09/04/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Vitamin D receptors have been identified in the spinal cord, nerve roots, dorsal root ganglia and glial cells, and its genetic polymorphism association with the development of lumbar disc degeneration and herniation has been documented. Metabolic effects of active vitamin D metabolites in the nucleus pulposus and annulus fibrosus cells have been studied. Lumbar disc herniation is a process that involves immune and inflammatory cells and processes that are targets for immune regulatory actions of vitamin D as a neurosteroid hormone. In addition to vitamin D's immune modulatory properties, its receptors have been identified in skeletal muscles. It also affects sensory neurons to modulate pain. In this study, we aim to study the role of vitamin D3 in discogenic pain and related sensory deficits. Additionally, we will address how post-treatment 25-hydroxy vitamin D3 level influences pain and sensory deficits severity. The cut-off value for serum 25-hydroxy vitamin D3 that would be efficacious in improving pain and sensory deficits in lumbar disc herniation will also be studied. METHODS/DESIGN We will conduct a randomized, placebo-controlled, double-blind clinical trial. Our study population will include 380 cases with one-level and unilateral lumbar disc herniation with duration of discogenic pain less than 8 weeks. Individuals who do not have any contraindications, will be divided into three groups based on serum 25-hydroxy vitamin D3 level, and each group will be randomized to receive either a single-dose 300,000-IU intramuscular injection of vitamin D3 or placebo. All patients will be under conservative treatment. Pre-treatment and post-treatment assessments will be performed with the McGill Pain Questionnaire and a visual analogue scale. For the 15-day duration of this study, questionnaires will be filled out during telephone interviews every 3 days (a total of five times). The initial and final interviews will be scheduled at our clinic. After 15 days, serum 25-hydroxy vitamin D3 levels will be measured for those who have received vitamin D3 (190 individuals). TRIAL REGISTRATION Iranian Registry for Clinical Trials ID: IRCT2014050317534N1 (trial registration: 5 June 2014).
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Affiliation(s)
- Mahsa Sedighi
- Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, PO Box 71345-1536, Shiraz, Iran.
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Gruber HE, Hoelscher GL, Ingram JA, Bethea S, Norton HJ, Hanley EN. Production and expression of RANTES (CCL5) by human disc cells and modulation by IL-1-β and TNF-α in 3D culture. Exp Mol Pathol 2014; 96:133-8. [DOI: 10.1016/j.yexmp.2014.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 01/17/2014] [Indexed: 11/30/2022]
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Risbud MV, Shapiro IM. Role of cytokines in intervertebral disc degeneration: pain and disc content. Nat Rev Rheumatol 2013; 10:44-56. [PMID: 24166242 DOI: 10.1038/nrrheum.2013.160] [Citation(s) in RCA: 1067] [Impact Index Per Article: 97.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Degeneration of the intervertebral discs (IVDs) is a major contributor to back, neck and radicular pain. IVD degeneration is characterized by increases in levels of the proinflammatory cytokines TNF, IL-1α, IL-1β, IL-6 and IL-17 secreted by the IVD cells; these cytokines promote extracellular matrix degradation, chemokine production and changes in IVD cell phenotype. The resulting imbalance in catabolic and anabolic responses leads to the degeneration of IVD tissues, as well as disc herniation and radicular pain. The release of chemokines from degenerating discs promotes the infiltration and activation of immune cells, further amplifying the inflammatory cascade. Leukocyte migration into the IVD is accompanied by the appearance of microvasculature tissue and nerve fibres. Furthermore, neurogenic factors, generated by both disc and immune cells, induce expression of pain-associated cation channels in the dorsal root ganglion. Depolarization of these ion channels is likely to promote discogenic and radicular pain, and reinforce the cytokine-mediated degenerative cascade. Taken together, an enhanced understanding of the contribution of cytokines and immune cells to these catabolic, angiogenic and nociceptive processes could provide new targets for the treatment of symptomatic disc disease. In this Review, the role of key inflammatory cytokines during each of the individual phases of degenerative disc disease, as well as the outcomes of major clinical studies aimed at blocking cytokine function, are discussed.
