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Xie X, Zhang G, Liu N. Comprehensive analysis of abnormal methylation modification differential expression mRNAs between low-grade and high-grade intervertebral disc degeneration and its correlation with immune cells. Ann Med 2024; 56:2357742. [PMID: 38819022 PMCID: PMC11146251 DOI: 10.1080/07853890.2024.2357742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/10/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Intervertebral disc degeneration (IDD) is an important cause of low back pain. The aim of this study is to identify the potential molecular mechanism of abnormal methylation-modified DNA in the progression of IDD, hoping to contribute to the diagnosis and management of IDD. METHODS Low-grade IDD (grade I-II) and high-grade IDD (grade III-V) data were downloaded from GSE70362 and GSE129789 datasets. The abnormally methylated modified differentially expressed mRNAs (DEmRNAs) were identified by differential expression analysis (screening criteria were p < .05 and |logFC| > 1) and differential methylation analysis (screening criteria were p < .05 and |δβ| > 0.1). The classification models were constructed, and the receiver operating characteristic analysis was also carried out. In addition, functional enrichment analysis and immune correlation analysis were performed and the miRNAs targeted for the abnormally methylated DEmRNAs were predicted. Finally, expression validation was performed using real-time PCR. RESULTS Compared with low-grade IDD, seven abnormal methylation-modified DEmRNAs (AOX1, IBSP, QDPR, ABLIM1, CRISPLD2, ACTC1 and EMILIN1) were identified in high-grade IDD, and the classification models of random forests (RF) and support vector machine (SVM) were constructed. Moreover, seven abnormal methylation-modified DEmRNAs and classification models have high diagnostic accuracy (area under the curve [AUC] > 0.8). We also found that AUC values of single abnormal methylation-modified DEmRNA were all lower than those of RF and SVM classification models. Pearson correlation analysis found that macrophages M2 and EMILIN1 had significant negative correlation, while macrophages M2 and IBSP had significant positive correlation. In addition, four targeted relationship pairs (hsa-miR-4728-5p-QDPR, hsa-miR-4533-ABLIM1, hsa-miR-4728-5p-ABLIM1 and hsa-miR-4534-CRISPLD2) and multiple signalling pathways (for example, PI3K-AKT signalling pathway, osteoclast differentiation and calcium signalling pathway) were also identified that may be involved in the progression of IDD. CONCLUSION The identification of abnormal methylation-modified DEmRNAs and the construction of classification models in this study were helpful for the diagnosis and management of IDD progression.
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Affiliation(s)
- Xuehu Xie
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Xicheng District, Beijing, China
| | - Guoqiang Zhang
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Xicheng District, Beijing, China
| | - Ning Liu
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Xicheng District, Beijing, China
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2
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Bonilla AF, Sikes KJ, Burton LH, Chow L, Kurihara J, Santangelo K, Dow SW, Easley JT. Immunization against nucleus pulposus antigens to accelerate degenerative disc disease in a rabbit model. Front Vet Sci 2024; 11:1382652. [PMID: 38803805 PMCID: PMC11128595 DOI: 10.3389/fvets.2024.1382652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024] Open
Abstract
Low back pain poses a significant societal burden, with progressive intervertebral disc degeneration (IDD) emerging as a pivotal contributor to chronic pain. Improved animal models of progressive IDD are needed to comprehensively investigate new diagnostic and therapeutic approaches to managing IDD. Recent studies underscore the immune system's involvement in IDD, particularly with regards to the role of immune privileged tissues such as the nucleus pulposus (NP) becoming an immune targeting following initial disc injury. We therefore hypothesized that generating an active immune response against NP antigens with an NP vaccine could significantly accelerate and refine an IDD animal model triggered by mechanical puncture of the disc. To address this question, rabbits were immunized against NP antigens following disc puncture, and the impact on development of progressive IDD was assessed radiographically, functionally, and histologically compared between vaccinated and non-vaccinated animals over a 12-week period. Immune responses to NP antigens were assessed by ELISA and Western blot. We found that the vaccine elicited strong immune responses against NP antigens, including a dominant ~37 kD antigen. Histologic evaluation revealed increases IDD in animals that received the NP vaccine plus disc puncture, compared to disc puncture and vaccine only animals. Imaging evaluation evidenced a decrease in disc height index and higher scores of disc degeneration in animals after disc punctures and in those animals that received the NP vaccine in addition to disc puncture. These findings therefore indicate that it is possible to elicit immune responses against NP antigens in adult animals, and that these immune responses may contribute to accelerated development of IDD in a novel immune-induced and accelerated IDD model.
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Affiliation(s)
- Andres F. Bonilla
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Katie J. Sikes
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Lindsey H. Burton
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Lyndah Chow
- Immunotherapy Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Jade Kurihara
- Immunotherapy Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Kelly Santangelo
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Steven W. Dow
- Immunotherapy Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Jeremiah T. Easley
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
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3
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Karchevskaya AE, Poluektov YM, Korolishin VA. Understanding Intervertebral Disc Degeneration: Background Factors and the Role of Initial Injury. Biomedicines 2023; 11:2714. [PMID: 37893088 PMCID: PMC10604877 DOI: 10.3390/biomedicines11102714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
The etiology of intervertebral disc degeneration (IVDD) is complex and multifactorial, and it is still not fully understood. A better understanding of the pathogenesis of IVDD will help to improve treatment regimens and avoid unnecessary surgical aggression. In order to summarize recent research data on IVDD pathogenesis, including genetic and immune factors, a literature review was conducted. The pathogenesis of IVDD is a complex multifactorial process without an evident starting point. There are extensive data on the role of the different genetic factors affecting the course of the disease, such as mutations in structural proteins and enzymes involved in the immune response. However, these factors alone are not sufficient for the development of the disease. Nevertheless, like mechanical damage, they can also be considered risk factors for IVDD. In conclusion, currently, there is no consensus on a single concept for the pathogenesis of IVDD. We consider the intervertebral disc autoimmune damage hypothesis to be the most promising hypothesis for clinicians, because it can be extrapolated to all populations and does not counteract other factors. The genetic factors currently known do not allow for building effective predictive models; however, they can be used to stratify the risks of individual populations.
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Affiliation(s)
- Anna E. Karchevskaya
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5A Butlerova Str., 117485 Moscow, Russia;
- Medical Faculty, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8-2 Trubetskaya Str., 119991 Moscow, Russia
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Vavilov Str. 32, 119334 Moscow, Russia
| | - Yuri M. Poluektov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Vavilov Str. 32, 119334 Moscow, Russia
- Department of Spinal Surgery, Burdenko Neurosurgical Institute, 4th-Tverskaya-Yamskaya Str. 16, 125047 Moscow, Russia
| | - Vasiliy A. Korolishin
- Russian Medical Academy of Postgraduate Education Studies, 2/1 Barrikadnaya Str., Building 1, 125993 Moscow, Russia;
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4
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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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Gao XW, Hu HL, Xie MH, Tang CX, Ou J, Lu ZH. CX3CL1/CX3CR1 axis alleviates inflammation and apoptosis in human nucleus pulpous cells via M2 macrophage polarization. Exp Ther Med 2023; 26:359. [PMID: 37324510 PMCID: PMC10265713 DOI: 10.3892/etm.2023.12058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 04/06/2023] [Indexed: 06/17/2023] Open
Abstract
CX3C chemokine ligand 1 (CX3CL1) belongs to the CX3C chemokine family and is involved in various disease processes. However, its role in intervertebral disc degeneration (IDD) remains to be elucidated. In the present study, western blotting, reverse transcription-quantitative PCR and ELISA assays were used to assess target gene expression. In addition, immunofluorescence and TUNEL staining were used to assess macrophage infiltration, monocyte migration and apoptosis. The present study aimed to reveal if and how CX3CL1 regulates IDD progression by exploring its effect on macrophage polarization and apoptosis of human nucleus pulposus cells (HNPCs). The data showed that CX3CL1 bound to CX3C motif chemokine receptor 1 (CX3CR1) promoted the M2 phenotype polarization via JAK2/STAT3 signaling, followed by increasing the secretion of anti-inflammatory cytokines from HNPCs. In addition, HNPC-derived CX3CL1 promoted M2 macrophage-derived C-C motif chemokine ligand 17 release thereby reducing the apoptosis of HNPCs. In clinic, the reduction of mRNA and protein levels CX3CL1 in degenerative nucleus pulposus tissues (NPs) was measured. Increased M1 macrophages and pro-inflammatory cytokines were found in NPs of IDD patients with low CX3CL1 expression. Collectively, these findings suggested that the CX3CL1/CX3CR1 axis alleviates IDD by reducing inflammation and apoptosis of HNPCs via macrophages. Therefore, targeting CX3CL1/CX3CR1 axis is expected to produce a new therapeutic approach for IDD.
