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Elmounedi N, Keskes H. Establishment of intervertebral disc degeneration models; A review of the currently used models. J Orthop 2024; 56:50-56. [PMID: 38784950 PMCID: PMC11109335 DOI: 10.1016/j.jor.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
One of the frequent causes of low back pain is intervertebral disc degeneration (IDD), which is followed by discogenic pain. Some significant risk factors that have been linked to the onset and progression of IDD include age, mechanical imbalance, changes in nutrition and inflammation. According to recent studies, five types of animal models are established for producing IDD: the spontaneous models, the puncture models, the biomechanical models, the chemical models and the hybrid models. These models are crucial in studying and understanding IDD's natural history and identifying potential treatment targets for IDD. In our study, we'll talk about the technical aspects of these models, the time between model establishment and the apparition of observable degradation, and their potential in various research. Each animal model should be compared to the human natural IDD pathogenesis to guide future research efforts in this area. By improving knowledge and appropriate application of various animal models, we seek to raise awareness of this illness and further translational research.
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Affiliation(s)
- Najah Elmounedi
- Cell Therapy and Experimental Surgery of Musculoskeletal System LR18SP1 Lab, Faculty of Medicine, Sfax, Tunisia
| | - Hassib Keskes
- Cell Therapy and Experimental Surgery of Musculoskeletal System LR18SP1 Lab, Faculty of Medicine, Sfax, Tunisia
- Department of Orthopedics and Traumatology, CHU Habib Bourguiba, Sfax, Tunisia
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Barbe MF, Chen FL, Loomis RH, Harris MY, Kim BM, Xie K, Hilliard BA, McGonagle ER, Bailey TD, Gares RP, Van Der Bas M, Kalicharan BA, Holt-Bright L, Stone LS, Hodges PW, Klyne DM. Characterization of pain-related behaviors in a rat model of acute-to-chronic low back pain: single vs. multi-level disc injury. FRONTIERS IN PAIN RESEARCH 2024; 5:1394017. [PMID: 38770243 PMCID: PMC11102983 DOI: 10.3389/fpain.2024.1394017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction Low back pain is the most common type of chronic pain. We examined pain-related behaviors across 18 weeks in rats that received injury to one or two lumbar intervertebral discs (IVD) to determine if multi-level disc injuries enhance/prolong pain. Methods Twenty-three Sprague-Dawley adult female rats were used: 8 received disc puncture (DP) of one lumbar IVD (L5/6, DP-1); 8 received DP of two lumbar IVDs (L4/5 & L5/6, DP-2); 8 underwent sham surgery. Results DP-2 rats showed local (low back) sensitivity to pressure at 6- and 12-weeks post-injury, and remote sensitivity to pressure (upper thighs) at 12- and 18-weeks and touch (hind paws) at 6, 12 and 18-weeks. DP-1 rats showed local and remote pressure sensitivity at 12-weeks only (and no tactile sensitivity), relative to Sham DP rats. Both DP groups showed reduced distance traveled during gait testing over multiple weeks, compared to pre-injury; only DP-2 rats showed reduced distance relative to Sham DP rats at 12-weeks. DP-2 rats displayed reduced positive interactions with a novel adult female rat at 3-weeks and hesitation and freezing during gait assays from 6-weeks onwards. At study end (18-weeks), radiological and histological analyses revealed reduced disc height and degeneration of punctured IVDs. Serum BDNF and TNFα levels were higher at 18-weeks in DP-2 rats, relative to Sham DP rats, and levels correlated positively with remote sensitivity in hind paws (tactile) and thighs (pressure). Discussion Thus, multi-level disc injuries resulted in earlier, prolonged and greater discomfort locally and remotely, than single-level disc injury. BDNF and TNFα may have contributing roles.
