Biomaterials and Cell-Based Regenerative Therapies for Intervertebral Disc Degeneration with a Focus on Biological and Biomechanical Functional Repair: Targeting Treatments for Disc Herniation

Overview

Journal Cells

Publisher MDPI

Specialties Biochemistry
Biophysics
Cell Biology
Molecular Biology

Date 2022 Feb 25

PMID 35203253

Authors

Katsuhisa Yamada

Norimasa Iwasaki

Hideki Sudo

Affiliations

Soon will be listed here.

Abstract

Intervertebral disc (IVD) degeneration is a common cause of low back pain and most spinal disorders. As IVD degeneration is a major obstacle to the healthy life of so many individuals, it is a major issue that needs to be overcome. Currently, there is no clinical treatment for the regeneration of degenerated IVDs. However, recent advances in regenerative medicine and tissue engineering suggest the potential of cell-based and/or biomaterial-based IVD regeneration therapies. These treatments may be indicated for patients with IVDs in the intermediate degenerative stage, a point where the number of viable cells decreases, and the structural integrity of the disc begins to collapse. However, there are many biological, biomechanical, and clinical challenges that must be overcome before the clinical application of these IVD regeneration therapies can be realized. This review summarizes the basic research and clinical trials literature on cell-based and biomaterial-based IVD regenerative therapies and outlines the important role of these strategies in regenerative treatment for IVD degenerative diseases, especially disc herniation.

Citing Articles

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Alginate vs. Hyaluronic Acid as Carriers for Nucleus Pulposus Cells: A Study on Regenerative Outcomes in Disc Degeneration.

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References

Bertram H, Kroeber M, Wang H, Unglaub F, Guehring T, Carstens C . Matrix-assisted cell transfer for intervertebral disc cell therapy. Biochem Biophys Res Commun. 2005; 331(4):1185-92. DOI: 10.1016/j.bbrc.2005.04.034. View

Sloan Jr S, Galesso D, Secchieri C, Berlin C, Hartl R, Bonassar L . Initial investigation of individual and combined annulus fibrosus and nucleus pulposus repair ex vivo. Acta Biomater. 2017; 59:192-199. DOI: 10.1016/j.actbio.2017.06.045. View

Cloyd J, Malhotra N, Weng L, Chen W, Mauck R, Elliott D . Material properties in unconfined compression of human nucleus pulposus, injectable hyaluronic acid-based hydrogels and tissue engineering scaffolds. Eur Spine J. 2007; 16(11):1892-8. PMC: 2223355. DOI: 10.1007/s00586-007-0443-6. View

Reitmaier S, Kreja L, Gruchenberg K, Kanter B, Silva-Correia J, Oliveira J . In vivo biofunctional evaluation of hydrogels for disc regeneration. Eur Spine J. 2013; 23(1):19-26. PMC: 3897837. DOI: 10.1007/s00586-013-2998-8. View

DiStefano T, Shmukler J, Danias G, Iatridis J . The Functional Role of Interface Tissue Engineering in Annulus Fibrosus Repair: Bridging Mechanisms of Hydrogel Integration with Regenerative Outcomes. ACS Biomater Sci Eng. 2020; 6(12):6556-6586. PMC: 7809646. DOI: 10.1021/acsbiomaterials.0c01320. View

Grunert P, Hudson K, Macielak M, Aronowitz E, Borde B, Alimi M . Assessment of intervertebral disc degeneration based on quantitative magnetic resonance imaging analysis: an in vivo study. Spine (Phila Pa 1976). 2014; 39(6):E369-78. PMC: 4486300. DOI: 10.1097/BRS.0000000000000194. View

Chou A, Akintoye S, Nicoll S . Photo-crosslinked alginate hydrogels support enhanced matrix accumulation by nucleus pulposus cells in vivo. Osteoarthritis Cartilage. 2009; 17(10):1377-84. PMC: 2753687. DOI: 10.1016/j.joca.2009.04.012. View