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Affiliation(s)
- Xiao-Wen Gao
- The Department of Spinal Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Han-Lin Hu
- The Department of Spinal Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Ming-Hua Xie
- The Department of Spinal Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Cai-Xia Tang
- The Department of Obstetrics and Gynecology, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Jun Ou
- The Department of Spinal Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Zheng-Hao Lu
- The Department of Spinal Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang, Hunan 421001, P.R. China
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6
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Wu XT, Wan BW, Feng XM, Tao YP, Wang YX, Sun HH. Nucleus Pulposus Cells Induce M2 Polarization of RAW264.7 via CX3CL1/CX3CR1 Pathway and M2 Macrophages Promote Proliferation and Anabolism of Nucleus Pulposus Cells. Stem Cells Int 2023; 2023:6400162. [PMID: 37274023 PMCID: PMC10234370 DOI: 10.1155/2023/6400162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/18/2022] [Accepted: 11/24/2022] [Indexed: 02/02/2024] Open
Abstract
Background The mechanisms underlying M2 macrophage polarization induced by nucleus pulposus (NP) cells are unclear. The effects that M2-polarized macrophages have on NP cells are also controversial. Methods Transcriptome sequencing was performed to detect the gene change profiles between NP cells from ruptured intervertebral disc (IVD) and normal IVD. The main difference on biological activities between the two cell groups were analyzed by GO analysis and KEGG analysis. Virus transduction, flow cytometry, immunofluorescence, RT-PCR, western blot, CCK-8, TUNEL staining, and AO/EB staining were performed to explore the interactions between NP cells and RAW264.7 macrophages. Statistics were performed using SPSS26. Results 801 upregulated and 276 downregulated genes were identified in NP cells from ruptured IVD in mouse models. According to GO and KEGG analysis, we found that the differentially expressed genes (DEG) were dominantly enriched in inflammatory response, extracellular matrix degradation, blood vessel morphogenesis, immune effector process, ossification, chemokine signaling pathway, macrophage activation, etc. CX3CL1 was one of the top 20% DEG, and we confirmed that both NP tissue and cells expressed remarkably higher level of CX3CL1 in mouse models (p < 0.001∗). Besides, we further revealed that both the recombinant CX3CL1 and NP cells remarkably induced M2 polarization of RAW264.7 (p < 0.001∗), respectively, while this effect was significantly reversed by si-CX3CL1 or JMS-17-2 (p < 0.001∗). Furthermore, we found that M2 macrophages significantly decreased the apoptosis rate (p < 0.001∗) and the catabolic gene levels (p < 0.001∗) of NP cells, while increased the viability, proliferation as well as the anabolic gene levels of NP cells (p < 0.01∗). Conclusions Via regulating CX3CL1/CX3CR1 pathway, NP cells can induce the M2 macrophage polarization. M2 polarized macrophages can further promote NP cell viability, proliferation, and anabolism, while inhibit NP cell apoptosis and catabolism.
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Affiliation(s)
- Xiao-Tao Wu
- Spine Department, Northern Jiangsu People's Hospital, Yangzhou 225001, China
- Spine Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Bo-Wen Wan
- Spine Department, Northern Jiangsu People's Hospital, Yangzhou 225001, China
| | - Xin-Min Feng
- Spine Department, Northern Jiangsu People's Hospital, Yangzhou 225001, China
| | - Yu-Ping Tao
- Spine Department, Northern Jiangsu People's Hospital, Yangzhou 225001, China
| | - Yong-Xiang Wang
- Spine Department, Northern Jiangsu People's Hospital, Yangzhou 225001, China
| | - Hui-Hui Sun
- Spine Department, Northern Jiangsu People's Hospital, Yangzhou 225001, China
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7
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Li X, Luo S, Fan W, Jiang C, Wang W, Chen J, Chen Y, Zhang Z, Qiu Z, Tan D, Huang C, Wang M, Bai X. Influence of macrophage polarization in herniated nucleus pulposus tissue on clinical efficacy after lumbar discectomy. JOR Spine 2023. [DOI: 10.1002/jsp2.1249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Xiao‐Chuan Li
- Department of Cell Biology, School of Basic Medical Sciences Southern Medical University Guangzhou Guangdong China
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital Maoming Guangdong China
- Department of Orthopaedic Surgery, Gaozhou People's Hospital Maoming Guangdong China
| | - Shao‐Jian Luo
- Department of Orthopaedic Surgery, Gaozhou People's Hospital Maoming Guangdong China
| | - Wu Fan
- Department of Orthopaedic Surgery, Gaozhou People's Hospital Maoming Guangdong China
| | - Cheng Jiang
- Graduate School of Guangdong Medical University Zhanjiang Guangdong China
| | - Wei Wang
- Graduate School of Guangdong Medical University Zhanjiang Guangdong China
| | - Jiong‐Hui Chen
- Graduate School of Guangdong Medical University Zhanjiang Guangdong China
| | - Yong‐Long Chen
- Graduate School of Guangdong Medical University Zhanjiang Guangdong China
| | - Zhen‐Wu Zhang
- Graduate School of Guangdong Medical University Zhanjiang Guangdong China
| | - Zhen‐Hua Qiu
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital Maoming Guangdong China
| | - Dan‐Qin Tan
- Department of Orthopaedic Surgery, Gaozhou People's Hospital Maoming Guangdong China
| | - Chun‐Ming Huang
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital Maoming Guangdong China
- Department of Orthopaedic Surgery, Gaozhou People's Hospital Maoming Guangdong China
| | - Mao‐Sheng Wang
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital Maoming Guangdong China
| | - Xiao‐Chun Bai
- Department of Cell Biology, School of Basic Medical Sciences Southern Medical University Guangzhou Guangdong China
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital Maoming Guangdong China
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8
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Wu XT, Wang YX, Feng XM, Feng M, Sun HH. Update on the roles of macrophages in the degeneration and repair process of intervertebral discs. Joint Bone Spine 2022; 90:105514. [PMID: 36529418 DOI: 10.1016/j.jbspin.2022.105514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Abstract
Intervertebral disc (IVD) degeneration is the common cause of lumbar degenerative diseases, causing severe social and economic burden. The process of IVD degeneration involves a complex of pathologic changes on both extracellular matrix degradation and resident cell apoptosis. In recent years, there is increasing evidence that macrophages play vital roles during the damage and repair process of IVD degeneration. Nevertheless, the interactions between macrophages and IVD are not well understood, even if the IVD has long been regarded as the immune privileged site. Therefore, this review mainly focuses on the progress and obstacles of studies investigating the blood supply, immune response and especially macrophages during the IVD degeneration process.
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Affiliation(s)
- Xiao-Tao Wu
- Spine department, Northern Jiangsu People's Hospital, Yangzhou City 225001, China; Spine Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing City 210009, Jiangsu, China
| | - Yong-Xiang Wang
- Spine department, Northern Jiangsu People's Hospital, Yangzhou City 225001, China
| | - Xin-Min Feng
- Spine department, Northern Jiangsu People's Hospital, Yangzhou City 225001, China
| | - Min Feng
- Day treatment ward, Northern Jiangsu People's Hospital, Yangzhou City 225001, China.
| | - Hui-Hui Sun
- Spine department, Northern Jiangsu People's Hospital, Yangzhou City 225001, China.
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9
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Song C, Cai W, Liu F, Cheng K, Guo D, Liu Z. An in-depth analysis of the immunomodulatory mechanisms of intervertebral disc degeneration. JOR Spine 2022; 5:e1233. [PMID: 36601372 PMCID: PMC9799087 DOI: 10.1002/jsp2.1233] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/29/2022] [Accepted: 10/20/2022] [Indexed: 12/13/2022] Open
Abstract
Intervertebral disc degeneration (IVDD) is the pathological basis of disc herniation, spinal stenosis, and other related diseases, and the lower back pain it produces lays a heavy financial burden on individuals and society. Thus, it is essential to comprehend IVDD's pathophysiology. Numerous factors, such as inflammatory factors, oxidative stress, apoptosis, matrix metalloproteinases, are linked to IVDD pathogenesis. Despite the fact that many researches has provided explanations for the pathophysiology of IVDD, these studies are typically singular, restricted, and isolated, expound only on one or two components, and do not systematically analyze and summarize the numerous influencing elements. In addition, we discovered that the incidence of many chronic diseases in the field of orthopedics may be thoroughly and systematically defined in terms of immunological systems. In order to provide a theoretical foundation for an in-depth understanding of the pathological process of IVDD and the formulation of more effective prevention and treatment measures, this review provides a comprehensive and systematic account of the pathogenesis of IVDD from the physical to the molecular barriers of the intervertebral disc, from the nucleus pulposus tissue to the cellular to the immune-molecular level.
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Affiliation(s)
- Chao Song
- Department of Orthopedics and Traumatology (Trauma and Bonesetting)The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical UniversityLuzhouChina
| | - Weiye Cai
- Department of Orthopedics and Traumatology (Trauma and Bonesetting)The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical UniversityLuzhouChina
| | - Fei Liu
- Department of Orthopedics and Traumatology (Trauma and Bonesetting)The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical UniversityLuzhouChina
| | - Kang Cheng
- Department of Orthopedics and Traumatology (Trauma and Bonesetting)The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical UniversityLuzhouChina
| | - Daru Guo
- Department of Orthopedics and Traumatology (Trauma and Bonesetting)The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical UniversityLuzhouChina
| | - Zongchao Liu
- Department of Orthopedics and Traumatology (Trauma and Bonesetting)The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical UniversityLuzhouChina
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10
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Li XC, Luo SJ, Wu F, Mu QC, Yang JH, Jiang C, Wang W, Zhou TL, Qin TD, Tan RX, Jian-Li, Huang CM, Wang MS, Bai XC. Investigation of macrophage polarization in herniated nucleus pulposus of patients with lumbar intervertebral disc herniation. J Orthop Res 2022; 41:1335-1347. [PMID: 36370141 DOI: 10.1002/jor.25480] [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] [Received: 08/07/2022] [Revised: 10/13/2022] [Accepted: 11/07/2022] [Indexed: 11/15/2022]
Abstract
Macrophage infiltration and polarization during lumbar intervertebral disc herniation (LDH) have attracted increased attention but their role remains unclear. To explore macrophage polarization in herniated nucleus pulposus (NP) tissue of patients with LDH and investigate the association between cell frequency and different clinical characteristics or symptoms, we conducted a retrospective study by analyzing NP tissue samples from 79 patients. Clinical features and symptoms, using the visual analog scale (VAS) and Oswestry disability index (ODI), were collected. The macrophage markers CD68, CCR7, CD163, and CD206; pro-inflammatory cytokine TNF-α; and anti-inflammatory factor IL-4 were analyzed by immunohistochemistry. The frequency of polarized macrophages and positivity rate of pro- and anti-inflammatory cytokines showed significant differences in some of clinical characteristics. Specifically, higher CCR7+ and TNF-α + proportions were identified in the high-intensity zone (HIZ) and the type of extrusion and sequestration NP tissue than in non-HIZ and protrude NP tissue. Higher CD206+ and IL-4+ proportion were detected in Modic changes. However, no differences in gender, age, smoking status, Pfirrmann grade, analgesic use, leg pain duration, and segments were found between groups. CD68+ , CCR7+ , and CD206+ cell proportions, and TNF-α and IL-4 showed positive associations with VAS scores preoperation. Associations between ODI and the macrophages markers were weak/insignificant. Our results indicated that macrophage polarization or macrophage-like cells contribute to LDH pathological features. Macrophage populations displaying significant associations with VAS score reflected continuous M1/M2 transition contributing to pain during LDH. These findings may contribute to enhanced/personalized pharmacological interventions for patients with LDH considering pain heterogeneity.
