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MRI Phenotyping of COL9A2/Trp2 and COL9A3/Trp3 Alleles in Lumbar Disc Disease: A Case-control Study in South-Western Iranian Population Reveals a Significant Trp3-Disease Association in Males. Spine (Phila Pa 1976) 2016; 41:1661-1667. [PMID: 27798555 DOI: 10.1097/brs.0000000000001617] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A case-control study of the Trp2/3 alleles of COL9A2/3 genes and their correlation with occurrence of Lumbar disc disease (DDD) as phenotyped by magnetic resonance imaging. OBJECTIVE To establish a better understanding of relationship between presence of said alleles and occurrence of DDD in South-Western Iranian population. SUMMARY OF BACKGROUND DATA A number of genetic predisposing factors have been identified in elevating the risk of developing DDD. Specifically, the Trp2 and Trp3 alleles of COL9A2 and COL9A3 genes have been suggested as DDD risk variants. METHODS A total of 108 patients (mean age = 41±11.8 yrs, range = 20-66 yrs) with 57 controls (mean age = 35±10.0 yrs, range = 20-58 yrs) participated in the study. The frequency of G/A polymorphism in COL9A2 gene on location 326 on chromosome 1 and G/A/C/ or T polymorphism in 103 location of COL9A3 gene on chromosome 20 was assessed using a PCR short-primer technique. Outcome measure was defined as presence of DDD on MRI. Odds ratios (OR) and 95% confidence intervals (CI) were used to assess the likelihood of DDD given occurrence of Trp2(3). RESULTS Each allele was present in both patients and controls. The Trp2 allele was positive in 28.5% of individuals (31.5% of patients; 22.8% of controls), OR 1.55 (0.71-3.56). The Trp3 allele, the frequency was 23.6% in all patients (26.9% patients; 17.5% controls), OR 1.72 (0.73-4.33). We observed a 5.8-fold increase in the odds of DDD in males when the Trp3 allele was present, OR 5.83 (1.09-9.98), P = 0.0273. CONCLUSION Both Trp2 and Trp3 alleles occurred more frequently compared with other studied ethnicities. The sampled Iranian population exhibited a similar Trp2 frequency to a Southern Chinese population, and Trp3 occurrence to Finnish and Greek population. We found that male patient were much more likely to develop DDD when Trp 3 was present. LEVEL OF EVIDENCE N/A.
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AlGarni N, Grant MP, Epure LM, Salem O, Bokhari R, Antoniou J, Mwale F. Short Link N Stimulates Intervertebral Disc Repair in a Novel Long-Term Organ Culture Model that Includes the Bony Vertebrae. Tissue Eng Part A 2016; 22:1252-1257. [DOI: 10.1089/ten.tea.2016.0115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Nizar AlGarni
- Department of Surgery, McGill University, Montreal, Canada
- Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Michael P. Grant
- Department of Surgery, McGill University, Montreal, Canada
- Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Laura M. Epure
- Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Omar Salem
- Department of Surgery, McGill University, Montreal, Canada
- Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Rakan Bokhari
- Department of Surgery, McGill University, Montreal, Canada
- Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - John Antoniou
- Department of Surgery, McGill University, Montreal, Canada
- Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Fackson Mwale
- Department of Surgery, McGill University, Montreal, Canada
- Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
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Grant M, Epure LM, Salem O, AlGarni N, Ciobanu O, Alaqeel M, Antoniou J, Mwale F. Development of a Large Animal Long-Term Intervertebral Disc Organ Culture Model That Includes the Bony Vertebrae for Ex Vivo Studies. Tissue Eng Part C Methods 2016; 22:636-43. [PMID: 27216856 DOI: 10.1089/ten.tec.2016.0049] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Intervertebral disc (IVD) degeneration is a common cause of low back pain. Testing potential therapeutics in the regeneration of the disc requires the use of model systems. Although several animal models have been developed to investigate IVD degeneration, they are technically challenging to prepare, expensive, present with limitations when performing biomechanical studies on the disc, and are impractical in large-scale screening of novel anabolic and scaffolding agents. An IVD organ culture system offers an inexpensive alternative. In the current paradigm, the bony endplates are removed to allow for nutrient diffusion and maintenance of disc cell viability. Although this is an excellent system for testing biologics, it results in concave cartilage endplates and, as such, requires special platens for loading purposes in a bioreactor as flat ones can overload the annular disc region leading to improper loading. Furthermore, the absence of bone makes it unsuitable for applying complex cyclic loading, a topic of interest in the study of chronic progressive degeneration, as multiaxial loading is more representative of daily forces encountered by the IVD. We have developed and validated a novel long-term IVD organ culture model that retains vertebral bone and is easy to prepare. Our model is ideal for testing potential drugs and alternate-based therapies, in addition to investigating the long-term effects of loading paradigms on disc degeneration and repair.
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Affiliation(s)
- Michael Grant
- 1 Department of Surgery, McGill University , Montreal, Canada .,2 Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research , Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Laura M Epure
- 2 Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research , Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Omar Salem
- 1 Department of Surgery, McGill University , Montreal, Canada .,2 Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research , Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Nizar AlGarni
- 1 Department of Surgery, McGill University , Montreal, Canada .,2 Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research , Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Ovidiu Ciobanu
- 2 Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research , Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Motaz Alaqeel
- 1 Department of Surgery, McGill University , Montreal, Canada .,2 Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research , Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - John Antoniou
- 1 Department of Surgery, McGill University , Montreal, Canada .,2 Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research , Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
| | - Fackson Mwale
- 1 Department of Surgery, McGill University , Montreal, Canada .,2 Orthopaedic Research Laboratory, Lady Davis Institute for Medical Research , Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Canada
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Wang H, Zhou Y, Chu TW, Li CQ, Wang J, Zhang ZF, Huang B. Distinguishing characteristics of stem cells derived from different anatomical regions of human degenerated intervertebral discs. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 25:2691-704. [PMID: 26984881 DOI: 10.1007/s00586-016-4522-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/05/2016] [Accepted: 03/06/2016] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Several types of stem cells have been successfully demonstrated to exist in the human degenerated intervertebral disc (IVD), which is composed of annulus fibrosus (AF), nucleus pulposus (NP) and cartilage endplate (CEP). However, the differences in the biological characteristics among these and bone marrow derived mesenchymal stem cells (BM-MSCs) remain unclear. MATERIALS AND METHODS To investigate this issue, cells were harvested from human AF, NP, CEP, and bone marrow, respectively; passage 2 cells were selected using the agarose suspension culture system to obtain stem cell clones. Following expansion in vitro, stem cells from different anatomical regions were compared regarding the morphology, proliferation ability, immunophenotypic expression, and multi-lineage differentiation capacity. In addition, stem cell-alginate bead compositions were constructed for the comparison of DNA and sGAG content. RESULTS There were subtle differences regarding cell morphology, but no significant differences in proliferation ability among the four types of stem cells. For the immunophenotypic analysis, all stem cells basically fulfilled the criteria for mesenchymal stem cells (MSCs), which have been published by the International Society for Cellular Therapy (ISCT), with a significant difference in CD105 expression. A comparison of the osteogenic capacities indicated: cartilage endplate-derived stem cells (CESCs) > annulus fibrosus-derived stem cells (AFSCs) > BM-MSCs > nucleus pulposus-derived stem cells (NPSCs). The chondrogenesis difference was similar to osteogenesis. For adipogenesis: BM-MSCs >NPSCs >CESCs >AFSCs. In the stem cell/alginate composition, the CESCs consistently showed the superior chondrogenic potential among all those cell types. CONCLUSIONS Our data indicated that all the four types of stem cells shared some similar biological properties (regarding shape, proliferation ability and immunophenotypic expression). CESCs, which had the strongest osteogenic and chondrogenic potentials, may serve as excellent seed cells for NP/cartilage or bone tissue engineering.
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Affiliation(s)
- Hai Wang
- Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
- Department of Orthopaedics, Kunming General Hospital of Chengdu Military Command, Kunming, 650032, People's Republic of China
| | - Yue Zhou
- Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - Tong-Wei Chu
- Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - Chang-Qing Li
- Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - Jian Wang
- Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - Zheng-Feng Zhang
- Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China
| | - Bo Huang
- Department of Orthopaedics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, People's Republic of China.
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Nam DC, Kim BK, Lee HJ, Shin HD, Lee CJ, Hwang SC. Effects of prunetin on the proteolytic activity, secretion and gene expression of MMP-3 in vitro and production of MMP-3 in vivo. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2016; 20:221-8. [PMID: 26937219 PMCID: PMC4770113 DOI: 10.4196/kjpp.2016.20.2.221] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 01/28/2016] [Accepted: 02/04/2016] [Indexed: 12/22/2022]
Abstract
We investigated whether prunetin affects the proteolytic activity, secretion, and gene expression of matrix metalloproteinase-3 (MMP-3) in primary cultured rabbit articular chondrocytes, as well as in vivo production of MMP-3 in the rat knee joint to evaluate the potential chondroprotective eff ect of prunetin. Rabbit articular chondrocytes were cultured in a monolayer, and reverse transcription-polymerase chain reaction (RT-PCR) was used to measure interleukin-1β (IL-1β)-induced expression of MMP-3, MMP-1, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), and ADAMTS-5. In rabbit articular chondrocytes, the effects of prunetin on IL-1β-induced secretion and proteolytic activity of MMP-3 were investigated using western blot analysis and casein zymography, respectively. The eff ect of prunetin on MMP-3 protein production was also examined in vivo. The results were as follows: (1) prunetin inhibited the gene expression of MMP-3, MMP-1, MMP-13, ADAMTS-4, and ADAMTS-5; (2) prunetin inhibited the secretion and proteolytic activity of MMP-3; (3) prunetin suppressed the production of MMP-3 protein in vivo. These results suggest that prunetin can regulate the gene expression, secretion, and proteolytic activity of MMP-3, by directly acting on articular chondrocytes.
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Affiliation(s)
- Dae Cheol Nam
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 52727, Korea
| | - Bo Kun Kim
- Department of Orthopedic Surgery, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Hyun Jae Lee
- Department of Pharmacology, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Hyun-Dae Shin
- Department of Orthopedic Surgery, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Choong Jae Lee
- Department of Pharmacology, School of Medicine, Chungnam National University, Daejeon 35015, Korea
| | - Sun-Chul Hwang
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 52727, Korea
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Park JS, Kim DK, Shin HD, Lee HJ, Jo HS, Jeong JH, Choi YL, Lee CJ, Hwang SC. Apigenin Regulates Interleukin-1β-Induced Production of Matrix Metalloproteinase Both in the Knee Joint of Rat and in Primary Cultured Articular Chondrocytes. Biomol Ther (Seoul) 2016; 24:163-70. [PMID: 26902085 PMCID: PMC4774497 DOI: 10.4062/biomolther.2015.217] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 01/17/2016] [Accepted: 01/22/2016] [Indexed: 11/29/2022] Open
Abstract
We examined whether apigenin affects the gene expression, secretion and activity of matrix metalloproteinase-3 (MMP-3) in primary cultured rabbit articular chondrocytes, as well as in vivo production of MMP-3 in the knee joint of rat to evaluate the potential chondroprotective effects of apigenin. Rabbit articular chondrocytes were cultured in a monolayer, and reverse transcription - polymerase chain reaction (RT-PCR) was used to measure interleukin-1β (IL-1β)-induced expression of MMP-3, MMP-1, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), and ADAMTS-5. In rabbit articular chondrocytes, the effects of apigenin on IL-1β-induced secretion and proteolytic activity of MMP-3 were investigated using western blot analysis and casein zymography, respectively. The effect of apigenin on MMP-3 protein production was also examined in vivo. In rabbit articular chondrocytes, apigenin inhibited the gene expression of MMP-3, MMP-1, MMP-13, ADAMTS-4, and ADAMTS-5. Furthermore, apigenin inhibited the secretion and proteolytic activity of MMP-3 in vitro, and inhibited production of MMP-3 protein in vivo. These results suggest that apigenin can regulate the gene expression, secretion, and activity of MMP-3, by directly acting on articular chondrocytes.