Meisel H, Ganey T, Hutton W, Libera J, Minkus Y, Alasevic O . Clinical experience in cell-based therapeutics: intervention and outcome. Eur Spine J. 2006; 15 Suppl 3:S397-405. PMC: 2335385. DOI: 10.1007/s00586-006-0169-x. View

Jeong J, Lee J, Jin E, Min J, Jeon S, Choi K . Regeneration of intervertebral discs in a rat disc degeneration model by implanted adipose-tissue-derived stromal cells. Acta Neurochir (Wien). 2010; 152(10):1771-7. DOI: 10.1007/s00701-010-0698-2. View

10.

Martin J, Milby A, Chiaro J, Kim D, Hebela N, Smith L . Translation of an engineered nanofibrous disc-like angle-ply structure for intervertebral disc replacement in a small animal model. Acta Biomater. 2014; 10(6):2473-81. PMC: 4412172. DOI: 10.1016/j.actbio.2014.02.024. View

11.

Leung V, Aladin D, Lv F, Tam V, Sun Y, Lau R . Mesenchymal stem cells reduce intervertebral disc fibrosis and facilitate repair. Stem Cells. 2014; 32(8):2164-77. DOI: 10.1002/stem.1717. View

12.

Amin R, Andrade N, Neuman B . Lumbar Disc Herniation. Curr Rev Musculoskelet Med. 2017; 10(4):507-516. PMC: 5685963. DOI: 10.1007/s12178-017-9441-4. View

13.

Bendtsen M, Bunger C, Zou X, Foldager C, Jorgensen H . Autologous stem cell therapy maintains vertebral blood flow and contrast diffusion through the endplate in experimental intervertebral disc degeneration. Spine (Phila Pa 1976). 2011; 36(6):E373-9. DOI: 10.1097/BRS.0b013e3181dce34c. View

14.

Schmitz T, Salzer E, Crispim J, Fabra G, LeVisage C, Pandit A . Characterization of biomaterials intended for use in the nucleus pulposus of degenerated intervertebral discs. Acta Biomater. 2020; 114:1-15. DOI: 10.1016/j.actbio.2020.08.001. View

15.

Vernengo J, Fussell G, Smith N, Lowman A . Evaluation of novel injectable hydrogels for nucleus pulposus replacement. J Biomed Mater Res B Appl Biomater. 2007; 84(1):64-9. DOI: 10.1002/jbm.b.30844. View

16.

Bron J, Koenderink G, Everts V, Smit T . Rheological characterization of the nucleus pulposus and dense collagen scaffolds intended for functional replacement. J Orthop Res. 2008; 27(5):620-6. DOI: 10.1002/jor.20789. View

17.

Lin C, Anseth K . PEG hydrogels for the controlled release of biomolecules in regenerative medicine. Pharm Res. 2008; 26(3):631-43. PMC: 5892412. DOI: 10.1007/s11095-008-9801-2. View

18.

Tsaryk R, Gloria A, Russo T, Anspach L, De Santis R, Ghanaati S . Collagen-low molecular weight hyaluronic acid semi-interpenetrating network loaded with gelatin microspheres for cell and growth factor delivery for nucleus pulposus regeneration. Acta Biomater. 2015; 20:10-21. DOI: 10.1016/j.actbio.2015.03.041. View

19.

Winzi M, Hyttel P, Kim Dale J, Serup P . Isolation and characterization of node/notochord-like cells from mouse embryonic stem cells. Stem Cells Dev. 2011; 20(11):1817-27. PMC: 3928718. DOI: 10.1089/scd.2011.0042. View

20.

Su W, Chen Y, Lin F . Injectable oxidized hyaluronic acid/adipic acid dihydrazide hydrogel for nucleus pulposus regeneration. Acta Biomater. 2010; 6(8):3044-55. DOI: 10.1016/j.actbio.2010.02.037. View