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Affiliation(s)
- Xiao-Chuan Li
- Department of Cell Biology, Southern Medical University, Guangzhou, China.,Department of Orthopaedic Surgery, Gaozhou People's Hospital, Zhanjiang, China
| | - Shao-Jian Luo
- Department of Orthopaedic Surgery, Gaozhou People's Hospital, Zhanjiang, China
| | - Fan Wu
- Department of Orthopaedic Surgery, Gaozhou People's Hospital, Zhanjiang, China
| | - Qing-Chun Mu
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital, Maoming, China.,Department of Neurosurgery, Gaozhou People's Hospital, Maoming, China
| | - Jun-Hui Yang
- Graduate School of Guangdong Medical University, Zhanjiang, China
| | - Cheng Jiang
- Graduate School of Guangdong Medical University, Zhanjiang, China
| | - Wei Wang
- Graduate School of Guangdong Medical University, Zhanjiang, China
| | - Tian-Li Zhou
- Department of Orthopaedic Surgery, Gaozhou People's Hospital, Zhanjiang, China
| | - Tan-Dan Qin
- Department of Orthopaedic Surgery, Gaozhou People's Hospital, Zhanjiang, China
| | - Rong-Xiong Tan
- Department of Orthopaedic Surgery, Gaozhou People's Hospital, Zhanjiang, China
| | - Jian-Li
- Department of Orthopaedic Surgery, Gaozhou People's Hospital, Zhanjiang, China
| | - Chun-Ming Huang
- Department of Orthopaedic Surgery, Gaozhou People's Hospital, Zhanjiang, China.,Postdoctoral Innovation Practice Base of Gaozhou People's Hospital, Maoming, China
| | - Mao-Sheng Wang
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital, Maoming, China
| | - Xiao-Chun Bai
- Department of Cell Biology, Southern Medical University, Guangzhou, China.,Postdoctoral Innovation Practice Base of Gaozhou People's Hospital, Maoming, China
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11
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Li XC, Luo SJ, Fan W, Zhou TL, Huang CM, Wang MS. M2 macrophage-conditioned medium inhibits intervertebral disc degeneration in a tumor necrosis factor-α-rich environment. J Orthop Res 2022; 40:2488-2501. [PMID: 35170802 DOI: 10.1002/jor.25292] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/26/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023]
Abstract
Inflammation is the primary pathological phenomenon associated with disc degeneration; the inflammatory cytokine tumor necrosis factor (TNF-α) plays a crucial role in this pathology. The anti-inflammatory and regenerative effects of M2 macrophages on nucleus pulposus cells (NPCs) in intervertebral disc degeneration (IDD) progression remain unknown. Here, M2 conditioned medium (M2CM) was harvested and purified from human acute monocytic leukaemia cell line (THP-1) cells and mouse peritoneal macrophages, respectively; it was used for culturing human NPCs and a mouse intervertebral disc (IVD) organ culture model. NPCs and IVD organ models were divided into three groups: group 1 treated with 10% fetal bovine serum (control); group 2 treated with 10 ng/ml TNF-α; and group 3 treated with 10 ng/ml TNF-α and M2CM (coculture group). After 2-14 days, cell proliferation, extracellular matrix synthesis, apoptosis, and NPC senescence were assessed. Cell proliferation was reduced in TNF-α-treated NPCs and inhibited in the M2CM co-culture treatment. Moreover, TNF-α treatment enhanced apoptosis, senescence, and expression of inflammatory factor-related genes, including interleukin-6, MMP-13, ADAMTS-4, and ADAMTS-5, whereas M2CM coculture significantly reversed these effects. In addition, co-culture with M2CM promoted aggrecan and collagen II synthesis, but reduced collagen Iα1 levels in TNF-α treatment groups. Using our established three-dimensional murine IVD organ culture model, we show that M2CM suppressed the inhibitory effect of TNF-α-rich environment. Therefore, co-culture with M2CM promotes cell proliferation and extracellular matrix synthesis and inhibits inflammation, apoptosis, and NPC senescence. This study highlights the therapeutic potential of M2CM for IDD.
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Affiliation(s)
- Xiao-Chuan Li
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital, Gaozhou People's Hospital, Maoming, Guangdong, China.,Department of Cell Biology, Southern Medical University, Guangzhou, China.,Department of Orthopedic Surgery, Gaozhou People's Hospital, Maoming, Guangdong, China
| | - Shao-Jian Luo
- Department of Orthopedic Surgery, Gaozhou People's Hospital, Maoming, Guangdong, China
| | - Wu Fan
- Department of Orthopedic Surgery, Gaozhou People's Hospital, Maoming, Guangdong, China
| | - Tian-Li Zhou
- Department of Orthopedic Surgery, Gaozhou People's Hospital, Maoming, Guangdong, China
| | - Chun-Ming Huang
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital, Gaozhou People's Hospital, Maoming, Guangdong, China.,Department of Orthopedic Surgery, Gaozhou People's Hospital, Maoming, Guangdong, China
| | - Mao-Sheng Wang
- Postdoctoral Innovation Practice Base of Gaozhou People's Hospital, Gaozhou People's Hospital, Maoming, Guangdong, China.,Department of Cell Biology, Southern Medical University, Guangzhou, China
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12
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Yu P, Mao F, Chen J, Ma X, Dai Y, Liu G, Dai F, Liu J. Characteristics and mechanisms of resorption in lumbar disc herniation. Arthritis Res Ther 2022; 24:205. [PMID: 35999644 PMCID: PMC9396855 DOI: 10.1186/s13075-022-02894-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 07/26/2022] [Indexed: 12/12/2022] Open
Abstract
Lumbar disc herniation (LDH) can be spontaneously absorbed without surgical treatment. However, the pathogenesis and physiological indications for predicting protrusion reabsorption are still unclear, which prevents clinicians from preferentially choosing conservative treatment options for LDH patients with reabsorption effects. The purpose of this review was to summarize previous reports on LDH reabsorption and to discuss the clinical and imaging features that favor natural absorption. We highlighted the biological mechanisms involved in the phenomenon of LDH reabsorption, including macrophage infiltration, inflammatory responses, matrix remodeling, and neovascularization. In addition, we summarized and discussed potential clinical treatments for promoting reabsorption. Current evidence suggests that macrophage regulation of inflammatory mediators, matrix metalloproteinases, and specific cytokines in intervertebral disc is essential for the spontaneous reabsorption of LDH.
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Affiliation(s)
- Pengfei Yu
- Department of Orthopaedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People's Republic of China
| | - Feng Mao
- Department of Orthopaedic Surgery, Kunshan Integrated TCM and Western Medicine Hospital, Suzhou, 215332, People's Republic of China
| | - Jingyun Chen
- State Key Laboratory of Bioreactor Engineering & Shanghai Key Laboratory of New Drug Design, School of Pharmacy, East China University of Science and Technology, Shanghai, 200237, People's Republic of China
| | - Xiaoying Ma
- State Key Laboratory of Bioreactor Engineering & Shanghai Key Laboratory of New Drug Design, School of Pharmacy, East China University of Science and Technology, Shanghai, 200237, People's Republic of China
| | - Yuxiang Dai
- Department of Orthopaedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People's Republic of China
| | - Guanhong Liu
- Department of Orthopaedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People's Republic of China
| | - Feng Dai
- Department of Orthopaedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People's Republic of China
| | - Jingtao Liu
- Department of Orthopaedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People's Republic of China.
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13
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Wan ZY, Shan H, Liu TF, Song F, Zhang J, Liu ZH, Ma KL, Wang HQ. Emerging Issues Questioning the Current Treatment Strategies for Lumbar Disc Herniation. Front Surg 2022; 9:814531. [PMID: 35419406 PMCID: PMC8999845 DOI: 10.3389/fsurg.2022.814531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/04/2022] [Indexed: 11/26/2022] Open
Abstract
Lumbar disc herniation is among the common phenotypes of degenerative lumbar spine diseases, significantly affecting patients' quality of life. The practice pattern is diverse. Choosing conservative measures or surgical treatments is still controversial in some areas. For those who have failed conservative treatment, surgery with or without instrumentation is recommended, causing significant expenditures and frustrating complications, that should not be ignored. In the article, we performed a literature review and summarized the evidence by subheadings to unravel the cons of surgical intervention for lumbar disc herniation. There are tetrad critical issues about surgical treatment of lumbar disc herniation, i.e., favorable natural history, insufficient evidence in a recommendation of fusion surgery for patients, metallosis, and implant removal. Firstly, accumulating evidence reveals immune privilege and auto-immunity hallmarks of human lumbar discs within the closed niche. Progenitor cells within human discs further expand the capacity with the endogenous repair. Clinical watchful follow-up studies with repeated diagnostic imaging reveal spontaneous resolution for lumbar disc herniation, even calcified tissues. Secondly, emerging evidence indicates long-term complications of lumbar fusion, such as adjacent segment disease, pseudarthrosis, implant failure, and sagittal spinal imbalance, which get increasing attention. Thirdly, systemic and local reactions (metallosis) for metal instrumentation have been noted with long-term health concerns and toxicity. Fourthly, the indications and timing for spinal implant removal have not reached a consensus. Other challenging issues include postoperative lumbar stiffness. The review provided evidence from a negative perspective for surgeons and patients who attempt to choose surgical treatment. Collectively, the emerging underlying evidence questions the benefits of traditional surgery for patients with lumbar disc herniation. Therefore, the long-term effects of surgery should be closely observed. Surgical decisions should be made prudently for each patient.