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Affiliation(s)
- Jin Sung Park
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Dong Kyu Kim
- Department of Orthopedic Surgery, School of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Hyun-Dae Shin
- Department of Orthopedic Surgery, School of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Hyun Jae Lee
- Department of Pharmacology, School of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Ho Seung Jo
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Jin Hoon Jeong
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Young Lac Choi
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Choong Jae Lee
- Department of Pharmacology, School of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Sun-Chul Hwang
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 52727, Republic of Korea
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Rigal J, Thelen T, Byrne F, Cogniet A, Boissière L, Aunoble S, Le Huec JC. Prospective study using anterior approach did not show association between Modic 1 changes and low grade infection in lumbar spine. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 25:1000-5. [PMID: 26818032 DOI: 10.1007/s00586-016-4396-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 01/11/2016] [Accepted: 01/15/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The modern literature is producing a rapidly growing number of articles which highlight the relationship between infection and lumbar disc degeneration. However, the means by which samples are collected is questionable. Posterior approach surgery is not free from skin contamination. The possibility of intraoperative contamination of disc biopsies cannot be excluded. OBJECTIVE The objective of this study was to determine if an association existed between lumbar disc degeneration and chronic infection of the intervertebral disc. MATERIALS AND METHODS 313 patients (186/127, F/M) with chronic low back pain secondary to degenerative disc disease which was resistant to medical treatment were included in a single-centre prospective study. All underwent a lumbar anterior video-assisted minimally invasive fusion or disc prosthesis in L4-L5 and/or L5-S1 via an anterior retroperitoneal approach. The patients MRI scans demonstrated in Pfirrmann's classification grade IV or V disc degeneration; 385 disc drives were taken. In terms of Modic changes, 303 Modic 1, 58 Modic II and 24 absence of Modic change, respectively. All underwent intraoperative biopsy, performed according to a strict aseptic protocol. The biopsies were then cultured for 4 weeks with specialised enrichment cultures and subjected to histopathological analysis. RESULTS The mean age was 47 ± 8.6 years sterile cultures were obtained in 379 samples (98.4%) and 6 were positive (1.6%). The cultured bacteria were: Propionibacterium acnes (n:2), Staphylococcus epidermidis (n:2), Citrobacter freundii (n:1), and Saccharopolyspora hirsuta (n:1). Histopathological analysis did not demonstrate any evidence of a neutrophilia. There were no delayed or secondary infections. DISCUSSION AND CONCLUSION Unlike the posterior approach where contamination is common, the anterior video-assisted approach allows a biopsy without skin contact. This approach to the spine is the most effective way to eliminate the risk of contamination. Our results confirm the absence of any relationship between infection and disc degeneration. We suggest that the 6 positive samples in our study may be related to contamination. The absence of infection at 1-year followup is an additional argument in favour of our results. In conclusion, our study shows no association between infection and disc degeneration. The pathophysiology of disc degeneration is complex, but the current literature opens new perspectives.
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Affiliation(s)
- Julien Rigal
- Orthorachis 2, Orthopaedic Department, University of Bordeaux, Talence, France
| | - Thomas Thelen
- Orthorachis 2, Orthopaedic Department, University of Bordeaux, Talence, France
| | - Fergus Byrne
- Orthorachis 2, Orthopaedic Department, University of Bordeaux, Talence, France
| | - Arnaud Cogniet
- Orthorachis 2, Orthopaedic Department, University of Bordeaux, Talence, France
| | - Louis Boissière
- Orthorachis 2, Orthopaedic Department, University of Bordeaux, Talence, France
| | - Stephane Aunoble
- Orthorachis 2, Orthopaedic Department, University of Bordeaux, Talence, France
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Majeed SA, Seshadrinath NAK, Binoy KR, Raji L. Lumbar disc herniation: Is there an association between histological and magnetic resonance imaging findings? Indian J Orthop 2016; 50:234-42. [PMID: 27293282 PMCID: PMC4885290 DOI: 10.4103/0019-5413.181794] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although validated radiological scoring systems and histological scoring system of surgically removed degenerated disc are used in assessment of progression of intervertebral disc degeneration, there have not been many studies that integrate these two aspects of assessments. The data available in this respect are very limited. This clinical study was designed to find the correlation between quantitative radiological score (Pfirmann grading system and Modic changes [MC]) and quantitative histological degeneration score (HDS). MATERIALS AND METHODS A cohort of 77 patients (45 males, 32 females; mean age of 38 years [range 18-58 years]) who presented with complaints of discogenic pain or radiculopathy at single level were assessed radiologically. They were graded according to the radiological pattern. The surgically excised disc specimen was graded according to HDS. The degree of radiological changes were correlated with the degree of histological changes. RESULTS Though the overall HDS (0-15) did not show statistically significant correlation with Pfirmann grading system, there were positive association found between mucoid degeneration, chondrocyte proliferation with the Pfirmann grading and mucoid degeneration, which were statistically significant. Female sex also had a higher association with instability pattern. CONCLUSION The study shows that the Pfirmann grading system, MCs and HDS can reliably be used as scoring systems for assessing lumbar disc degeneration. The radiological assessment can be used as a noninvasive tool to assess the probable change in content rather than the microstructure of a disc undergoing degeneration.
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Affiliation(s)
- Shiju A Majeed
- Department of Orthopedics and Spine Surgery, Government Medical College, Thiruvananthapuram, Kerala, India, INdia,Address for correspondence: Dr. Shiju A Majeed, Department of Orthopedics and Spine Surgery, Government Medical College, Thiruvananthapuram - 695 011, Kerala, India. E-mail:
| | - N Arun Kumar Seshadrinath
- Department of Orthopedics and Spine Surgery, Government Medical College, Thiruvananthapuram, Kerala, India, INdia
| | - Kavitha Ravi Binoy
- Department of Pathology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Laila Raji
- Department of Pathology, Government Medical College, Thiruvananthapuram, Kerala, India
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Sainoh T, Orita S, Miyagi M, Sakuma Y, Yamauchi K, Suzuki M, Kubota G, Oikawa Y, Inage K, Sato J, Fujimoto K, Shiga Y, Inoue G, Aoki Y, Takahashi K, Ohtori S. Interleukin-6 and interleukin-6 receptor expression, localization, and involvement in pain-sensing neuron activation in a mouse intervertebral disc injury model. J Orthop Res 2015; 33:1508-14. [PMID: 26010074 DOI: 10.1002/jor.22925] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 04/02/2015] [Indexed: 02/04/2023]
Abstract
The pathological mechanism of intractable low back pain is unclear. However, intervertebral disc (IVD) degeneration is a primary cause of low back pain, and pain-related mediators, such as interleukin-6 (IL-6), have been correlated with discogenic pain. The objective of this study is to elucidate the mechanism of local IL-6 and IL-6 receptor (IL-6R) expression after IVD injury as well as determine the involvement of IL-6/IL-6 signaling in discogenic pain. To do this, quantitative and immunohistological analyses in a mouse model of IVD injury were performed. Firstly, we measured the local expression levels of IL-6 and IL-6R in IVDs by enzyme-linked immunosorbent assay (ELISA). Secondly, we immunohistochemically confirmed their localization in injured IVDs. Lastly, we evaluated the effects of intradiscal injection of an IL-6 inhibitor by evaluating pain-related protein, calcitonin gene-related peptide (CGRP), expression in dorsal root ganglia (DRG) neurons that innervate IVDs. Injured IVDs showed increased production of IL-6 and IL-6R. IL-6 and IL-6R expression in the injured IVD were predominantly localized in the annulus fibrosus and endplate, and intradiscal injection of the IL-6 inhibitor suppressed CGRP expression in the DRG neurons. These results show that IL-6 and IL-6R expression levels are responsive to IVD injury and that inhibition of IL-6/IL-6R signaling may be a promising analgesic treatment for degenerative disc diseases.
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Affiliation(s)
- Takeshi Sainoh
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Sumihisa Orita
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masayuki Miyagi
- Department of Orthopaedic Surgery, Kitasato University, Kanagawa, Japan
| | - Yoshihiro Sakuma
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuyo Yamauchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Miyako Suzuki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Go Kubota
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuhiro Oikawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuhide Inage
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Jun Sato
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kazuki Fujimoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuhiro Shiga
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Gen Inoue
- Department of Orthopaedic Surgery, Kitasato University, Kanagawa, Japan
| | - Yasuchika Aoki
- Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Chiba, Japan
| | - Kazuhisa Takahashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Sokai A, Handa T, Tanizawa K, Oga T, Uno K, Tsuruyama T, Kubo T, Ikezoe K, Nakatsuka Y, Tanimura K, Muro S, Hirai T, Nagai S, Chin K, Mishima M. Matrix metalloproteinase-10: a novel biomarker for idiopathic pulmonary fibrosis. Respir Res 2015; 16:120. [PMID: 26415518 PMCID: PMC4587921 DOI: 10.1186/s12931-015-0280-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/20/2015] [Indexed: 02/10/2023] Open
Abstract
Background Matrix metalloproteinases (MMPs) are believed to be involved in the pathogenesis of idiopathic pulmonary fibrosis (IPF), and MMP-7 has been described as a useful biomarker for IPF. However, little is known regarding the significance of MMP-10 as a biomarker for IPF. Methods This observational cohort study included 57 patients with IPF. Serum MMPs were comprehensively measured in all patients, and the relationships between these markers and both disease severity and prognosis were evaluated. Bronchoalveolar lavage fluid (BALF) MMP-7 and -10 levels were measured in 19 patients to investigate the correlation between these markers and their corresponding serum values. Immunohistochemical staining for MMP-10 was also performed in IPF lung tissue. Results Serum MMP-7 and -10 levels correlated significantly with both the percentage of predicted forced vital capacity (ρ = −0.31, p = 0.02 and ρ = −0.34, p < 0.01, respectively) and the percentage of predicted diffusing capacity of the lung for carbon monoxide (ρ = −0.32, p = 0.02 and ρ = −0.43, p < 0.01, respectively). BALF MMP-7 and -10 levels correlated with their corresponding serum concentrations. Only serum MMP-10 predicted clinical deterioration within 6 months and overall survival. In IPF lungs, the expression of MMP-10 was enhanced and localized to the alveolar epithelial cells, macrophages, and peripheral bronchiolar epithelial cells. Conclusions MMP-10 may be a novel biomarker reflecting both disease severity and prognosis in patients with IPF. Electronic supplementary material The online version of this article (doi:10.1186/s12931-015-0280-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Akihiko Sokai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Tomohiro Handa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Kiminobu Tanizawa
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Toru Oga
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Kazuko Uno
- Louis Pasteur Center for Medical Research, Kyoto, Japan.