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Affiliation(s)
- Makarand V Risbud
- Department of Orthopaedic Surgery, Jefferson Medical College, 1025 Walnut Street, 511 College Building, Philadelphia, PA 19107, USA
| | - Irving M Shapiro
- Department of Orthopaedic Surgery, Jefferson Medical College, 1025 Walnut Street, 511 College Building, Philadelphia, PA 19107, USA
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Di Martino A, Merlini L, Faldini C. Autoimmunity in intervertebral disc herniation: from bench to bedside. Expert Opin Ther Targets 2013; 17:1461-70. [DOI: 10.1517/14728222.2013.834330] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Gruber HE, Hoelscher GL, Ingram JA, Norton HJ, Hanley EN. Increased IL-17 expression in degenerated human discs and increased production in cultured annulus cells exposed to IL-1ß and TNF-α. Biotech Histochem 2013; 88:302-10. [PMID: 23627571 DOI: 10.3109/10520295.2013.783235] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
IL-17 is expressed in a number of tissues including the intervertebral disc, where it exerts strong inflammatory properties. We evaluated IL-17 using immunolocalization in herniated and non-herniated human discs, IL-17 gene expression, and the production of IL-17 by annulus cells cultured in three dimensions in the presence of IL-1ß or TNF-α. There was no difference in the percentage of IL-17 positive cells in annulus or nucleus in herniated vs. non-herniated disc specimens. Molecular studies confirmed expression of IL-17 in disc tissue, with significantly increased expression in more degenerated discs; there was no difference in expression between herniated vs. non-herniated discs. Exposure to IL-1ß or TNF-α resulted in significantly greater production of IL-17. Our findings expand understanding of IL-17 production by disc cells and reveal the importance of non-canonical IL-17 production in the disc. Significantly greater expression of IL-17 in more degenerated discs adds to our understanding of the changes in disc cell function with advancing stages of disc degeneration.
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Affiliation(s)
- H E Gruber
- Department of Orthopaedic Surgery, Carolinas Medical Center, P.O. Box 32861, Charlotte, NC 28232, USA.
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Gruber HE, Hoelscher GL, Bethea S, Hanley EN. Interleukin 1-beta upregulates brain-derived neurotrophic factor, neurotrophin 3 and neuropilin 2 gene expression and NGF production in annulus cells. Biotech Histochem 2012; 87:506-11. [PMID: 22853041 DOI: 10.3109/10520295.2012.703692] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The relationship between disc cells, nerves and pain production in the intervertebral disc is poorly understood. Neurotrophins, signaling molecules involved in the survival, differentiation and migration of neurons, and neurite outgrowth, are expressed in non-neuronal tissues including the disc. We hypothesized that three-dimensional exposure of human disc cells to the proinflammatory cytokine IL-1ß in vitro would elevate neurotrophin gene expression levels and production of nerve growth factor (NGF). Cells isolated from Thompson grade III and IV discs were cultured for 14 days under control conditions or with addition of 10(2) pM IL-1ß; mRNA was isolated and conditioned media assayed for NGF content. IL-1ß exposure in three-dimensional culture significantly increased expression of neurotrophin 3, brain-derived neurotrophic factor, and neuropilin 2 compared to controls. IL-1ß-exposed cells showed significantly increased NGF production compared to controls. Findings support our hypothesis, expand previous data concerning expression of neurotrophins, and provide the first documented expression of neurotrophin 3 and neuropilin 2. Our results have direct translational relevance, because they address the primary clinical issue of low back pain and open the possibility of novel analgesic therapies using specific small-molecular antagonists to neurotrophins.
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Affiliation(s)
- H E Gruber
- Department of Orthopaedic Surgery, Carolinas Medical Center, P.O. Box 32861, Charlotte, NC 28232, USA.
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