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Affiliation(s)
- Zhong Y. Wan
- Department of Orthopedics, The Seventh Medical Center of General Hospital of People's Liberation Army (PLA), Beijing, China
| | - Hua Shan
- Institute of Integrative Medicine, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Tang F. Liu
- Institute of Integrative Medicine, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Fang Song
- Department of Stomatology, The Specialty Medical Center Rocket Force of People's Liberation Army (PLA), Beijing, China
| | - Jun Zhang
- Department of Orthopedics, Baoji Central Hospital, Baoji, China
| | - Zhi H. Liu
- Department of Cardiac Surgery, Xijing Hospital, Air Force Medical University, Xi'an, China
| | - Kun L. Ma
- Department of Orthopedics, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Hai Q. Wang
- Institute of Integrative Medicine, Shaanxi University of Chinese Medicine, Xi'an, China
- *Correspondence: Hai Q. Wang ;
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14
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Erario MDLÁ, Croce E, Moviglia Brandolino MT, Moviglia G, Grangeat AM. Ozone as Modulator of Resorption and Inflammatory Response in Extruded Nucleus Pulposus Herniation. Revising Concepts. Int J Mol Sci 2021; 22:ijms22189946. [PMID: 34576108 PMCID: PMC8469341 DOI: 10.3390/ijms22189946] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 12/21/2022] Open
Abstract
Ozone therapy has been used to treat disc herniation for more than four decades. There are several papers describing results and mechanism of action. However, it is very important to define the characteristics of extruded disc herniation. Although ozone therapy showed excellent results in the majority of spinal diseases, it is not yet fully accepted within the medical community. Perhaps it is partly due to the fact that, sometimes, indications are not appropriately made. The objective of our work is to explain the mechanisms of action of ozone therapy on the extruded disc herniation. Indeed, these mechanisms are quite different from those exerted by ozone on the protruded disc herniation and on the degenerative disc disease because the inflammatory response is very different between the various cases. Extruded disc herniation occurs when the nucleus squeezes through a weakness or tear in the annulus. Host immune system considers the nucleus material to be a foreign invader, which triggers an immune response and inflammation. We think ozone therapy modulates this immune response, activating macrophages, which produce phagocytosis of extruded nucleus pulposus. Ozone would also facilitate the passage from the M1 to M2 phase of macrophages, going from an inflammatory phase to a reparative phase. Further studies are needed to verify the switch of macrophages.
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Affiliation(s)
| | - Eduardo Croce
- Instituto Argentino de Ozonoterapia (IAOT), Buenos Aires C1425ASG, Argentina; (M.d.l.Á.E.); (E.C.)
| | - Maria Teresita Moviglia Brandolino
- Research Center for Tissue Engineering and Cell Therapy (CIITT), Civil Association for Research and Development of Advanced Therapies (ACIDTA), Buenos Aires C1425DKA, Argentina; (M.T.M.B.); (G.M.)
| | - Gustavo Moviglia
- Research Center for Tissue Engineering and Cell Therapy (CIITT), Civil Association for Research and Development of Advanced Therapies (ACIDTA), Buenos Aires C1425DKA, Argentina; (M.T.M.B.); (G.M.)
| | - Aníbal M. Grangeat
- Instituto Argentino de Ozonoterapia (IAOT), Buenos Aires C1425ASG, Argentina; (M.d.l.Á.E.); (E.C.)
- Correspondence: ; Tel.: +54-11-4809-3110
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15
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Zhang XB, Hu YC, Cheng P, Zhou HY, Chen XY, Wu D, Zhang RH, Yu DC, Gao XD, Shi JT, Zhang K, Li SL, Song PJ, Wang KP. Targeted therapy for intervertebral disc degeneration: inhibiting apoptosis is a promising treatment strategy. Int J Med Sci 2021; 18:2799-2813. [PMID: 34220308 PMCID: PMC8241771 DOI: 10.7150/ijms.59171] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 05/19/2021] [Indexed: 02/06/2023] Open
Abstract
Intervertebral disc (IVD) degeneration (IDD) is a multifactorial pathological process associated with low back pain (LBP). The pathogenesis is complicated, and the main pathological changes are IVD cell apoptosis and extracellular matrix (ECM) degradation. Apoptotic cell loss leads to ECM degradation, which plays an essential role in IDD pathogenesis. Apoptosis regulation may be a potential attractive therapeutic strategy for IDD. Previous studies have shown that IVD cell apoptosis is mainly induced by the death receptor pathway, mitochondrial pathway, and endoplasmic reticulum stress (ERS) pathway. This article mainly summarizes the factors that induce IDD and apoptosis, the relationship between the three apoptotic pathways and IDD, and potential therapeutic strategies. Preliminary animal and cell experiments show that targeting apoptotic pathway genes or drug inhibition can effectively inhibit IVD cell apoptosis and slow IDD progression. Targeted apoptotic pathway inhibition may be an effective strategy to alleviate IDD at the gene level. This manuscript provides new insights and ideas for IDD therapy.
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Affiliation(s)
- Xiao-Bo Zhang
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Department of Orthopedics, Honghui Hospital, Xi'an, Shanxi, 710000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Yi-Cun Hu
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Peng Cheng
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Hai-Yu Zhou
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Xigu District People's Hospital, Lanzhou, Gansu 730000, PR China
| | - Xiang-Yi Chen
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Ding Wu
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Rui-Hao Zhang
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - De-Chen Yu
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Xi-Dan Gao
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Jin-Tao Shi
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Kai Zhang
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Shao-Long Li
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Peng-Jie Song
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, Gansu 730000, PR China
| | - Ke-Ping Wang
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, PR China.,Xigu District People's Hospital, Lanzhou, Gansu 730000, PR China
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16
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Notochordal-Cell-Derived Exosomes Induced by Compressive Load Inhibit Angiogenesis via the miR-140-5p/Wnt/β-Catenin Axis. MOLECULAR THERAPY. NUCLEIC ACIDS 2020; 22:1092-1106. [PMID: 33294295 PMCID: PMC7691158 DOI: 10.1016/j.omtn.2020.10.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/13/2020] [Indexed: 12/16/2022]
Abstract
Angiogenesis is a pathological signature of intervertebral disc degeneration (IDD). Accumulating evidence has shown that notochordal cells (NCs) play an essential role in maintaining intervertebral disc development and homeostasis with inhibitive effect on blood vessel in-growth. However, the anti-angiogenesis mechanism of NCs is still unclear. In the current study, we, for the first time, isolated NC-derived exosomes (NC-exos) and showed their increased concentration following compressive load cultures. We further found that NC-exos from 0.5 MPa compressive load cultures (0.5 MPa/NC-exos) inhibit angiogenesis via transferring high expressed microRNA (miR)-140-5p to endothelial cells and regulating the downstream Wnt/β-catenin pathway. Clinical evidence showed that exosomal miR-140-5p expression of the nucleus pulposus is negatively correlated with angiogenesis in IDD. Finally, 0.5 MPa/NC-exos were demonstrated to have a therapeutical impact on the degenerated disc with an anti-angiogenesis effect in an IDD model. Consequently, our present findings provide insights into the anti-angiogenesis mechanism of NC-exos, indicating their therapeutic potential for IDD.
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17
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Hu S, Shao Z, Zhang C, Chen L, Mamun AA, Zhao N, Cai J, Lou Z, Wang X, Chen J. Chemerin facilitates intervertebral disc degeneration via TLR4 and CMKLR1 and activation of NF-kB signaling pathway. Aging (Albany NY) 2020; 12:11732-11753. [PMID: 32526705 PMCID: PMC7343479 DOI: 10.18632/aging.103339] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 05/18/2020] [Indexed: 12/25/2022]
Abstract
Now days, obesity is a major risk factor for intervertebral disc degeneration (IDD). However, adipokine, such as chemerin is a novel cytokine, which is secreted by adipose tissue, and are thought to be played major roles in various degenerative diseases. Obese individuals are known to have high concentration of serum chemerin. Our purpose was to study whether chemerin acts as a biochemical relationship between obesity, and IDD. In this study, we found that the expression level of chemerin was significantly increased in the human degenerated nucleus pulposus (NP) tissues, and had higher level in the obese people than the normal people. Chemerin significantly increased the inflammatory mediator level, contributing to ECM degradation in nucleus pulposus cells (NPCs). Furthermore, chemerin overexpression aggravates the puncture-induced IVDD progression in rats, while knockdown CMKLR1 reverses IVDD progression. Chemerin activates the NF-kB signaling pathway via its receptors CMKLR1, and TLR4 to release inflammatory mediators, which cause matrix degradation, and cell aging. These findings generally provide novel evidence supporting the causative role of obesity in IDD, which is essentially important to literally develop novel preventative or generally therapeutic treatment in the disc degenerative disorders.
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Affiliation(s)
- Sunli Hu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Zhenxuan Shao
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Chenxi Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Liang Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Abdullah Al Mamun
- Molecular Pharmacology Research Center, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Ning Zhao
- The First School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Jinfeng Cai
- The First School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Zhiling Lou
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiangyang Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Jiaoxiang Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China.,The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
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18
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He M, Pang J, Sun H, Zheng G, Lin Y, Ge W. Overexpression of TIMP3 inhibits discogenic pain by suppressing angiogenesis and the expression of substance P in nucleus pulposus. Mol Med Rep 2020; 21:1163-1171. [PMID: 31922222 PMCID: PMC7003021 DOI: 10.3892/mmr.2020.10922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 09/04/2019] [Indexed: 12/11/2022] Open
Abstract
Approximately 50% of the cases of low back pain (LBP) are attributed to discogenic origin. The causes of discogenic pain are complicated and consist of a complex biochemical cascade. Neovascularization of intervertebral discs (IVDs) is believed to be associated with discogenic pain. The anti‑angiogenesis ability of tissue inhibitor of metalloproteinase‑3 (TIMP3) has been reported in many tumors, yet whether TIMP3 is associated with neovascularization of IVDs remains unknown. In the present study, both in vitro and in vivo models were used to investigate the association between discogenic pain and TIMP3 expression in nucleus pulposus (NP). PCR results demonstrated that inflammation induced downregulation of TIMP3 expression in NP cells. By using an adenovirus system to upregulate TIMP3 expression, the effect of TIMP3 on angiogenesis was measured by endothelial cell migration and tube formation assays. The results demonstrated that overexpression of TIMP3 suppressed angiogenesis in NP without the regulation of vascular endothelial growth factor (VEGF) expression. TNF‑α converting enzyme (TACE) expression was downregulated by TIMP3, thus inhibiting the TACE‑induced activation of TNF‑α in NP cells. Immunohistochemical staining of IVDs also confirmed that TIMP3 inhibited the expression of substance P in NP. Taken together, the present results indicated the expression of TIMP3 in NP may have a key role in the development of discogenic pain.