| | - Tatsuaki Tsuruyama
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Takeshi Kubo
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Kohei Ikezoe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Yoshinari Nakatsuka
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Kazuya Tanimura
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Shigeo Muro
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Sonoko Nagai
- Kyoto Central Clinic/Clinical Research Center, Sakyo-ku, Kyoto, Japan.
| | - Kazuo Chin
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Michiaki Mishima
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
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Park JS, Lee HJ, Lee DY, Jo HS, Jeong JH, Kim DH, Nam DC, Lee CJ, Hwang SC. Chondroprotective Effects of Wogonin in Experimental Models of Osteoarthritis in vitro and in vivo. Biomol Ther (Seoul) 2015; 23:442-8. [PMID: 26336584 PMCID: PMC4556204 DOI: 10.4062/biomolther.2015.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 05/26/2015] [Accepted: 06/09/2015] [Indexed: 01/01/2023] Open
Abstract
We evaluated the chondroprotective effects of wogonin by investigating its effects on the gene expression and production of matrix metalloproteinase-3 (MMP-3) in primary cultured rabbit articular chondrocytes, as well as on production of MMP-3 in the rat knee. Rabbit articular chondrocytes were cultured in a monolayer, and RT-PCR was used to measure interleukin-1β (IL-1β)-induced expression of MMP-3, MMP-1, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), and type II collagen. In rabbit articular chondrocytes, the effects of wogonin on IL-1β-induced production and proteolytic activity of MMP-3 were investigated using western blot analysis and casein zymography, respectively. The effect of wogonin on MMP-3 protein production was also examined in vivo. In rabbit articular chondrocytes, wogonin inhibited the expression of MMP-3, MMP-1, MMP-13, and ADAMTS-4, but increased expression of type II collagen. Furthermore, wogonin inhibited the production and proteolytic activity of MMP-3 in vitro, and inhibited production of MMP-3 protein in vivo. These results suggest that wogonin can regulate the gene expression and production of MMP-3, by directly acting on articular chondrocytes.
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Affiliation(s)
- Jin Sung Park
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 660-701, Republic of Korea
| | - Hyun Jae Lee
- Department of Pharmacology, School of Medicine, Chungnam National University, Daejeon 301-131, Republic of Korea
| | - Dong Yeong Lee
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 660-701, Republic of Korea
| | - Ho Seung Jo
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 660-701, Republic of Korea
| | - Jin Hoon Jeong
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 660-701, Republic of Korea
| | - Dong Hee Kim
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 660-701, Republic of Korea
| | - Dae Cheol Nam
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 660-701, Republic of Korea
| | - Choong Jae Lee
- Department of Pharmacology, School of Medicine, Chungnam National University, Daejeon 301-131, Republic of Korea
| | - Sun-Chul Hwang
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 660-701, Republic of Korea
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Abdel-Hakiem M, Yamashita A, Atiba A, Okamura Y, Katayama M, Youssef H, Isomura H, Uzuka Y. Expression of NG2 proteoglycan in the degenerated intervertebral disc in dachshunds. J Vet Med Sci 2015; 78:97-100. [PMID: 26300439 PMCID: PMC4751123 DOI: 10.1292/jvms.14-0233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The pathogenesis of intervertebral disc (IVD) degeneration is not fully understood. The
biomolecular signaling pathways involved in the IVD degeneration require further
investigation. The aim of this study was to investigate the expression of NG2 proteoglycan
in the degenerated IVD. IVD samples were obtained from 16 Dachshunds that were confirmed
to have IVD herniation and subsequently underwent hemilaminectomy. The samples were
subjected to histological and immunohistochemical (IHC) examinations. IHC revealed
positive results for the expression of NG2 proteoglycan in all examined samples. The
results showed the expression of NG2 proteoglycan by the degenerated IVDs.
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Affiliation(s)
- Mohammed Abdel-Hakiem
- Division of Veterinary Diagnostic Imaging, Cooperative Department of Veterinary Medicine, Faculty of Agriculture, Iwate University, Morioka 020-8550, Japan
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Zhang J, Sun X, Liu J, Liu J, Shen B, Nie L. The role of matrix metalloproteinase 14 polymorphisms in susceptibility to intervertebral disc degeneration in the Chinese Han population. Arch Med Sci 2015; 11:801-6. [PMID: 26322093 PMCID: PMC4548033 DOI: 10.5114/aoms.2015.53301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/03/2013] [Accepted: 08/18/2013] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Matrix metalloproteinase 14 (MMP14) plays an important role in the pathophysiology of intervertebral disc degeneration (IVDD). The present study aimed to determine whether two single nucleotide polymorphisms (-378 T/C and -364 G/T) of MMP14 were associated with the risk and severity of IVDD in the Chinese Han population. MATERIAL AND METHODS A total of 908 patients with IVDD and 906 healthy controls were enrolled in this study. The grade of disc degeneration was determined according to Schneiderman's classification for magnetic resonance imaging. The polymorphisms of MMP14 were genotyped using polymerase chain reaction and direct sequencing. RESULTS The genotype distribution of -364G/T did not show a significant difference between IVDD patients and healthy controls. The frequencies of the -378T/C and CC genotypes were significantly lower among IVDD patients compared with healthy controls (p < 0.001); unconditional logistic regression analysis revealed that the CT and CC genotypes were significantly associated with a decreased risk of IVDD compared with the TT genotype (p < 0.001). Patients with IVDD showed significantly higher frequencies of the T allele at -378T/C than healthy controls (p < 0.001). In addition, the -375 CC genotype, as well as the C allele, was associated with lower degenerative grades of IVDD compared with the TT genotype and the T allele, respectively (both p < 0.001). CONCLUSIONS The -378T/C polymorphism of MMP14 may be associated with the risk and severity of IVDD in the Chinese Han population. It shows potential to become a biomarker to predict risk and severity of IVDD.
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Affiliation(s)
- Jianfeng Zhang
- Department of Orthopedics, Qilu Hospital of Shandong University, JiNan City, Shandong Province, China
- Department of Spine Surgery, Yantaishan Hospital, YanTai City, Shandong Province, China
| | - Xiujiang Sun
- Department of Bone and Joint, Yantaishan Hospital, YanTai City, Shandong Province, China
| | - Jing Liu
- Department of Basic Research, Occupation College of Yantai, YanTai City, Shandong Province, China
| | - Jianqing Liu
- Department of Spine Surgery, Yantaishan Hospital, YanTai City, Shandong Province, China
| | - Binghua Shen
- Department of Bone and Joint, Yantaishan Hospital, YanTai City, Shandong Province, China
| | - Lin Nie
- Department of Orthopedics, Qilu Hospital of Shandong University, JiNan City, Shandong Province, China
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Dagistan Y, Cukur S, Dagistan E, Gezici AR. Importance of IL-6, MMP-1, IGF-1, and BAX Levels in Lumbar Herniated Disks and Posterior Longitudinal Ligament in Patients with Sciatic Pain. World Neurosurg 2015. [PMID: 26211852 DOI: 10.1016/j.wneu.2015.07.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of this study was to evaluate prognostic importance of interleukin-6 (IL-6), matrix metalloproteinase (MMP)-1, insulin-like growth factor (IGF)-1, and Bcl-2-associated X protein (BAX) levels in biopsy specimens taken from the intervertebral disk specimens and the posterior longitudinal ligaments of patients with sciatic pain. METHODS The specimens of the intervertebral disk and the posterior longitudinal ligament were obtained from 52 patients undergoing herniectomy and diskectomy at the Neurosurgery Department of the Abant Izzet Baysal University Izzet Baysal Training and Research Hospital between April 2012 and February 2014. The immunohistochemical expressions of IL-6, MMP-1, IGF-1, and BAX were evaluated in three categories: mild, moderate, and intense. RESULTS The IL-6 expression in the intervertebral disk specimens was intense in the sequestration group when compared with that of the "protrusion" and "extrusion" groups. The intervertebral disk specimens in "extrusion" and "sequestration" groups were stained intensely for MMP-1. The IGF-1 expression was stained intensely in the intervertebral disk tissue of the extrude group patients. For the "extrusion" and "sequestration" groups, the intervertebral disk specimens were stained intensely for BAX compared with the protrude group. The IL-6 expression in the posterior longitudinal ligament specimens was more intense in the "sequestration" and "extrusion" groups when compared with that of the protrude group. The MMP-1 expressions were milder in the sequestration group when compared with that of the "extrusion" and "protrusion" groups. CONCLUSIONS Our findings suggest that the cytokines, enzymes, growth factors, and proapoptotic proteins, such as IL-6, MMP-1, IGF-1, and BAX, may be critical factors in the pathophysiology of the degeneration of the intervertebral disks in patients with symptomatic degenerative disk disease.
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Affiliation(s)
- Yasar Dagistan
- Department of Neurosurgery, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey.
| | - Selma Cukur
- Department of Pathology, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey
| | - Emine Dagistan
- Department of Radiology, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey
| | - Ali Riza Gezici
- Department of Neurosurgery, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey
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Chen MH, Sun JS, Liao SY, Tai PA, Li TC, Chen MH. Low-intensity pulsed ultrasound stimulates matrix metabolism of human annulus fibrosus cells mediated by transforming growth factor β1 and extracellular signal-regulated kinase pathway. Connect Tissue Res 2015; 56:219-27. [PMID: 25658041 DOI: 10.3109/03008207.2015.1016609] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE There are limited strategies to restore the damaged annulus fibrosus (AF) of the intervertebral disc. Low-intensity pulsed ultrasound (LIPUS) has positive effects on the proliferation of several types of cells and the repair of damage tissue in vivo. However, scientific evidence of therapeutic effects of LIPUS on AF cells remains limited. The purpose of this study is to evaluate the feasibility of applying LIPUS to the repair of the AF. MATERIALS AND METHODS We used an in vitro model of human AF cells subjected to LIPUS stimulation to examine its effects on cell proliferation and matrix metabolism. Cell viability, synthesis of collagen and glycosaminoglycan (GAG), expression of matrix metalloproteinases (MMPs) and transforming growth factor β1 and pathways involving mitogen-activated protein kinases (MAPKs) were investigated. RESULTS LIPUS significantly enhanced proliferation of AF cells after 5 days of treatment. LIPUS with an intensity of 0.5 W/cm(2) increased the collagen and GAG synthesis and decreased the expressions of MMP-1 and -3 of human AF cells. Real-time polymerase chain reactions and western blotting analysis revealed that LIPUS could increase transforming growth factor β1 (TGF-β1) and activate extracellular signal-regulated kinase (ERK) pathway. In addition, TGF-β receptor kinase inhibitor could suppress the ultrasound-induced alterations in cell viability and matrix metabolism. CONCLUSIONS The findings suggested that LIPUS could be useful as a physical stimulation of cell metabolism for the repair of the AF.
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Affiliation(s)
- Mei-Hsiu Chen
- Department of Internal Medicine, Far Eastern Memorial Hospital , Taipei , Taiwan
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Pathomechanisms of discogenic low back pain in humans and animal models. Spine J 2015; 15:1347-55. [PMID: 24657737 DOI: 10.1016/j.spinee.2013.07.490] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 02/10/2013] [Accepted: 07/25/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Although explored in humans and animal models, the pathomechanisms of discogenic low back pain (LBP) remain unknown. PURPOSE The aim of this study was to review the literature about the pathomechanisms of discogenic LBP. METHODS Animal models of discogenic pain and specimens from degenerated human intervertebral discs (IVDs) have provided clues about the pathomechanisms of discogenic LBP. Painful discs are characterized by a confluence of innervation, inflammation, and mechanical hypermobility. These three possible mechanisms are discussed in this review. RESULTS Animal models and specimens from humans have revealed sensory innervation of lumbar IVDs and sensory nerve ingrowth into the inner layer of IVDs. Cytokines such as tumor necrosis factor-α and interleukins induce this ingrowth. Nerve growth factor has also been recently identified as an inducer of ingrowth. Finally, disc degeneration induces several collagenases; their action results in hypermobility and pain. CONCLUSIONS To treat discogenic LBP, it is important to prevent sensitization of sensory nerve fibers innervating the IVD, to suppress pathogenic increases of cytokines, and to decrease disc hypermobility.
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Blanquer SBG, Grijpma DW, Poot AA. Delivery systems for the treatment of degenerated intervertebral discs. Adv Drug Deliv Rev 2015; 84:172-87. [PMID: 25451138 DOI: 10.1016/j.addr.2014.10.024] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 08/29/2014] [Accepted: 10/20/2014] [Indexed: 12/25/2022]
Abstract
The intervertebral disc (IVD) is the most avascular and acellular tissue in the body and therefore prone to degeneration. During IVD degeneration, the balance between anabolic and catabolic processes in the disc is deregulated, amongst others leading to alteration of extracellular matrix production, abnormal enzyme activities and production of pro-inflammatory substances like cytokines. The established treatment strategy for IVD degeneration consists of physiotherapy, pain medication by drug therapy and if necessary surgery. This approach, however, has shown limited success. Alternative strategies to increase and prolong the effects of bioactive agents and to reverse the process of IVD degeneration include the use of delivery systems for drugs, proteins, cells and genes. In view of the specific anatomy and physiology of the IVD and depending on the strategy of the therapy, different delivery systems have been developed which are reviewed in this article.
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Affiliation(s)
- S B G Blanquer
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
| | - D W Grijpma
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland; University of Groningen, University Medical Center Groningen, W.J. Kolff Institute, Department of Biomedical Engineering, P.O. Box 196, 9700 AD Groningen, The Netherlands.
| | - A A Poot
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; Collaborative Research Partner Annulus Fibrosus Rupture Program of AO Foundation, Davos, Switzerland
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Pacholczyk-Sienicka B, Radek M, Radek A, Jankowski S. Characterization of metabolites determined by means of 1H HR MAS NMR in intervertebral disc degeneration. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2014; 28:173-83. [PMID: 25108703 PMCID: PMC4385564 DOI: 10.1007/s10334-014-0457-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 07/18/2014] [Accepted: 07/22/2014] [Indexed: 12/02/2022]
Abstract
Object The objective of this study is the identification of metabolites by means of 1H high resolution magic angle spinning nuclear magnetic resonance (1H HR MAS NMR) spectroscopy and the evaluation of their applicability in distinguishing between healthy and degenerated disc tissues.
Materials and methods Differences between the metabolic profiles of healthy and degenerated disc tissues were studied by means of 1H HR MAS NMR. Analysis was performed for 81 disc tissue samples (control samples n = 21, degenerated disc tissue samples n = 60). Twenty six metabolites (amino acids, carbohydrates, and alcohols) were identified and quantified. Results The results indicate that the metabolic profile of degenerated discs is characterized by the presence of 2-propanol and the absence of scyllo-inositol and taurine. The concentrations of 2-propanol and lactate increase with age. Conclusion PCA analysis of ex vivo 1H HR MAS NMR data revealed the occurrence of two groups: healthy and degenerative disc tissues. The effects of insufficient nutrient supply of discs, leading to their degeneration and back pain, are discussed. Electronic supplementary material The online version of this article (doi:10.1007/s10334-014-0457-0) contains supplementary material, which is available to authorized users.
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Chen MH, Hu CK, Chen PR, Chen YS, Sun JS, Chen MH. Dose-dependent regulation of cell proliferation and collagen degradation by estradiol on ligamentum flavum. BMC Musculoskelet Disord 2014; 15:238. [PMID: 25022571 PMCID: PMC4108226 DOI: 10.1186/1471-2474-15-238] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 07/09/2014] [Indexed: 01/15/2023] Open
Abstract
Background Estradiol plays an important role in the regulation of collagen metabolism. Deficiency of estradiol has been reported to be associated with the degeneration of many connective tissues. However, the association of estradiol and hypertrophy of the ligamentum flavum was seldom explored. Therefore, we studied the effects of estradiol on cultured cells from the ligamentum flavum. Methods Primary cultures of human ligamentum flavum cells obtained from surgical specimens of 14 patients undergoing spinal surgery were used to investigate the effect of estradiol on cell proliferation and the expression of collagen, elastin, and matrix metalloproteinases. Downstream pathways of estrogen receptor underlying the regulation of metalloproteinases were also investigated. Results In our study, we revealed the existence of estrogen receptors on both female and male ligamentum flavum cells with a gender difference. 17β-estradiol increased early (24 hours) proliferation of ligamentum flavum cells in a dose dependent manner and the effect could not be seen when the cell density increased. Estradiol with a concentration of 10-9 M decreased collagen levels and increased the expression of MMP-13. Adding an antagonist of PI3K downstream pathway could reverse the expression of MMP-13 caused by estradiol. Conclusions The results implied estradiol regulated the expression of MMP-13 via PI3K pathway and contributed to the homeostasis of extracellular matrix in the ligamentum flavum.
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Affiliation(s)
| | | | | | | | | | - Ming-Hong Chen
- Department of Biomedical Engineering, Ming Chuan University, Taoyuan, Taiwan.
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Kang BJ, Ryu J, Lee CJ, Hwang SC. Luteolin Inhibits the Activity, Secretion and Gene Expression of MMP-3 in Cultured Articular Chondrocytes and Production of MMP-3 in the Rat Knee. Biomol Ther (Seoul) 2014; 22:239-45. [PMID: 25009705 PMCID: PMC4060084 DOI: 10.4062/biomolther.2014.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 04/01/2014] [Accepted: 04/09/2014] [Indexed: 12/22/2022] Open
Abstract
We investigated whether luteolin affects the gene expression, secretion and activity of matrix metalloproteinase-3 (MMP-3) in primary cultured rabbit articular chondrocytes, as well as production of MMP-3 in the rat knee to evaluate the potential chondro-protective effects of luteolin. Rabbit articular chondrocytes were cultured in a monolayer and IL-1β-induced gene expression levels of MMP-3, MMP-1, MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4), ADAMTS-5 and type II collagen were measured by reverse transcription - polymerase chain reaction (RT-PCR). Effects of luteolin on interleukin-1β (IL-1β)-induced secretion and enzyme activity of MMP-3 in rabbit articular chondrocytes were investigated by western blot analysis and casein zymography, respectively. The effect of luteolin on MMP-3 protein production was also examined in vivo. The results were as follows: (1) luteolin inhibited the gene expression levels of MMP-3, MMP-1, MMP-13, ADAMTS-4 and ADAMTS-5. However, it increased the gene expression level of collagen in rabbit articular chondrocytes; (2) luteolin inhibited the secretion and activity of MMP-3; (3) luteolin inhibited in vivo production of MMP-3 protein. These results suggest that luteolin can regulate the gene expression, secretion and activity of MMP-3, by directly acting on articular chondrocytes.
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Affiliation(s)
- Bun-Jung Kang
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 660-702
| | - Jiho Ryu
- Department of Pharmacology, School of Medicine, Chungnam National University, Daejeon 301-740, Republic of Korea
| | - Choong Jae Lee
- Department of Pharmacology, School of Medicine, Chungnam National University, Daejeon 301-740, Republic of Korea
| | - Sun-Chul Hwang
- Department of Orthopedic Surgery and Institute of Health Sciences, School of Medicine and Hospital, Gyeongsang National University, Jinju 660-702
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Mwale F, Wang HT, Roughley P, Antoniou J, Haglund L. Link N and mesenchymal stem cells can induce regeneration of the early degenerate intervertebral disc. Tissue Eng Part A 2014; 20:2942-9. [PMID: 24786145 DOI: 10.1089/ten.tea.2013.0749] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Link N is a naturally occurring peptide that can stimulate proteoglycan synthesis in intervertebral disc (IVD) cells. IVD repair can also potentially be enhanced by mesenchymal stem cell (MSC) supplementation to maximize extracellular matrix (ECM) production. In a previous study, we have shown that Link N can inhibit osteogenesis and increase the chondrogenesis of MSCs in vitro. The aim of the present study was to determine the potential of MSCs and Link N alone or in combination with regard to tissue repair in the degenerate disc. Bovine IVDs with trypsin-induced degeneration were treated with MSCs, Link N, or a combination of MSCs and Link N. Trypsin-treated discs were also injected with phosphate-buffered saline to serve as a degeneration control. The ECM proteins and proteoglycans were extracted from the inner nucleus pulposus (NP) of the discs, and sulfated glycosaminoglycans (GAGs) were analyzed by the dimethyl methylene blue dye-binding assay. The expression of type II collagen was analyzed by western blot. To track the MSCs after injection, MSCs were labeled with PKH67 and observed under confocal microscopy after the 2 week culture period. The GAG content significantly increased compared with the degeneration control when degenerate discs were treated with MSCs, Link N, or a combination of both Link N and MSCs. Histological analysis revealed that the newly synthesized proteoglycan was able to diffuse throughout the ECM and restore tissue content even in areas remote from the cells. The quantity of extractable type II collagen was also increased when the degenerate discs were treated with MSCs and Link N, either alone or together. MSCs survived, integrated in the tissue, and were found distributed throughout the NP after the 2 week culture period. MSCs and Link N can restore GAG content in degenerate discs, when administered separately or together. Treatment with MSCs and Link N can also increase the expression of type II collagen. The results support the concept that biological repair of disc degeneration is feasible, and that the administration of either MSCs or Link N has therapeutic potential in early stages of the disease.
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Affiliation(s)
- Fackson Mwale
- 1 Division of Orthopaedic Surgery, McGill University , Montreal, Canada
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The effect of electroacupuncture on the extracellular matrix synthesis and degradation in a rabbit model of disc degeneration. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:731395. [PMID: 24987434 PMCID: PMC4058458 DOI: 10.1155/2014/731395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/24/2014] [Accepted: 05/06/2014] [Indexed: 01/07/2023]
Abstract
The present study was aimed at determining if the electroacupuncture (EA) is able to protect degenerated disc in vivo. New Zealand white rabbits (n = 40) were used for the study. The rabbits were randomly assigned to four groups. EA intervention was applied to one of the four groups. Magnetic resonance imaging and Pfirrmann's classification were obtained for each group to evaluate EA treatment on the intervertebral disc degeneration. Discs were analyzed using immunofluorescence for the labeling of collagens 1 and 2, bone morphogenetic protein-2 (BMP-2), matrix metalloproteinase-13 (MMP-13), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1). For protein expression analysis, western blot was used for biglycan and decorin. Outcomes indicated that EA intervention decreased the grades compared with the compressed disc. Immunofluorescence analysis showed a significant increase of collagens 1 and 2, TIMP-1, and BMP-2 positive cells, in contrast to MMP-13 after EA treatment for 28 days. The protein expression showed a sign of regeneration that decorin and biglycan were upregulated. It was concluded that EA contributed to the extracellular matrix (ECM) anabolic processes and increased the ECM components. MMPs and their inhibitors involved in the mechanism of EA intervention on ECM decreased disc. It kept a dynamic balance between ECM synthesis and degradation.