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Affiliation(s)
- Mingwei He
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
| | - Jinlei Pang
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
| | - Haiyan Sun
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
| | - Guanrong Zheng
- Department of Pain, Shengli Oilfield Central Hospital, Dongying, Shandong 257000, P.R. China
| | - Yan Lin
- Department of Pain, Shengli Oilfield Central Hospital, Dongying, Shandong 257000, P.R. China
| | - Weipeng Ge
- Department of Pain, Shengli Oilfield Central Hospital, Dongying, Shandong 257000, P.R. China
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19
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Sun Z, Liu B, Luo ZJ. The Immune Privilege of the Intervertebral Disc: Implications for Intervertebral Disc Degeneration Treatment. Int J Med Sci 2020; 17:685-692. [PMID: 32210719 PMCID: PMC7085207 DOI: 10.7150/ijms.42238] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023] Open
Abstract
The intervertebral disc (IVD) is the largest avascular organ of the body. It is composed of three parts: the nucleus pulposus (NP), the annulus fibrosus (AF) and the cartilaginous endplate (CEP). The central NP is surrounded by the AF and sandwiched by the two CEPs ever since its formation. This unique structure isolates the NP from the immune system of the host. Additionally, molecular factors expressed in IVD have been shown inhibitive effect on immune cells and cytokines infiltration. Therefore, the IVD has been identified as an immune privilege organ. The steady state of immune privilege is fundamental to the homeostasis of the IVD. The AF and the CEP, along with the immunosuppressive molecular factors are defined as the blood-NP barrier (BNB), which establishes a strong barrier to isolate the NP from the host immune system. When the BNB is damaged, the auto-immune response of the NP occurs with various downstream cascade reactions. This effect plays an important role in the whole process of IVD degeneration and related complications, such as herniation, sciatica and spontaneous herniated NP regression. Taken together, an enhanced understanding of the immune privilege of the IVD could provide new targets for the treatment of symptomatic IVD disease. However, the underlying mechanism above is still not fully clarified. Accordingly, the current study will extensively review and discuss studies regarding the immune privilege of the IVD.
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Affiliation(s)
- Zhen Sun
- Department of Orthopedic, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
| | - Bing Liu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
| | - Zhuo-Jing Luo
- Department of Orthopedic, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
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20
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Eid RA, Alkhateeb MA, Eleawa SM, Zaki MSA, El-Kott AF, El-Sayed F, Otifi H, Alqahtani S, Asiri ZA, Aldera H. Fas/FasL-mediated cell death in rat's diabetic hearts involves activation of calcineurin/NFAT4 and is potentiated by a high-fat diet rich in corn oil. J Nutr Biochem 2019; 68:79-90. [PMID: 31030170 DOI: 10.1016/j.jnutbio.2019.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/17/2019] [Accepted: 03/12/2019] [Indexed: 01/29/2023]
Abstract
This study investigated if calcineurin/nuclear factor of activated T cells (NFAT) axis mediates the cardiac apoptosis in rats with type 1 diabetes mellitus (T1DM)-induced rats or administered chronically high-fat diet rich in corn oil (CO-HFD). Also, it investigated the impact of chronic administration of CO-HFD on Fas/Fas ligand (Fas/FasL)-induced apoptosis in the hearts of T1DM-induced rats. Adult male Wistar rats (140-160 g) were classified as control: (10% fat) CO-HFD: (40% fat), T1DM, and T1DM + CO-HFD (n=20/each). In vitro, cardiomyocytes were cultured in either low glucose (LG) or high glucose (HG) media in the presence or absence of linoleic acid (LA) and other inhibitors. Compared to the control, increased reactive oxygen species (ROS), protein levels of cytochrome C, cleaved caspase-8 and caspase-3, myocardial damage and impeded left ventricular (LV) function were observed in the hearts of all treated groups and maximally in T1DM + CO-HFD-treated rats. mRNA of all NFAT members (NFAT1-4) were not affected by any treatment. CO-HFD or LA significantly up-regulated Fas levels in both LVs and cultured cardiomyocytes in a ROS dependent mechanism and independent of modulating intracellular Ca2+ levels or calcineurin activity. T1DM or hyperglycemia significant up-regulated mRNA and protein levels of Fas and FasL by activating Ca2+/calcineurin/NFAT-4 axis. Furthermore, Fas/FasL cell death induced by recombinant FasL (rFasL) or HG media was enhanced by pre-incubating the cells with LA. In conclusion, activation of the Ca2+/calcineurin/NFAT4 axis is indispensable for hyperglycemia-induced Fas/FasL cell death in the cardiomyocytes and CO-HFD sensitizes this by up-regulation of Fas.
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Affiliation(s)
- Refaat A Eid
- Department of Pathology, College of Medicine, King Khalid University, P.O. 641, Abha,61421, Saudi Arabia.
| | - Mahmoud A Alkhateeb
- Department of basic medical Sciences, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Samy M Eleawa
- Department of Applied Medical Sciences, College of Health Sciences, PAAET, Shuwaikh, Kuwait
| | - Mohamed Samir Ahmed Zaki
- Department of Anatomy, College of Medicine, King Khalid University, P.O. 641, Abha, 61421, Saudi Arabia; Department of Histology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Attalla Farag El-Kott
- Department of Biology, College of Science, King Khalid University, P.O. 641, Abha, 61421, Saudi Arabia; Department of Zoology, Faculty of Science, Damanhour University, Damanhour, Egypt
| | - Fahmy El-Sayed
- Department of Pathology, College of Medicine, King Khalid University, P.O. 641, Abha,61421, Saudi Arabia
| | - Hassan Otifi
- Department of Pathology, College of Medicine, King Khalid University, P.O. 641, Abha,61421, Saudi Arabia
| | - Sultan Alqahtani
- Department of Zoology, Faculty of Science, Damanhour University, Damanhour, Egypt
| | - Ziad A Asiri
- Department of clinical biochemistry, Central Laboratory Department, Asser central Hospital, Abha, Saudi Arabia
| | - Hussain Aldera
- Department of Zoology, Faculty of Science, Damanhour University, Damanhour, Egypt
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Shi P, Chee A, Liu W, Chou PH, Zhu J, An HS. Therapeutic effects of cell therapy with neonatal human dermal fibroblasts and rabbit dermal fibroblasts on disc degeneration and inflammation. Spine J 2019; 19:171-181. [PMID: 30142460 DOI: 10.1016/j.spinee.2018.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND CONTEXT Increasing evidence suggests transplanting viable cells into the degenerating intervertebral disc (IVD) may be effective in treating disc degeneration and back pain. Clinical studies utilizing autologous or allogeneic mesenchymal stem cells to treat patients with back pain have reported some encouraging results. Animal studies have shown that cells injected into the disc can survive for months and have regenerative effects. Studies to determine the advantages and disadvantages of cell types and sources for therapy are needed. PURPOSE The objective of this study is to determine the impact of donor source on the therapeutic effects of dermal fibroblast treatment on disc degeneration and inflammation. STUDY DESIGN Using the rabbit disc degeneration model, we compared transplantation of neonatal human dermal fibroblasts (nHDFs) and rabbit dermal fibroblasts (RDFs) into rabbit degenerated discs on host immune response, disc height, and IVD composition. METHODS New Zealand white rabbits received an annular puncture using an 18-guage needle to induce disc degeneration. Four weeks after injury, rabbit IVDs were treated with 5 × 106 nHDFs, RDFs, or saline. At eight weeks post-treatment, animals were sacrificed. X-ray images were obtained. IVDs were isolated for inflammatory and collagen gene expression analysis using real-time polymerase chain reaction and biochemical analysis of proteoglycan contents using dimethylmethylene blue assay. These studies were funded by a research grant from SpinalCyte, LLC ($414,431). RESULTS Eight weeks after treatment, disc height indexes of discs treated with nHDF increased significantly by 7.8% (p<.01), whereas those treated with saline or RDF increased by 1.5% and 2.0%, respectively. Gene expression analysis showed that discs transplanted with nHDFs and RDFs displayed similar inflammatory responses (p=.2 to .8). Compared to intact discs, expression of both collagen types I and II increased significantly in nHDF-treated discs (p<.05), trending to significant in RDF-treated discs, and not significantly in saline treated discs. The ratio of collagen type II/collagen type I was higher in the IVDs treated with nHDFs (1.26) than those treated with RDFs (0.81) or saline (0.59) and intact discs (1.00). Last, proteoglycan contents increased significantly in discs treated with nHDF (p<.05) and were trending toward significance in the RDF-treated discs compared to those treated with saline. CONCLUSIONS This study showed that cell transplantation with nHDF into degenerated IVDs can significantly increase markers of disc regeneration (disc height, collagen type I and II gene expression, and proteoglycan contents). Transplantation with RDFs showed similar regenerative trends, but these trends were not significant. This study also showed that the human cells transplanted into the rabbit discs did not induce a higher immune response than the rabbit cells. These results support that the IVD is immune privileged and would tolerate allogeneic or xenogeneic grafts.