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73
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Sharifi S, Bulstra SK, Grijpma DW, Kuijer R. Treatment of the degenerated intervertebral disc; closure, repair and regeneration of the annulus fibrosus. J Tissue Eng Regen Med 2014; 9:1120-32. [PMID: 24616324 DOI: 10.1002/term.1866] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Revised: 09/19/2013] [Accepted: 11/25/2013] [Indexed: 12/25/2022]
Abstract
Degeneration of the intervertebral disc (IVD) and disc herniation are two causes of low back pain. The aetiology of these disorders is unknown, but tissue weakening, which primarily occurs due to inherited genetic factors, ageing, nutritional compromise and loading history, is the basic factor causing disc degeneration. Symptomatic disc herniation mainly causes radicular pain. Current treatments of intervertebral disc degeneration and low back pain are based on alleviating the symptoms and comprise administration of painkillers or surgical methods such as spinal fusion. None of these methods is completely successful. Current research focuses on regeneration of the IVD and particularly on regeneration of the nucleus pulposus. Less attention has been directed to the repair or regeneration of the annulus fibrosus, although this is the key to successful nucleus pulposus, and therewith IVD, repair. This review focuses on the importance of restoring the function of the annulus fibrosus, as well as on the repair, replacement or regeneration of the annulus fibrosus in combination with restoration of the function of the nucleus pulposus, to treat low back pain.
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Affiliation(s)
- Shahriar Sharifi
- University of Groningen, University Medical Center Groningen, W. J. Kolff Institute, Department of Biomedical Engineering, Groningen, The Netherlands
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology, University of Twente, Enschede, The Netherlands
| | - Sjoerd K Bulstra
- University of Groningen, University Medical Center Groningen, Department of Orthopaedic Surgery, Groningen, The Netherlands
| | - Dirk W Grijpma
- University of Groningen, University Medical Center Groningen, W. J. Kolff Institute, Department of Biomedical Engineering, Groningen, The Netherlands
- MIRA Institute for Biomedical Technology and Technical Medicine, Department of Biomaterials Science and Technology, University of Twente, Enschede, The Netherlands
| | - Roel Kuijer
- University of Groningen, University Medical Center Groningen, W. J. Kolff Institute, Department of Biomedical Engineering, Groningen, The Netherlands
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Mercuri J, Addington C, Pascal R, Gill S, Simionescu D. Development and initial characterization of a chemically stabilized elastin-glycosaminoglycan-collagen composite shape-memory hydrogel for nucleus pulposus regeneration. J Biomed Mater Res A 2014; 102:4380-93. [PMID: 24497431 DOI: 10.1002/jbm.a.35104] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 12/27/2013] [Accepted: 01/29/2014] [Indexed: 01/07/2023]
Abstract
Nucleus pulposus (NP) is a resilient and hydrophilic tissue which plays a significant role in the biomechanical function of the intervertebral disc (IVD). Destruction of the NP extracellular matrix (ECM) is observed during the early stages of IVD degeneration. Herein, we describe the development and initial characterization of a novel biomaterial which attempts to recreate the resilient and hydrophilic nature of the NP via the construction of a chemically stabilized elastin-glycosaminoglycan-collagen (EGC) composite hydrogel. Results demonstrated that a resilient, hydrophilic hydrogel which displays a unique "shape-memory" sponge characteristic could be formed from a blend of soluble elastin aggregates, chondroitin-6-sulfate, hyaluronic acid and collagen following freeze-drying, stabilization with a carbodiimide and penta-galloyl glucose-based fixative, and subsequent partial degradation with glycosaminoglycan degrading enzymes. The resultant material exhibited the ability to restore its original dimensions and water content following multi-cycle mechanical compression and illustrated resistance to accelerated enzymatic degradation. Preliminary in vitro studies utilizing human adipose derived stem cells (hADSCs) demonstrated that the material was cytocompatible and supported differentiation towards an NP cell-like phenotype. In vivo biocompatibility studies illustrated host cell infiltration and evidence of active remodeling following 4 weeks of implantation. Feasibility studies demonstrated that the EGC hydrogel could be delivered via minimally invasive methods.
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Affiliation(s)
- Jeremy Mercuri
- Department of Bioengineering, Biocompatibility and Tissue Regeneration Laboratory, Clemson University, Rhodes Engineering Research Center, Clemson, South Carolina, 29634
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75
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Xu H, Mei Q, He J, Liu G, Zhao J, Xu B. Correlation of Matrix Metalloproteinases-1 and Tissue Inhibitor of Metalloproteinases-1 with Patient Age and Grade of Lumbar Disk Herniation. Cell Biochem Biophys 2014; 69:439-44. [DOI: 10.1007/s12013-014-9815-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Quero L, Klawitter M, Schmaus A, Rothley M, Sleeman J, Tiaden AN, Klasen J, Boos N, Hottiger MO, Wuertz K, Richards PJ. Hyaluronic acid fragments enhance the inflammatory and catabolic response in human intervertebral disc cells through modulation of toll-like receptor 2 signalling pathways. Arthritis Res Ther 2013; 15:R94. [PMID: 23968377 PMCID: PMC3978638 DOI: 10.1186/ar4274] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 08/22/2013] [Indexed: 12/12/2022] Open
Abstract
Introduction Intervertebral disc (IVD) degeneration is characterized by extracellular matrix breakdown and is considered to be a primary cause of discogenic back pain. Although increases in pro-inflammatory cytokine levels within degenerating discs are associated with discogenic back pain, the mechanisms leading to their overproduction have not yet been elucidated. As fragmentation of matrix components occurs during IVD degeneration, we assessed the potential involvement of hyaluronic acid fragments (fHAs) in the induction of inflammatory and catabolic mediators. Methods Human IVD cells isolated from patient biopsies were stimulated with fHAs (6 to 12 disaccharides) and their effect on cytokine and matrix degrading enzyme production was assessed using quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA). The involvement of specific cell surface receptors and signal transduction pathways in mediating the effects of fHAs was tested using small interfering RNA (siRNA) approaches and kinase inhibition assays. Results Treatment of IVD cells with fHAs significantly increased mRNA expression levels of interleukin (IL)-1β, IL-6, IL-8, cyclooxygenase (COX)-2, matrix metalloproteinase (MMP)-1 and -13. The stimulatory effects of fHAs on IL-6 protein production were significantly impaired when added to IVD cells in combination with either Toll-like receptor (TLR)-2 siRNA or a TLR2 neutralizing antibody. Furthermore, the ability of fHAs to enhance IL-6 and MMP-3 protein production was found to be dependent on the mitogen-activated protein (MAP) kinase signaling pathway. Conclusions These findings suggest that fHAs may have the potential to mediate IVD degeneration and discogenic back pain through activation of the TLR2 signaling pathway in resident IVD cells.
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Abstract
Vertebral axial decompression (VAX-D) is capable of reducing intradiscal pressure to the negative range. The purpose of this study was to compare the effects of two dosage regimens of VAX-D treatments on the level of low back pain in patients who were referred to a neurosurgical practice after failing standard medical therapy. In this study, one group of patients received an average course of treatment consisting of 18 daily sessions and another group received half that number of daily treatment sessions. The treatment parameters for all patients differed only in the number of sessions. Seventy-six percent of the higher dosage group achieved remission of low back pain compared to 43% of the lower dosage group. Chi-squared analysis revealed that the differences in response in the two dosage groups were statistically significant at p< 0.0001.
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Affiliation(s)
- Gustavo Ramos
- Valley Neurosurgical Clinic, McAllen, TX 78503, USA.
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78
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Erwin WM. Biologically based therapy for the intervertebral disk: who is the patient? Global Spine J 2013; 3:193-200. [PMID: 24436870 PMCID: PMC3854584 DOI: 10.1055/s-0033-1343074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 02/04/2013] [Indexed: 12/25/2022] Open
Abstract
The intervertebral disk (IVD) is a fascinating and resilient tissue compartment given the myriad of functions that it performs as well as its unique anatomy. The IVD must tolerate immense loads, protect the spinal cord, and contribute considerable flexibility and strength to the spinal column. In addition, as a consequence of its anatomical and physiological configuration, a unique characteristic of the IVD is that it also provides a barrier to metastatic disease. However, when injured and/or the subject of significant degenerative change, the IVD can be the source of substantial pain and disability. Considerable efforts have been made over the past several decades with respect to regenerating or at least modulating degenerative changes affecting the IVD through the use of many biological agents such as growth factors, hydrogels, and the use of plant sterols and even spices common to Ayurvedic medicine. More recently stem/progenitor and autologous chondrocytes have been used mostly in animal models of disk disease but also a few trials involving humans. At the end of the day if biological therapies are to offer benefit to the patient, the outcomes must be improved function and/or less pain and also must be improvements upon measures that are already in clinical practice. Here some of the challenges posed by the degenerative IVD and a summary of some of the regenerative attempts both in vitro and in vivo are discussed within the context of the vital question: "Who is the patient?"
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Affiliation(s)
- William Mark Erwin
- Department of Surgery, Divisions of Orthopaedic and Neurological Surgery, Toronto Western Research Institute; University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada,Address for correspondence William Mark Erwin, DC, PhD University of Toronto, Toronto Western Hospital399 Bathurst Street, McLaughlin Pavilion Room 11-408, Toronto, OntarioCanada M5T 2S8
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Abstract
Matrix metalloproteinases (MMP) are involved in the development of tendinopathy. These potent enzymes completely degrade all components of the connective tissue, modify the extracellular matrix (ECM), and mediate the development of painful tendinopathy. To control the local activity of activated proteinases, the same cells produce tissue inhibitors of metalloproteinases (TIMP). These latter bind to the enzyme and prevent degradation. The balance between the activities of MMPs and TIMPs regulates tendon remodeling, whereas an imbalance produces a collagen dis-regulation and disturbances in tendons. ADAMs (a disintegrin and metalloproteinase) are cell membrane-linked enzymes with proteolytic and cell signaling functions. ADAMTSs (ADAM with thrombospondin motifs) are secreted into the circulation and constitute a heterogenous family of proteases with both anabolic and catabolic functions. Further studies are needed to better define the mechanism of action, and whether these new strategies are safe and effective in larger models.
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Affiliation(s)
- Angelo Del Buono
- Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Italy
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80
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Differences in MMPs and TIMP-1 expression between intervertebral disc and disc herniation. Joint Bone Spine 2013; 80:341-2. [DOI: 10.1016/j.jbspin.2012.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 08/23/2012] [Indexed: 11/21/2022]
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Omair A, Holden M, Lie BA, Reikeras O, Brox JI. Treatment outcome of chronic low back pain and radiographic lumbar disc degeneration are associated with inflammatory and matrix degrading gene variants: a prospective genetic association study. BMC Musculoskelet Disord 2013; 14:105. [PMID: 23522322 PMCID: PMC3610293 DOI: 10.1186/1471-2474-14-105] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 03/20/2013] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Inflammatory and matrix degrading gene variants have been reported to be associated with disc degeneration. Some of these variants also modulate peripheral pain. This study examines the association of these genetic variants with radiographic lumbar disc degeneration and changes in pain and disability at long-term after surgical and cognitive behavioural management. METHODS 93 unrelated patients with chronic low back pain (CLBP) for duration of >1 year and lumbar disc degeneration were treated with lumbar fusion or cognitive intervention and exercises. Standardised questionnaires included the Oswestry Disability Index (ODI) and Visual Analog Score (VAS) for CLBP, were filled in by patients both at baseline and at 9 years follow-up. Degenerative changes at baseline Magnetic Resonance Imaging and Computed Tomography scans, were graded as moderate and severe (N=79). Yield and quality of blood and saliva DNA was assessed by nano drop spectrophotometry. Eight SNPs in 5 inflammatory and matrix degrading genes were successfully genotyped. Single marker and haplotype association with severity of degeneration, number of discs involved, changes in ODI and VAS CLBP, was done using Haploview, linear regression and R-package Haplostats. RESULTS Association analysis of individual SNPs revealed association of IL18RAP polymorphism rs1420100 with severe degeneration (p = 0.05) and more than one degenerated disc (p = 0.02). From the same gene two SNPs, rs917997 and rs1420106, were found to be in strong linkage disequilibrium (LD) and were associated with post treatment improvement in disability (p = 0.02). Haplotype association analysis of 5 SNPs spanning across IL18RAP, IL18R1 and IL1A genes revealed significant associations with improvement in disability (p=0.02) and reduction in pain (p=0.04). An association was found between MMP3 polymorphism rs72520913 and improvement in pain (p = 0.03) and with severe degeneration (p = 0.006). CONCLUSIONS The findings of the current study suggest a role of variation at inflammatory and matrix degrading genes with severity of lumbar disc degeneration, pain and disability.
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Affiliation(s)
- Ahmad Omair
- Department of Orthopaedics, Oslo University Hospital-Rikshospitalet, Sognsvannsveien 20, Oslo 0027, Norway.
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Schroeder M, Viezens L, Schaefer C, Friedrichs B, Algenstaedt P, Rüther W, Wiesner L, Hansen-Algenstaedt N. Chemokine profile of disc degeneration with acute or chronic pain. J Neurosurg Spine 2013; 18:496-503. [PMID: 23473344 DOI: 10.3171/2013.1.spine12483] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECT Disc-related disorders such as herniation and chronic degenerative disc disease (DDD) are often accompanied by acute or chronic pain. Different mediators have been identified in the development of radicular pain and DDD. Previous studies have not analyzed individual cytokine profiles discriminating between acute sciatic and chronic painful conditions, nor have they distinguished between different anatomical locations within the disc. The aim of this study was to elucidate the protein biochemical mechanisms in DDD. METHODS The authors determined expression levels of matrix metalloproteinase-3, transforming growth factor-β (TGF-β), tumor necrosis factor-α, interleukin-1α, and pro-substance P using enzyme-linked immunosorbent assay and Western blot analyses in patients suffering from DDD (n = 7), acute back pain due to herniated discs with radiculopathy (n = 7), and a control group (n = 7). Disc tissue samples from the anulus fibrosus (AF) and nucleus pulposus (NP) were analyzed. Statistical analysis was performed using nonparametric tests. RESULTS A distinct distribution of cytokines was found in different anatomical regions of intervertebral discs in patients with DDD and herniated NP. Increased TGF-β levels were predominantly found in DDD. Matrix metalloproteinase-3 was increased in acute herniated disc material. Increased levels of substance P were found in patients suffering from DDD but not in patients with disc herniation. The data showed significantly higher levels of proinflammatory cytokines in the AF and NP of patients with DDD, and the expression levels in the AF were even higher than in the NP, suggesting that the inflammatory response initiates from the AF. CONCLUSIONS These results highlight the complex mechanisms involved during disc degeneration and the need to distinguish between acute and chronic processes as well as different anatomical regions, namely the AF and NP. They also highlight potential problems in disc nucleus replacement therapies because the results suggest a biochemical link between AF and NP cytokine expression.
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Affiliation(s)
- Malte Schroeder
- Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg 20246, Germany.
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Mayer JE, Iatridis JC, Chan D, Qureshi SA, Gottesman O, Hecht AC. Genetic polymorphisms associated with intervertebral disc degeneration. Spine J 2013; 13:299-317. [PMID: 23537453 PMCID: PMC3655694 DOI: 10.1016/j.spinee.2013.01.041] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 01/02/2013] [Accepted: 01/25/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Disc degeneration (DD) is a multifaceted chronic process that alters the structure and function of the intervertebral discs and can lead to painful conditions. The pathophysiology of degeneration is not well understood, but previous studies suggest that certain genetic polymorphisms may be important contributing factors leading to an increased risk of DD. PURPOSE To review the genetic factors in DD with a focus on polymorphisms and their putative role in the pathophysiology of degeneration. Elucidating the genetic components that are associated with degeneration could provide insights into the mechanism of the process. Furthermore, defining these relationships and eventually using them in a clinical setting may allow an identification and early intervention for those who are at a high risk for painful DD. STUDY DESIGN Literature review. METHODS This literature review focused on the studies concerning genetic polymorphisms and their associations with DD. RESULTS Genetic polymorphisms in 20 genes have been analyzed in association with DD, including vitamin D receptor, growth differentiation factor 5 (GDF5), aggrecan, collagen Types I, IX, and XI, fibronectin, hyaluronan and proteoglycan link protein 1 (HAPLN1), thrombospondin, cartilage intermediate layer protein (CILP), asporin, MMP1, 2, and 3, parkinson protein 2, E3 ubiquitin protein ligase (PARK2), proteosome subunit β type 9 (PSMB9), tissue inhibitor of metalloproteinase (TIMP), cyclooxygenase-2 (COX2), and IL1α, IL1β, and IL6. Each genetic polymorphism codes for a protein that has a functional role in the pathogenesis of DD. CONCLUSIONS There are known associations between several genetic polymorphisms and DD. Of the 20 genes analyzed, polymorphisms in vitamin D receptor, aggrecan, Type IX collagen, asporin, MMP3, IL1, and IL6 show the most promise as functional variants. Genetic studies are crucial for understanding the mechanism of the degeneration. This genetic information could eventually be used as a predictive model for determining a patient's risk for symptomatic DD.
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Affiliation(s)
- Jillian E. Mayer
- Leni and Peter W May Department of Orthopaedics, Mount Sinai Medical Center, 5 East 98th Street, 9th Floor, New York, NY 10029, USA
| | - James C. Iatridis
- Leni and Peter W May Department of Orthopaedics, Mount Sinai Medical Center, 5 East 98th Street, 9th Floor, New York, NY 10029, USA
| | - Danny Chan
- Department of Biochemistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Sheeraz A. Qureshi
- Leni and Peter W May Department of Orthopaedics, Mount Sinai Medical Center, 5 East 98th Street, 9th Floor, New York, NY 10029, USA
| | - Omri Gottesman
- Institute for Personalized Medicine, Mount Sinai Medical Center, 1468 Madison Avenue, 18th Floor, New York, NY 10029, USA
| | - Andrew C. Hecht
- Leni and Peter W May Department of Orthopaedics, Mount Sinai Medical Center, 5 East 98th Street, 9th Floor, New York, NY 10029, USA,Corresponding Author: Andrew C. Hecht, Mount Sinai Medical Center. 5 East 98 Street, 9 Floor, New York, NY 10029, USA. Tel: (212) 241-8892; Fax: (212) 423-0827.
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Chan SCW, Bürki A, Bonél HM, Benneker LM, Gantenbein-Ritter B. Papain-induced in vitro disc degeneration model for the study of injectable nucleus pulposus therapy. Spine J 2013; 13:273-83. [PMID: 23353003 DOI: 10.1016/j.spinee.2012.12.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 09/27/2012] [Accepted: 12/09/2012] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Proteolytic enzyme digestion of the intervertebral disc (IVD) offers a method to simulate a condition of disc degeneration for the study of cell-scaffold constructs in the degenerated disc. PURPOSE To characterize an in vitro disc degeneration model (DDM) of different severities of glycosaminoglycans (GAG) and water loss by using papain, and to determine the initial response of the human mesenchymal stem cells (MSCs) introduced into this DDM. STUDY DESIGN Disc degeneration model of a bovine disc explant with an end plate was induced by the injection of papain at various concentrations. Labeled MSCs were later introduced in this model. METHODS Phosphate-buffered saline (PBS control) or papain in various concentrations (3, 15, 30, 60, and 150 U/mL) were injected into the bovine caudal IVD explants. Ten days after the injection, GAG content of the discs was evaluated by dimethylmethylene blue assay and cell viability was determined by live/dead staining together with confocal microscopy. Overall matrix composition was evaluated by histology, and water content was visualized by magnetic resonance imaging. Compressive and torsional stiffness of the DDM were also recorded. In the second part, MSCs were labeled with a fluorescence cell membrane tracker and injected into the nucleus of the DDM or a PBS control. Mesenchymal stem cell viability and distribution were evaluated by confocal microscopy. RESULTS A large drop of GAG and water content of the bovine disc were obtained by injecting >30 U/mL papain. Magnetic resonance imaging showed Grade II, III, and IV disc degeneration by injecting 30, 60, and 150 U/mL papain. A cavity in the center of the disc could facilitate later injection of the nucleus pulposus tissue engineering construct while retaining an intact annulus fibrosus. The remaining disc cell viability was not affected. Mesenchymal stem cells injected into the protease-treated DDM disc showed significantly higher cell viability than when injected into the PBS-injected control disc. CONCLUSIONS By varying the concentration of papain for injection, an increasing amount of GAG and water loss could be induced to simulate the different severities of disc degeneration. MSC suspension introduced into the disc has a very low short-term survival. However, it should be clear that this bovine IVD DDM does not reflect a clinical situation but offers exciting possibilities to test novel tissue engineering protocols.
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Affiliation(s)
- Samantha C W Chan
- Tissue & Organ Mechanobiology, Institute of Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland.