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Affiliation(s)
- Peng Shi
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St, Suite 300, Chicago, IL 60612, USA; Tufts University School of Dental Medicine, 1 Kneeland St, Boston, MA 02111, USA
| | - Ana Chee
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St, Suite 300, Chicago, IL 60612, USA
| | - Weijun Liu
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St, Suite 300, Chicago, IL 60612, USA; Department of Orthopedics, Wuhan Pu'Ai Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 473 Hanzheng St, Wuhan 430033, China
| | - Po-Hsin Chou
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St, Suite 300, Chicago, IL 60612, USA; Department of Orthopaedic and Traumatology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan 11217, ROC; School of Medicine, National Yang-Ming University, No.155, Sec. 2, Linong St., Beitou District, Taipei City, Taiwan 112, ROC
| | - Jun Zhu
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St, Suite 300, Chicago, IL 60612, USA; The Minimally Invasive Department of Orthopedics, The First People's Hospital of Huaihua, The Research Center of Translational Medicine, Jishou University School of Medicine, 144 South Road Jinxi South Road, Huaihua City, Hunan 418000, China
| | - Howard S An
- Department of Orthopedic Surgery, Rush University Medical Center, 1611 W Harrison St, Suite 300, Chicago, IL 60612, USA.
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Ren GJ, Fan XC, Liu TL, Wang SS, Zhao GH. Genome-wide analysis of differentially expressed profiles of mRNAs, lncRNAs and circRNAs during Cryptosporidium baileyi infection. BMC Genomics 2018; 19:356. [PMID: 29747577 PMCID: PMC5946474 DOI: 10.1186/s12864-018-4754-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/02/2018] [Indexed: 01/17/2023] Open
Abstract
Background Cryptosporidium baileyi is the most common Cryptosporidium species in birds. However, effective prevention measures and treatment for C. baileyi infection were still not available. Long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs) play important roles in regulating occurrence and progression of many diseases and are identified as effective biomarkers for diagnosis and prognosis of several diseases. In the present study, the expression profiles of host mRNAs, lncRNAs and circRNAs associated with C. baileyi infection were investigated for the first time. Results The tracheal tissues of experimental (C. baileyi infection) and control chickens were collected for deep RNA sequencing, and 545,479,934 clean reads were obtained. Of them, 1376 novel lncRNAs were identified, including 1161 long intergenic non-coding RNAs (lincRNAs) and 215 anti-sense lncRNAs. A total of 124 lncRNAs were found to be significantly differentially expressed between the experimental and control groups. Additionally, 14,698 mRNAs and 9085 circRNAs were identified, and significantly different expressions were observed for 1317 mRNAs and 104 circRNAs between two groups. Bioinformatic analyses of gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway for their targets and source genes suggested that these dysregulated genes may be involved in the interaction between the host and C. baileyi. Conclusions The present study revealed the expression profiles of mRNAs, lncRNAs and circRNAs during C. baileyi infection for the first time, and sheds lights on the roles of lncRNAs and circRNAs underlying the pathogenesis of Cryptosporidium infection. Electronic supplementary material The online version of this article (10.1186/s12864-018-4754-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guan-Jing Ren
- Department of Parasitology, College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, China
| | - Xian-Cheng Fan
- Department of Parasitology, College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, China
| | - Ting-Li Liu
- Department of Parasitology, College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, China
| | - Sha-Sha Wang
- Department of Parasitology, College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, China
| | - Guang-Hui Zhao
- Department of Parasitology, College of Veterinary Medicine, Northwest A&F University, Yangling, 712100, China.
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Dudli S, Miller S, Demir-Deviren S, Lotz JC. Inflammatory response of disc cells against Propionibacterium acnes depends on the presence of lumbar Modic changes. 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 2018; 27:1013-1020. [PMID: 28884220 PMCID: PMC5842102 DOI: 10.1007/s00586-017-5291-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/06/2017] [Accepted: 09/02/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE Intervertebral disc with Propionibacterium acnes (P. acnes) is suggested to be an etiology of Modic type I changes in the adjacent bone marrow. However it is unknown if disc cells can respond to P. acnes and if bone marrow cells respond to bacterial and disc metabolites draining from infected discs. METHODS Human disc cells (n = 10) were co-cultured with 10- and 100-fold excess of P. acnes over disc cells for 3 h and 24 h. Lipopolysaccharide was used as positive control. Expression of IL1, IL6, IL8, and CCL2 by disc cells was quantified by quantitative PCR. Lipase activity was measured in culture supernatants (n = 6). Human vertebral bone marrow mononuclear cells (BMNCs) (n = 2) were cultured in conditioned media from disc cell/P. acnes co-cultures and expression of IL1, IL6, IL8, and CCL2 was measured after 24 h. RESULTS All disc cells responded to lipopolysaccharide but only 6/10 responded to P. acnes with increased cytokine expression. Cytokine increase was time- but not P. acnes concentration-dependent. Disc cell responsiveness was associated with the presence of lumbar Modic changes in the donor. Lipase activity was increased independent of disc cell responsiveness. BMNCs responded with inflammatory activity only when cultured in supernatants from responsive disc cell lines. CONCLUSION Disc cell responsiveness to P. acnes associates with the presence of lumbar Modic changes. Furthermore, bone marrow cells had an inflammatory response to the cocktail of disc cytokines and P. acnes metabolites. These data indicate that low virulent P. acnes infection of the disc is a potential exacerbating factor to Modic changes.
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Affiliation(s)
- Stefan Dudli
- Department of Orthopaedic Surgery, University of California San Francisco, 513 Parnassus Ave, S-1164, San Francisco, CA, 94143, USA.
- Center of Experimental Rheumatology, University Hospital Zurich, Lengghalde 5, 8008, Zurich, Switzerland.
| | - S Miller
- Department of Laboratory Medicine, University of California San Francisco, 185 Berry St, Suite 290, San Francisco, CA, 94107, USA
| | - S Demir-Deviren
- Department of Orthopaedic Surgery, University of California San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA
| | - J C Lotz
- Department of Orthopaedic Surgery, University of California San Francisco, 513 Parnassus Ave, S-1164, San Francisco, CA, 94143, USA
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Abstract
Accumulating evidence indicates noncoding RNAs (ncRNAs) fine-tune gene expression with mysterious machinery. We conducted a combination of mRNA, miRNA, circRNA, LncRNA microarray analyses on 10 adults' lumbar discs. Moreover, we performed additional global exploration on RNA interacting machinery in terms of in silico computational pipeline. Here we show the landscape of RNAs in human lumbar discs. In general, the RNA-abundant landscape comprises 14,635 mRNAs (37.93%), 2,059 miRNAs (5.34%), 18,995 LncRNAs (49.23%) and 2,894 (7.5%) circRNAs. Chromosome 1 contributes for RNA transcription at most (10%). Bi-directional transcription contributes evenly for RNA biogenesis, in terms of 5′ to 3′ and 3′ to 5′. Despite the majority of circRNAs are exonic, antisense (1.49%), intergenic (0.035%), intragenic (1.69%), and intronic (6.29%) circRNAs should not be ignored. A single miRNA could interact with a multitude of circRNAs. Notably, CDR1as or ciRS-7 harbors 66 consecutive binding sites for miR-7-5p (previous miR-7), evidencing our pipeline. The majority of binding sites are perfect-matched (78.95%). Collectively, global landscape of RNAs sheds novel insights on RNA interacting mechanisms in human intervertebral disc degeneration.
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Cytokine Involvement in Biological Inflammation Related to Degenerative Disorders of the Intervertebral Disk: A Narrative Review. J Chiropr Med 2018; 17:54-62. [PMID: 29628809 DOI: 10.1016/j.jcm.2017.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/12/2017] [Accepted: 09/09/2017] [Indexed: 11/22/2022] Open
Abstract
Objective The purpose of this narrative literature review is to discuss the literature regarding the potential role that cytokines play in degenerative disk disease. Methods The inclusion criteria were studies that used inflammatory mediators in advancing disk disease processes. Research studies were limited to the last 3 decades that had free full-text available online in English. Exclusion criteria were review articles and articles pertaining to temporomandibular joints and other joints of the body other than the intervertebral disk. The following databases were searched: PubMed, EBSCOhost, and Google Scholar through March 13, 2017. Results A total of 82 studies were included in this review. The papers were reviewed for complex mechanisms behind the degenerative cascade, emphasizing the role of proinflammatory cytokines, which may be instrumental in processes of inflammation, neurologic pain, and disk degeneration. Interleukin-1β and tumor necrosis factor α were among the more notable cytokines involved in this cascade. Because monocyte chemoattractant protein-1 stimulates and activates macrophages in the event of infiltration, additional proinflammatory cytokines are released to act on molecules to promote blood and nerve ingrowth, resulting in pain signaling and tissue degradation. Excessive inflammation and/or tissue damage initiates a pathologic imbalance between anabolic and catabolic processes. Conclusions This literature review describes how inflammatory and biochemical changes may trigger disk degeneration. Proinflammatory cytokines stimulate microvascular blood and nerve ingrowth, resulting in pain signaling and tissue degradation. This may sensitize a person to chemical and/or mechanical stimuli, contributing to severe low back pain.
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26
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Zhang F, Zhao X, Shen H, Zhang C. Molecular mechanisms of cell death in intervertebral disc degeneration (Review). Int J Mol Med 2016; 37:1439-48. [PMID: 27121482 PMCID: PMC4866972 DOI: 10.3892/ijmm.2016.2573] [Citation(s) in RCA: 168] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 04/18/2016] [Indexed: 02/07/2023] Open
Abstract
Intervertebral discs (IVDs) are complex structures that consist of three parts, namely, nucleus pulposus, annulus fibrosus and cartilage endplates. With aging, IVDs gradually degenerate as a consequence of many factors, such as microenvironment changes and cell death. Human clinical trial and animal model studies have documented that cell death, particularly apoptosis and autophagy, significantly contribute to IVD degeneration. The mechanisms underlying this phenomenon include the activation of apoptotic pathways and the regulation of autophagy in response to nutrient deprivation and multiple stresses. In this review, we briefly summarize recent progress in understanding the function and regulation of apoptosis and autophagy signaling pathways. In particular, we focus on studies that reveal the functional mechanisms of these pathways in IVD degeneration.