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Itoh H, Hara Y, Tagawa M, Kato T, Ochi H, Koga D, Okawa A, Asou Y. Evaluation of the association between runt-related transcription factor 2 expression and intervertebral disk aging in dogs. Am J Vet Res 2013; 73:1553-9. [PMID: 23013180 DOI: 10.2460/ajvr.73.10.1553] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the relationship between runt-related transcription factor 2 (RUNX2) expression in canine nucleus pulposus (NP) cells and intervertebral disk aging in chondrodystrophoid dogs. ANIMALS 7 healthy Beagles (mean age, 35.6 months) and 11 Dachshunds with herniated disks (mean age, 61 months). PROCEDURES All dogs underwent MRI examination of the thoracic and lumbar vertebral column immediately before sample collection under general anesthesia. The disk center-to-CSF T2-weighted signal intensity ratio was determined for healthy Beagles. Samples of NP were obtained from nonherniated disks in healthy Beagles and from herniated disks during surgical treatment of hospitalized Dachshunds. Samples were evaluated for RUNX2 and matrix metalloproteinase 13 transcript expression via reverse transcriptase PCR assay; RUNX2 protein expression was evaluated via immunohistochemical analysis, and correlation between these variables and age of dogs was evaluated. A 3' and 5' rapid amplification of cDNA ends method was used to identify the RUNX2 coding region. RESULTS RUNX2 cDNA had > 97% conservation with the human cDNA sequence and approximately 95% conservation with the mouse cDNA sequence; RUNX2 and matrix metalloproteinase 13 mRNA expression and RUNX2 protein expression in NP cells were positively correlated with age. The disk center-to-CSF T2-weighted signal intensity ratio was negatively correlated with RUNX2 protein expression in the NP of healthy dogs. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that RUNX2 mRNA and protein expression in the NP are enhanced in aging intervertebral disks in dogs.
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Affiliation(s)
- Hisanori Itoh
- Division of Veterinary Surgery, Department of Veterinary Science, Faculty of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino, Tokyo, Japan
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Thermosensitive hydrogel made of ferulic acid-gelatin and chitosan glycerophosphate. Carbohydr Polym 2012; 92:1512-9. [PMID: 23399183 DOI: 10.1016/j.carbpol.2012.10.074] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 10/27/2012] [Accepted: 10/29/2012] [Indexed: 12/19/2022]
Abstract
Reactive oxygen species-induced oxidative stress is involved in apoptosis of nucleus pulposus (NP) cells that can alter cellular phenotype and accelerate disc degeneration. Ferulic acid (FA) possesses an excellent antioxidant and anti-inflammatory properties. In the study, we developed the thermosensitive FA-gelatin/chitosan/glycerol phosphate (FA-G/C/GP) hydrogel which was applied as a sustained release system of FA to treat NP cells from the damage caused by oxidative stress. The gelation temperature of the FA-G/C/GP hydrogel was 32.17 °C. NP cells submitted to oxidative stress promoted by H(2)O(2), and post-treated with FA-G/C/GP exhibited down-regulation of MMP-3 and up-regulation aggrecan and type II collagen in mRNA level. The sulfated-glycosaminoglycan production was increased and the apoptosis was inhibited in the post-treatment group. The results suggest that the thermosensitive FA-G/C/GP hydrogel can treat NP cells from the damage caused by oxidative stress and may apply in minimally invasive surgery for NP regeneration.
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87
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Renani HB, Ghorbani M, Beni BH, Karimi Z, Mirhosseini MM, Zarkesh H, Kabiri A. Determination and comparison of specifics of nucleus pulposus cells of human intervertebral disc in alginate and chitosan-gelatin scaffolds. Adv Biomed Res 2012; 1:81. [PMID: 23326811 PMCID: PMC3544085 DOI: 10.4103/2277-9175.102996] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 02/23/2012] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Low back pain is a major economical and social problem nowadays. Intervertebral disc herniation and central degeneration of disc are two major reasons of low back pain that occur because of structural impairment of disc. The intervertebral disc contains three parts as follows : Annulus fibrosus, transitional region, and nucleus pulposus, which forms the central nucleus of the disc. The reduction of cell count and extracellular matrix, especially in nucleus pulposus, causes disc degeneration. Different scaffolds (natural and synthetic) have been used for tissue repairing and regeneration of the intervertebral disc in tissue engineering. Most scaffolds have biodegradable and biocompatible characteristics and also prepare a fine condition for proliferation and migration of cells. In this study, proliferation of NP cells of human intervertebral disc compromised in Chitosan-gelatin scaffold with alginate scaffold was studied. MATERIALS AND METHODS NP cells derived from nucleus pulposus by collagenase enzymatic hydrolysis. They were derived from patients who undergoing open surgery for discectomy in the Isfahan Alzahra hospital. Chitosan was blended with gelatin and glutaraldehyde was used for cross linking the two polymers. Then, alginate scaffold was prepared. Cellular suspension with 1 × 10(5) transferred to each scaffold and cultured for 21 days. Cell viability and proliferation investigated by trypan blue and (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Scanning electron microscope (SEM) was used to assert the porosity and to survey structure of scaffold. RESULTS MTT assay dem1onstrated that cell viability of third day had significant difference in contrast by first day in both scaffolds. Accordingly, there was a significant decreased in cellular viability from day 3 to 21. Results of the cell count showed a punctual elevation cell numbers for alginate scaffold but there was no similar result for chitosan-gelatin scaffold. CONCLUSION Alginate scaffold prepared a better condition for proliferation of NP cells in comparison with chitosan-gelatin scaffold. Results of this study suggest that alginate scaffold could be useful in in vivo studies and treatment.
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Affiliation(s)
| | - Masood Ghorbani
- Department of Anatomy and Molecular Biology, School of Medicine, Isfahan, Iran
- Tissue Engineering and Cell Therapy, New Productions School, Tehran University, Tehran, Iran
| | | | - Z Karimi
- Medicine School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - MM Mirhosseini
- Medicine School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - H Zarkesh
- Department of Immunology, Medicine School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - A Kabiri
- Department of Anatomy and Molecular Biology, School of Medicine, Isfahan, Iran
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88
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Esparza R, Gortazar AR, Forriol F. Cell study of the three areas of the meniscus: effect of growth factors in an experimental model in sheep. J Orthop Res 2012; 30:1647-51. [PMID: 22447524 DOI: 10.1002/jor.22110] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 02/23/2012] [Indexed: 02/04/2023]
Abstract
Meniscus had two areas with different vascular supply. Cells of the two areas and the synovium were monolayer cultivated. We analyzed the expression of genes of Col1, Col 2A, MMP-2, MMP-13, and aggrecan in a baseline state and after incubation with VEGF, TGF-β, FGF, and IGF. We found that the growth factors used produced a major increase in the MMP-13 in all three areas. In the vascular area, the stimulation of MMP-3 was produced by FGF, while in the synovial and avascular areas, it was caused by TGF-β. MMP-2 was only stimulated in the synovial area by IGF. Col 2A was stimulated in the synovial area by VEGF, and in the avascular area by TGF-β, FGF, and IGF, whereas Col 1 was stimulated in the avascular area by IGF, FGF, and VEGF. The vascular or avascular areas of the meniscus, behave differently in terms of repair, and their cells express different factors. The growth factors act in a different way in each meniscal area.
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Affiliation(s)
- Raul Esparza
- Orthopaedic Department, School of Medicine, University CEU Campus de Montepríncipe, 28886 - Boadilla del Monte, Madrid, Spain
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89
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Del Buono A, Oliva F, Longo UG, Rodeo SA, Orchard J, Denaro V, Maffulli N. Metalloproteases and rotator cuff disease. J Shoulder Elbow Surg 2012; 21:200-8. [PMID: 22244063 DOI: 10.1016/j.jse.2011.10.020] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 10/22/2011] [Accepted: 10/24/2011] [Indexed: 02/07/2023]
Abstract
The molecular changes occurring in rotator cuff tears are still unknown, but much attention has been paid to better understand the role of matrix metalloproteinases (MMP) in the development of tendinopathy. These are potent enzymes that, once activated, can completely degrade all components of the connective tissue, modify the extracellular matrix (ECM), and mediatethe development of painful tendinopathy and tendon rupture. To control the local activity of activated proteinases, the same cells produce tissue inhibitors of metalloproteinases (TIMP) that bind to the enzymes and prevent degradation. The balance between the activities of MMPs and TIMPs regulates tendon remodeling, whereas an imbalance produces a collagen dis-regulation and disturbances intendons. ADAMs (a disintegrin and metalloproteinase) are cell membrane-linked enzymes with proteolytic and cell signaling functions. ADAMTSs (ADAM with thrombospondin motifs) are secreted into the circulation, and constitute a heterogenous family of proteases with both anabolic and catabolic functions. Biologic modulation of endogenous MMP activity to basal levels may reduce pathologic tissue degradation and favorably influence healing after rotator cuff repair. Further studies are needed to better define the mechanism of action, and whether these new strategies are safe and effective in larger models.
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Affiliation(s)
- Angelo Del Buono
- Department of Orthopaedic and Trauma Surgery, Campus Biomedico, University of Rome, Rome, Italy
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90
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Pifer MA, Kibuule LK, Maerz T, Studzinski DM, Baker KC, Herkowitz HN. In vitro response of human chondrocytes to a combination of growth factors and a proteinase inhibitor. Orthopedics 2012; 35:35-42. [PMID: 22229919 DOI: 10.3928/01477447-20111122-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Degenerative disk disease is an accelerating cascade of tissue degeneration in the intervertebral disk. A harsh catabolic environment perpetuates the degeneration of the intervertebral disk. Tissue engineering-based techniques offer effective treatment to slow the progression of degenerative disk disease and regenerate intervertebral disk tissue. The purpose of this study was to assess the efficacy of a regenerative therapy for degenerative disk disease by treating human chondrocytes with anabolic growth factors and a proteinase inhibitor. The use of both proved effective in upregulating important extracellular matrix markers of human chondrocytes. These successful in vitro results have implications for the regeneration of the intervertebral disk.
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Affiliation(s)
- Matthew A Pifer
- Department of Orthopaedic Research, William Beaumont Hospital, Royal Oak, Michigan 48073, USA
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91
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Rathod TN, Chandanwale AS, Gujrathi S, Patil V, Chavan SA, Shah MN. Association between single nucleotide polymorphism in collagen IX and intervertebral disc disease in the Indian population. Indian J Orthop 2012; 46:420-6. [PMID: 22912517 PMCID: PMC3421932 DOI: 10.4103/0019-5413.97261] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Symptomatic intervertebral disc degeneration is being recently reported in younger population, questions the basis of its degenerative etiology. Latest evidences show that genetics play a significant role. Collagen IX, an important constituent of disc, is found to be altered in genetically predisposed individuals. Mutations have been reported in COL9A2 and COL9A3 genes, which encode Collagen IX, in Finnish and various other populations. The purpose of the present study is to test the significance of these genes in the Indian population. MATERIALS AND METHODS One hundred proven cases of intervertebral disc disease (IDD) of various regions of spine were selected for the study, along with matched controls. They were tested for the above mentioned alleles by allelic discrimination method with real-time polymerase chain reaction (PCR) study after isolation of DNA from blood sample. Each blood sample was classified into one of the three types - homozygous, heterozygous, and wild (normal) type allele - separately for COL9A2 and COL9A3 genes. RESULTS Homozygosity for COL9A2 allelic variation was associated with 100% occurrence of the disease. Heterozygous allele of COL9A2 was significantly higher in the study group (42%) as compared to the control group (17%). In contrast, allelic variation in COL9A3 gene was found to have no significant correlation with disc disease. There was no single patient with homozygous allelic variation for COL9A3, suggesting predominance of COL9A2 variation in the Indian population. CONCLUSION This candidate gene strategy approach adds considerably to our knowledge of genetic makeup of Indian populations in relation with disc disease. This study highlights importance of COL9A2 gene variation especially of homozygous variety in contrast to COL9A3 variation in causing disc disease in Indian population.