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Affiliation(s)
- Fan Zhang
- Department of Orthopedics, Changhai Hospital Affiliated to The Second Military Medical University, Shanghai 200433, P.R. China
| | - Xueling Zhao
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, P.R. China
| | - Hongxing Shen
- Department of Orthopedics, Changhai Hospital Affiliated to The Second Military Medical University, Shanghai 200433, P.R. China
| | - Caiguo Zhang
- Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, CO 80045, USA
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27
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CHU HUI, YU HANG, REN DING, ZHU KEJUN, HUANG HONG. Plumbagin exerts protective effects in nucleus pulposus cells by attenuating hydrogen peroxide-induced oxidative stress, inflammation and apoptosis through NF-κB and Nrf-2. Int J Mol Med 2016; 37:1669-76. [DOI: 10.3892/ijmm.2016.2564] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 04/01/2016] [Indexed: 11/06/2022] Open
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Li XK, Wu ZG, Ding T, Wang HQ. Revisiting the nomenclature and grading schemes for disc degeneration: issues to be solved. Spine J 2015; 15:2594-5. [PMID: 26698031 DOI: 10.1016/j.spinee.2015.08.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 07/07/2015] [Accepted: 08/06/2015] [Indexed: 02/03/2023]
Affiliation(s)
- Xin-Kui Li
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, 127 Changle Western Rd, Fourth Military Medical University, Xi'an 710032, China
| | - Zhi-Gang Wu
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, 127 Changle Western Rd, Fourth Military Medical University, Xi'an 710032, China
| | - Tan Ding
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, 127 Changle Western Rd, Fourth Military Medical University, Xi'an 710032, China
| | - Hai-Qiang Wang
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, 127 Changle Western Rd, Fourth Military Medical University, Xi'an 710032, China
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29
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Lee JTY, Cheung KMC, Leung VYL. Systematic study of cell isolation from bovine nucleus pulposus: Improving cell yield and experiment reliability. J Orthop Res 2015; 33:1743-55. [PMID: 26036782 DOI: 10.1002/jor.22942] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 05/08/2015] [Indexed: 02/04/2023]
Abstract
Differences in matrix compositions in human nucleus pulposus (NP) clinical samples demand different cell isolation protocols for optimal results but there is no clear guide about this to date. Sub-optimal protocols may result in low cell yield, limited reliability of results or even failure of experiments. Cell yield, viability and attachment of cells isolated from bovine NP tissue with different protocols were estimated by cell counting, Trypan blue staining and cell culturing respectively. RNA was extracted from isolated cells and quantified by Nanodrop spectrometry and RT-qPCR. Higher collagenase concentration, longer digestion duration and pronase pre-treatment increased the cell yield. Cell viability remained high (<5% dead cells) even after 0.2% collagenase treatment for overnight. NP cells remained to have high ACAN, COL2A1, CDH2, KRT18, and KRT19 expression compared to muscle cells for different cell isolation conditions tested. Digestion by collagenase alone without the use of pronase could isolate cells from human degenerated NP tissue but clusters of cells were observed. We suggest the use of the disappearance of tissue as an indirect measure of cells released. This study provides a guide for researchers to decide the parameters involved in NP cell isolation for optimal outcome.
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Affiliation(s)
- Juliana T Y Lee
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Kenneth M C Cheung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Victor Y L Leung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Liu ZH, Huo JL, Wu ZG, Sun Z, Bai F, Samartzis D, Gantenbein B, Fan SD, Wang HQ. RASSF7 expression and its regulatory roles on apoptosis in human intervertebral disc degeneration. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:16097-16103. [PMID: 26884887 PMCID: PMC4730100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 11/17/2015] [Indexed: 06/05/2023]
Abstract
Apoptosis plays an important role in intervertebral disc degeneration (IDD). Overwhelming evidence indicates that RASSF7 is essential for cell growth and apoptosis. Recently, it has been noted that the JNK signaling can be negatively regulated by suppressing phosphorylated-MKK7 activation during pro-apoptosis. We aimed to investigate the RASSF7 expression level in human degenerative nucleus pulposus (NP) cells and non-degenerative NP cells and the link between RASSF7-JNK with NP cells apoptosis. We harvested NP tissues from 20 IDD patients as disease group and 8 cadaveric donors as normal controls. We detected RASSF7 expression by Real-time-PCR and western blotting. Consequently, we found that the expression of RASSF7 was higher in non-degenerative group than in degenerative group (P<0.05). Overexpression of RASSF7 in degenerative NP cells led to decreased apoptosis rate than that in scramble group (P<0.05). Collectively, our findings suggest that RASSF7 plays an important role in human IDD and RASSF7 might be potentially developed as a curative agent.
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Affiliation(s)
- Zhi-Heng Liu
- Department of Orthopaedics, Xi’an Air Force Hospital, PLA172 Youyi Eastern Road, Xi’an, P. R. China
| | - Jun-Li Huo
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University127 Changle Western Road, Xi’an, P. R. China
| | - Zhi-Gang Wu
- Department of Orthopaedics, Lanzhou General Hospital of Lanzhou Military Region, PLALanzhou, P. R. China
| | - Zhen Sun
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University127 Changle Western Road, Xi’an, P. R. China
| | - Feng Bai
- Department of Orthopaedics, Xi’an Air Force Hospital, PLA172 Youyi Eastern Road, Xi’an, P. R. China
| | - Dino Samartzis
- Department of Orthopaedics and Traumatology, The University of Hong KongPokfulam, Hong Kong, SAR China
| | - Benjamin Gantenbein
- Institute for Surgical Technology and Biomechanics, Tissue and Organ Mechanobiology, University of BernBern, Switzerland
| | - Shao-Di Fan
- Department of Orthopaedics, Xi’an Air Force Hospital, PLA172 Youyi Eastern Road, Xi’an, P. R. China
| | - Hai-Qiang Wang
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University127 Changle Western Road, Xi’an, P. R. China
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Wei HK, Yang SD, Bai ZL, Zhang X, Yang DL, Ding WY. Levofloxacin increases apoptosis of rat annulus fibrosus cells via the mechanism of upregulating MMP-2 and MMP-13. Int J Clin Exp Med 2015; 8:20198-20207. [PMID: 26884932 PMCID: PMC4723777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 10/27/2015] [Indexed: 06/05/2023]
Abstract
Levofloxacin was previously reported to induce apoptosis of rat annulus fibrosus (AF) cells by upregulating active caspase-3 and matrix metalloproteinase (MMP)-3 expression in vitro. However, the effects of levofloxacin on rat AF cells, as well as the related mechanism, have not been revealed completely. The purpose of this study was to further explore the changes in extracellular matrix and MMPs of rat AF cells based on levofloxacin-induced apoptosis. AF cells isolated from rat AF regions were cultured in monolayers and treated with levofloxacin in a dose- and time-dependent manner. To determine the cytotoxic effects of levofloxacin, inverted phase-contrast microscopy was used to perform morphological observation of apoptotic cells. The mRNA expression levels of MMP-2, -9 and -13 were quantified by reverse transcription and real-time quantitative polymerase chain reaction (RT-qPCR). Protein level of MMP-2 and MMP-13 were determined by western blot. The results showed that levofloxacin induced marked AF cell apoptosis, which was observed by inverted phase-contrast microscopy, and indicated by the increased expression of active caspase-3. Both RT-qPCR and western blot revealed that MMP-2 and MMP-13 expression were upregulated by levofloxacin treatment in a time- and dose-dependent manner. Moreover, cellular binding to type I collagen was found to be decreased by levofloxacin. In conclusion, the results above suggest that the possible cytotoxic effects of levofloxacin on AF cells in vitro may be attributed to the decreased cell binding to type I collagen and up-regulated expression of MMP-2 and MMP-13.
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Affiliation(s)
- Hai-Kun Wei
- Department of Spinal Surgery, The Third Hospital of Hebei Medical UniversityShijiazhuang 050051, China
| | - Si-Dong Yang
- Department of Spinal Surgery, The Third Hospital of Hebei Medical UniversityShijiazhuang 050051, China
| | - Zhi-Long Bai
- Department of Spinal Surgery, The Third Hospital of Hebei Medical UniversityShijiazhuang 050051, China
| | - Xu Zhang
- Department of Spinal Surgery, The Third Hospital of Hebei Medical UniversityShijiazhuang 050051, China
| | - Da-Long Yang
- Department of Spinal Surgery, The Third Hospital of Hebei Medical UniversityShijiazhuang 050051, China
| | - Wen-Yuan Ding
- Department of Spinal Surgery, The Third Hospital of Hebei Medical UniversityShijiazhuang 050051, China
- Hebei Provincial Key Laboratory of Orthopedic BiomechanicsShijiazhuang 050051, China
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Chen SQ, Lin JP, Zheng QK, Chen SJ, Li M, Lin XZ, Wang SZ. Protective effects of paeoniflorin against FasL-induced apoptosis of intervertebral disc annulus fibrosus cells via Fas-FasL signalling pathway. Exp Ther Med 2015; 10:2351-2355. [PMID: 26668640 DOI: 10.3892/etm.2015.2776] [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: 04/10/2014] [Accepted: 12/29/2014] [Indexed: 11/06/2022] Open
Abstract
In the present study, we demonstrate that the degeneration of intervertebral discs is caused by ageing and apoptosis of matrix cells. Apoptosis is as essential as the function of proteoglycan synthesis in assessing the possible degeneration of intervertebral discs; paeoniflorin (PF) induces cytoprotective effects on various types of cells. In this study, the function of PF in inhibiting Fas ligand (FasL)-induced apoptosis in annulus fibrosus cells was assessed, and the correlation between apoptosis and the Fas-FasL pathway was determined. Annulus fibrosus cells were derived from the intervertebral discs of 1-month-old Sprague Dawley rats; the cells were characterised by toluidine blue staining and subjected to apoptosis with FasL. PF was diluted to various concentrations and added to annulus fibrosus cells at various times. The impact of PF and FasL on cell apoptosis of annulus fibrosus cells was determined by flow cytometry. Western blot analysis was performed to determine the protein expression levels of Fas and caspase-3. The percentages of apoptotic annulus fibrosus cells as well as the expression levels of caspase-3 and Fas were significantly reduced following treatment with 208, 20.8 or 2.08 µM PF. PF inhibits the activation of the Fas-FasL signal pathway and decreases FasL-induced apoptosis of annulus fibrosus cells.
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Affiliation(s)
- Shao-Qing Chen
- Department of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Jian-Ping Lin
- The Affiliated Rehabilitation Hospital to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350000, P.R. China
| | - Qi-Kai Zheng
- The Affiliated Rehabilitation Hospital to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350000, P.R. China
| | - Shui-Jin Chen
- The Affiliated Rehabilitation Hospital to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350000, P.R. China
| | - Ming Li
- Department of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Xian-Zhao Lin
- Ministry of Education (Provincial Total Construction) Key Laboratory of Chinese Orthopedics and Athletic Rehabilitation, Fuzhou, Fujian 350000, P.R. China
| | - Shi-Zhong Wang
- The Affiliated Rehabilitation Hospital to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350000, P.R. China
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Stich S, Stolk M, Girod PP, Thomé C, Sittinger M, Ringe J, Seifert M, Hegewald AA. Regenerative and immunogenic characteristics of cultured nucleus pulposus cells from human cervical intervertebral discs. PLoS One 2015; 10:e0126954. [PMID: 25993467 PMCID: PMC4438063 DOI: 10.1371/journal.pone.0126954] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 04/09/2015] [Indexed: 12/24/2022] Open
Abstract
Cell-based regenerative approaches have been suggested as primary or adjuvant procedures for the treatment of degenerated intervertebral disc (IVD) diseases. Our aim was to evaluate the regenerative and immunogenic properties of mildly and severely degenerated cervical nucleus pulposus (NP) cells with regard to cell isolation, proliferation and differentiation, as well as to cell surface markers and co-cultures with autologous or allogeneic peripheral blood mononuclear cells (PBMC) including changes in their immunogenic properties after 3-dimensional (3D)-culture. Tissue from the NP compartment of 10 patients with mild or severe grades of IVD degeneration was collected. Cells were isolated, expanded with and without basic fibroblast growth factor and cultured in 3D fibrin/poly (lactic-co-glycolic) acid transplants for 21 days. Real-time reverse-transcription polymerase chain reaction (RT-PCR) showed the expression of characteristic NP markers ACAN, COL1A1 and COL2A1 in 2D- and 3D-culture with degeneration- and culture-dependent differences. In a 5,6-carboxyfluorescein diacetate N-succinimidyl ester-based proliferation assay, NP cells in monolayer, regardless of their grade of degeneration, did not provoke a significant proliferation response in T cells, natural killer (NK) cells or B cells, not only with donor PBMC, but also with allogeneic PBMC. In conjunction with low inflammatory cytokine expression, analyzed by Cytometric Bead Array and fluorescence-activated cell sorting (FACS), a low immunogenicity can be assumed, facilitating possible therapeutic approaches. In 3D-culture, however, we found elevated immune cell proliferation levels, and there was a general trend to higher responses for NP cells from severely degenerated IVD tissue. This emphasizes the importance of considering the specific immunological alterations when including biomaterials in a therapeutic concept. The overall expression of Fas receptor, found on cultured NP cells, could have disadvantageous implications on their potential therapeutic applications because they could be the targets of cytotoxic T-cell activity acting by Fas ligand-induced apoptosis.
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Affiliation(s)
- Stefan Stich
- Tissue Engineering Laboratory and Berlin-Brandenburg Center for Regenerative Therapies, Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Meaghan Stolk
- Institute of Medical Immunology and Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Pierre Pascal Girod
- Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria
| | - Claudius Thomé
- Department of Neurosurgery, Innsbruck Medical University, Innsbruck, Austria
| | - Michael Sittinger
- Tissue Engineering Laboratory and Berlin-Brandenburg Center for Regenerative Therapies, Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jochen Ringe
- Tissue Engineering Laboratory and Berlin-Brandenburg Center for Regenerative Therapies, Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Martina Seifert
- Institute of Medical Immunology and Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Aldemar Andres Hegewald
- Department of Neurosurgery, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
- * E-mail:
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Wei A, Shen B, Williams L, Diwan A. Mesenchymal stem cells: potential application in intervertebral disc regeneration. Transl Pediatr 2014; 3:71-90. [PMID: 26835326 PMCID: PMC4729108 DOI: 10.3978/j.issn.2224-4336.2014.03.05] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Chronic low back pain is one of the leading public health problems in developed countries. Degeneration of the intervertebral disc (IVD) is a major pathological process implicated in low back pain, which is characterized by cellular apoptosis and senescence with reduced synthesis of extracellular matrix (ECM). Currently, there is no clinical therapy targeting the reversal of disc degeneration. Recent advances in cellular and molecular biology have provided an exciting approach to disc regeneration that focuses on the delivery of viable cells to the degenerative disc. Adult mesenchymal stem cells (MSCs) are multipotent stem cells with self-renewal capacities and are able to differentiate into diverse specialized cell types, including chondrocyte lineages. The potential of stem cell therapy in disc degeneration is to repopulate the disc with viable cells capable of producing the ECM and restoring damaged tissue. The present literature review summarizes recent advances in basic research and clinical trials of MSCs to provide an outline of the key roles of MSCs therapies in disc repair. The review also discusses the controversies, challenges and therapeutic concepts for the future.
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Affiliation(s)
- Aiqun Wei
- 1 Department of Orthopaedic Research, Orthopaedic Research Institute, St George Hospital University of New South Wales, Sydney, Australia ; 2 Department of Cell & Molecular Therapies, Royal Prince Alfred Hospital, Sydney, Australia
| | - Bojiang Shen
- 1 Department of Orthopaedic Research, Orthopaedic Research Institute, St George Hospital University of New South Wales, Sydney, Australia ; 2 Department of Cell & Molecular Therapies, Royal Prince Alfred Hospital, Sydney, Australia
| | - Lisa Williams
- 1 Department of Orthopaedic Research, Orthopaedic Research Institute, St George Hospital University of New South Wales, Sydney, Australia ; 2 Department of Cell & Molecular Therapies, Royal Prince Alfred Hospital, Sydney, Australia
| | - Ashish Diwan
- 1 Department of Orthopaedic Research, Orthopaedic Research Institute, St George Hospital University of New South Wales, Sydney, Australia ; 2 Department of Cell & Molecular Therapies, Royal Prince Alfred Hospital, Sydney, Australia
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Wang HQ, Samartzis D. Clarifying the nomenclature of intervertebral disc degeneration and displacement: from bench to bedside. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:1293-1298. [PMID: 24817926 PMCID: PMC4014210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 03/10/2014] [Indexed: 06/03/2023]
Abstract
As a significant determinant of low back pain, intervertebral disc degeneration (IDD) has attracted more and more attention of both investigators and physicians. Disc herniation, termed as intervertebral disc displacement, is amongst the most prevalent spinal diseases closely linked with IDD. Due to the same origins and similar pathophysiology, the ambiguity regarding the similarity and difference of IDD and intervertebral disc displacement thus remains. The aim of this study was to clarify the nomenclature of IDD and disc herniation in terms of molecular etiology, pathophysiology, nature history and clinical outcomes. Collectively, IDD is a type of multifaceted, progressive spinal disease with or without clinical symptoms as back pain, characterized by extracellular matrix and the integrity of NP and AF lost, fissures formation. Disc herniation (termed as intervertebral disc displacement) is a type of spinal disease based on IDD or not, with local pain and/or sciatica due to mechanical compression and autoimmune cascades upon the corresponding nerve roots. Clarifying the nomenclature of intervertebral disc degeneration and displacement has important implications both for investigators and for physicians.
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Affiliation(s)
- Hai-Qiang Wang
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical UniversityXi’an, China
| | - Dino Samartzis
- Department of Orthopaedics and Traumatology, University of Hong KongPokfulam, Hong Kong, China
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Sun Z, Wan ZY, Guo YS, Wang HQ, Luo ZJ. FasL on human nucleus pulposus cells prevents angiogenesis in the disc by inducing Fas-mediated apoptosis of vascular endothelial cells. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2013; 6:2376-2385. [PMID: 24228099 PMCID: PMC3816806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 09/30/2013] [Indexed: 06/02/2023]
Abstract
The intervertebral disc is the largest avascular organ in the human body. However, with the progress of intervertebral disc degeneration (IDD), the disc tends to be vascularized increasingly via angiogenesis. It is well established that both human nucleus pulposus (NP) cells and vascular endothelial cells express FasL and Fas. However, the issue remains open as to whether there are certain active mechanisms preventing angiogenesis in the disc via the FasL-Fas machinery. Here, we established a co-culture system of human NP cells and vascular endothelial (HMEC-1) cells. We found that normal NP cells were more capable of inducing apoptosis in HMEC-1 cells (14.2±3.4%) than degenerate NP cells (6.7±1.9%), p<0.05. By up-regulating the FasL expression in degenerate NP cells, we found that FasL played an essential role in the mediation of HMEC-1 cell apoptosis with the activation of downstream FADD and caspase-3. Furthermore, we found an increased Fas expression in HMEC-1 cells following co-cultured with NP cells, which might be closely linked with FasL produced by NP cells and enhance their interaction. Collectively, this is the first study showing FasL-Fas network might plays an important role in the molecular mechanisms of angiogenesis avoidance of human disc. Consequently, our findings might shed light on the pathogenesis in human IDD and provide a novel target for the treatment strategies for IDD.
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Affiliation(s)
- Zhen Sun
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University Xi'an, China
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