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Affiliation(s)
- Tushar N Rathod
- Department of Orthopaedics, Grant Medical College, Sir J. J. Group of Hospitals, Mumbai, India,Address for correspondence: Dr. Tushar N Rathod, Flat No. 704, Building no. H7, Gulmohar Hsg. Soc., Pratiksha Nagar, Sion (East), Mumbai 400 022, India. E-mail:
| | - Ajay S Chandanwale
- Department of Orthopaedics, Grant Medical College, Sir J. J. Group of Hospitals, Mumbai, India
| | - Shubhangi Gujrathi
- Department of Biochemistry, Grant Medical College, Sir J. J. Group of Hospitals, Mumbai, India
| | - Vinayak Patil
- Department of Biochemistry, Grant Medical College, Sir J. J. Group of Hospitals, Mumbai, India
| | - Shital A Chavan
- Department of Medicine, Grant Medical College, Sir J. J. Group of Hospitals, Mumbai, India
| | - Munjal N Shah
- Student, Grant Medical College, Sir J. J. Group of Hospitals, Mumbai, India
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92
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Molecular basis of intervertebral disc degeneration. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2012; 760:114-33. [PMID: 23281517 DOI: 10.1007/978-1-4614-4090-1_8] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Intervertebral disc (IVD) degeneration is a disease of the discs connecting adjoining vertebrae in which structural damage leads to degeneration of the disc and surrounding area. Degeneration of the disc is considered to be a normal process of aging, but can accelerate faster than expected or be precipitated by other factors. The scientific community has come a long way in understanding the biological basis and interpreting the lifestyle implications of IVD degeneration. Of all the diseases of the intervertebral disc, degeneration is the most common and has earned much attention due to its diversity in presentation and potential multiorgan involvement. We will provide a brief overview of the anatomic, cellular, and molecular structure of the IVD, and delve into the cellular and molecular pathophysiology surrounding IVD degeneration. We will then highlight some of the newest developments in stem cell, protein, and genetic therapy for IVD degeneration.
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93
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Jacobs LJ, Vo N, Kang JD. Identifying inflammatory targets for biologic therapies for spine pain. PM R 2011; 3:S12-7. [PMID: 21703568 DOI: 10.1016/j.pmrj.2011.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Accepted: 05/01/2011] [Indexed: 11/25/2022]
Abstract
The costs associated with treating spine-related conditions are enormous and are trending upward. Current methods employed to treat inflammatory-mediated pain are targeted at alleviating symptoms, rather than correcting the underlying cause of disease. It is clear that a biochemical basis for inflammatory-mediated intervertebral disk, facet joint, and nerve pain exists. Biologic therapies that address the underlying cause of pain could potentially decrease the costs associated with treating spine pathology. MMPs, IL-1, TNF- α, IL-6, NGF, bradykinin, prostaglandins, and nitric oxide are implicated in much of the catabolic effects seen in the pathogenesis of inflammatory-mediated pain and are good targets for inhibition. The anticatabolic and anabolic effects of TIMPs, BMPs, TGF- β, and IGF-1 are targets already shown to favorably impact disk matrix homeostasis. With rapid advances in biomedical technology, these interventions may be available for clinical use in the near future.
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Affiliation(s)
- Lloydine J Jacobs
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
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94
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Chan WCW, Sze KL, Samartzis D, Leung VYL, Chan D. Structure and biology of the intervertebral disk in health and disease. Orthop Clin North Am 2011; 42:447-64, vii. [PMID: 21944583 DOI: 10.1016/j.ocl.2011.07.012] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The intervertebral disks along the spine provide motion and protection against mechanical loading. The 3 structural components, nucleus pulposus, annulus fibrosus, and cartilage endplate, function as a synergistic unit, though each has its own role. The cells within each of these components have distinct origins in development and morphology, producing specific extracellular matrix proteins that are organized into unique architectures fit for intervertebral disk function. This article focuses on various aspects of intervertebral disk biology and disruptions that could lead to diseases such as intervertebral disk degeneration.
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Affiliation(s)
- Wilson C W Chan
- Department of Biochemistry, The University of Hong Kong, LKS Faculty of Medicine, Pokfulam, Hong Kong SAR, China
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95
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Genetics of lumbar disk degeneration: technology, study designs, and risk factors. Orthop Clin North Am 2011; 42:479-86, vii. [PMID: 21944585 DOI: 10.1016/j.ocl.2011.07.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Lumbar disk degeneration (LDD) is a common musculoskeletal condition. Genetic risk factors have been suggested to play a major role in its cause. This article reviews the main research strategies that have been used to study the genetics of LDD, and the genes that thus far have been identified to influence susceptibility to LDD. With the rapid progress in genomic technologies, further advances in the genetics of LDD are expected in the next few years.
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96
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Li H, Liang C, Chen Q, Yang Z. Rhein: a potential biological therapeutic drug for intervertebral disc degeneration. Med Hypotheses 2011; 77:1105-7. [PMID: 21962453 DOI: 10.1016/j.mehy.2011.09.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Revised: 08/30/2011] [Accepted: 09/08/2011] [Indexed: 10/17/2022]
Abstract
Intervertebral disc degeneration (IDD) is regarded as an important cause of low back pain, which continues to be a common disability. IDD is thought to involve sequential changes of intervertebral disc that lead to the reduction of disc cells and the extracellular matrix. In addition, inflammation is crucially involved in IDD. Currently, there is urgent need to develop biological therapies for IDD that can both relieve symptoms and directly reverse the process of degeneration. Rhein (RH) is an anthraquinone molecule with the abilities of enhancing the synthesis of matrix components and inhibiting inflammatory response. Recently, the metabolic precursor of RH called diacerein has been demonstrated to have significant effects on pain relief and function improvement in the treatment of osteoarthritis. Given the occurrence of matrix degeneration and involvement of inflammation in IDD, we propose that RH might be a promising biological therapeutic drug for IDD due to its bioactivities. In addition, we hypothesize that the underlying mechanisms might be that RH has the ability to diminish interleukin-1 (IL-1) induced apoptosis and inhibit IL-1 induced secretion of MMPs and aggrecanases.
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Affiliation(s)
- Hao Li
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, Hangzhou, PR China
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97
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Cheng YH, Yang SH, Yang KC, Chen MP, Lin FH. The effects of ferulic acid on nucleus pulposus cells under hydrogen peroxide-induced oxidative stress. Process Biochem 2011. [DOI: 10.1016/j.procbio.2011.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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98
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See EYS, Toh SL, Goh JCH. Simulated intervertebral disc-like assembly using bone marrow-derived mesenchymal stem cell sheets and silk scaffolds for annulus fibrosus regeneration. J Tissue Eng Regen Med 2011; 6:528-35. [DOI: 10.1002/term.457] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 06/11/2011] [Indexed: 12/13/2022]
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99
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Mwale F, Masuda K, Pichika R, Epure LM, Yoshikawa T, Hemmad A, Roughley PJ, Antoniou J. The efficacy of Link N as a mediator of repair in a rabbit model of intervertebral disc degeneration. Arthritis Res Ther 2011; 13:R120. [PMID: 21787415 PMCID: PMC3239358 DOI: 10.1186/ar3423] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 06/27/2011] [Accepted: 07/25/2011] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Intervertebral disc (IVD) degeneration is associated with proteolytic degradation of the extracellular matrix, and its repair requires both the production of extracellular matrix and the downregulation of proteinase activity. These properties are associated with several growth factors. However, the use of growth factors in clinical practice is limited by their high cost. This cost can be circumvented using synthetic peptides, such as Link N, which can stimulate the synthesis of proteoglycan and collagen by IVD cells in vitro. The purpose of the present study was to evaluate the effect of Link N in vivo in a rabbit model of IVD degeneration. METHODS New Zealand white rabbits received annular puncture in two lumbar discs. Two weeks after puncture, both punctured discs of each rabbit were injected with either Link N or saline. After 2 weeks, nine rabbits were euthanized and the annulus fibrosus (AF) and nucleus pulposus (NP) of Link N-injected and saline-injected IVDs were removed and used to prepare total RNA. Following reverse transcription, quantitative PCR was performed for aggrecan, COL2A1, COL1A1, ADAMTS-4, ADAMTS-5 and MMP-3. After 12 weeks, 19 rabbits were euthanized and the injected IVDs were removed for biochemical and histological analysis. Proteinase K digests were analyzed for DNA and sulfated glycosaminoglycan content. Disc height was monitored radiographically biweekly. RESULTS Following needle puncture, disc height decreased by about 25% over 2 weeks, and was partially restored by Link N injection. Puncture of the IVD resulted in a trend towards decreased proteoglycan content in both the NP and AF, and a trend towards partial restoration following Link N injection, although under the time course used this did not achieve statistical significance. Link N did not alter the DNA content of the discs. Link N injection led to a significant increase in aggrecan gene expression and a significant decrease in proteinase gene expression in both the NP and AF, when compared with saline alone. CONCLUSIONS When administered to the degenerate disc in vivo, Link N stimulated aggrecan gene expression and downregulated metalloproteinase expression, and there was a trend towards increased proteoglycan content of the disc, in both the NP and AF. These are features needed for any agent designed to stimulate disc repair. In principle, therefore, Link N supplementation could be an option for treating disc degeneration.
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Affiliation(s)
- Fackson Mwale
- Division of Orthopaedic Surgery, McGill University, 1650 Cedar Avenue, Montreal, QC, Canada, H3G 1A4.
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100
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Thermosensitive chitosan-gelatin-glycerol phosphate hydrogel as a controlled release system of ferulic acid for nucleus pulposus regeneration. Biomaterials 2011; 32:6953-61. [PMID: 21774981 DOI: 10.1016/j.biomaterials.2011.03.065] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 03/28/2011] [Indexed: 01/07/2023]
Abstract
In the degenerative disc, overproduction of reactive oxygen species (ROS) involves in apoptosis and senescence of nucleus pulposus (NP) cells that could accelerate the degenerative process. Ferulic acid (FA) has been reported to have an excellent antioxidant property. In the study, injectable thermosensitive chitosan/gelatin/glycerol phosphate (C/G/GP) hydrogel was applied as a controlled release system for FA delivery. The study was aimed to evaluate possible therapeutic effects of FA-incorporated C/G/GP hydrogel on hydrogen peroxide (H(2)O(2))-induced oxidative stress NP cells. The results showed that the release of FA from C/G/GP hydrogel could decrease the H(2)O(2)-induced oxidative stress. Post-treatment of FA-incorporated C/G/GP hydrogel on H(2)O(2)-induced oxidative stress NP cells showed up-regulation of Aggrecan and type II collagen and down-regulation of MMP-3 in mRNA level. The results of sulfated-glycosaminoglycans (GAGs) to DNA ratio and alcian blue staining revealed that the GAGs production of H(2)O(2)-induced oxidative stress NP cells could reach to normal level. The results of caspase-3 activity and TUNEL staining indicated that FA-incorporated C/G/GP hydrogel decreased the apoptosis of H(2)O(2)-induced oxidative stress NP cells. The results suggested that the C/G/GP hydrogel was very suitable for sustained delivery of FA. The FA-incorporated C/G/GP hydrogel would be used to treat the degenerative disc in the early stage before it developed into the latter irreversible stages.
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