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Affiliation(s)
- Mary F. Barbe
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Frank Liu Chen
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Regina H. Loomis
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Michele Y. Harris
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Brandon M. Kim
- Medical Doctor Program, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Kevin Xie
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Brendan A. Hilliard
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Elizabeth R. McGonagle
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Taylor D. Bailey
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Ryan P. Gares
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Megan Van Der Bas
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Betsy A. Kalicharan
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Lewis Holt-Bright
- Aging + Cardiovascular Discovery Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Laura S. Stone
- Department of Anesthesiology, University of Minnesota, Minneapolis, MN, United States
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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Li C, Zhang Y, Deng Y, Chen Y, Wu C, Zhao X, Chen X, Wang X, Zhou Y, Zhang X, Tian N. Fisetin suppresses ferroptosis through Nrf2 and attenuates intervertebral disc degeneration in rats. Eur J Pharmacol 2024; 964:176298. [PMID: 38145645 DOI: 10.1016/j.ejphar.2023.176298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
Low back pain, primarily caused by intervertebral disc degeneration (IVDD), lacks effective pharmacological treatments. Oxidative stress has been identified as a significant contributor to IVDD. This study aims to establish an in vitro model of IVDD induced by oxidative stress and identify potential therapeutic agents and their underlying mechanisms. By screening the natural product library, fisetin emerged as the most promising compound in suppressing cell death induced by oxidative stress in nucleus pulposus cells (NPCs). Furthermore, our investigation revealed that the cell death induced by oxidative stress was predominantly associated with ferroptosis, and fisetin demonstrated the ability to inhibit ferroptosis in NPCs. Mechanistic exploration suggested that the impact of fisetin on ferroptosis may be mediated through the Nrf2/HO-1 (Nuclear factor erythroid 2-related factor 2/heme oxygenase-1) axis. Notably, the in vivo study demonstrated that fisetin could alleviate IVDD in rats. These findings highlight fisetin as a potential therapeutic option for IVDD and implicate the involvement of the Nrf2/HO-1 pathway in its mechanism of action.
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Affiliation(s)
- Chenchao Li
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Yekai Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Yuxin Deng
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Yu Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Chenyu Wu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Xiaoying Zhao
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Ximiao Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Xiangyang Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China; Chinese Orthopaedic Regenerative Medicine Society, Hangzhou, 310000, Zhejiang Province, China
| | - Yifei Zhou
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China; Chinese Orthopaedic Regenerative Medicine Society, Hangzhou, 310000, Zhejiang Province, China
| | - Xiaolei Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China; Chinese Orthopaedic Regenerative Medicine Society, Hangzhou, 310000, Zhejiang Province, China.
| | - Naifeng Tian
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China; Chinese Orthopaedic Regenerative Medicine Society, Hangzhou, 310000, Zhejiang Province, China.
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Chung YH, Hu MH, Kao SC, Kao YH, Wang FH, Hsieh CY, Shen CI, Chuang CH, Chen DWC, Kuo CC, Su HL, Lin CL. Preclinical Animal Study and Pilot Clinical Trial of Using Enriched Peripheral Blood-Derived Mononuclear Cells for Intervertebral Disc Degeneration. Cell Transplant 2024; 33:9636897231219733. [PMID: 38173231 PMCID: PMC10768619 DOI: 10.1177/09636897231219733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/24/2023] [Accepted: 11/24/2023] [Indexed: 01/05/2024] Open
Abstract
Low back pain (LBP) is a leading cause of long-term disability globally. Intervertebral disk degeneration (IVDD) is mainly responsible for discogenic pain in LBP-affected young patients. There is no effective therapy to reverse disease severity and IVDD progression. This study investigates the effect of human peripheral blood-derived mononuclear cells (PBMCs) on pain relief and life quality improvement in IVDD patients. The enriched monocytes of the PBMCs could differentiate into CD14 and CD206 double-positive M2 macrophages in vitro. Preclinical evidence in rats showed that the transplanted PBMCs exhibited anti-inflammatory and moderate tissue-repair effects on controlling IVDD progress in the rat model. The PBMCs significantly steered the aggrecan and type II collagen expressions and attenuated the pro-inflammatory cytokines in the affected disk. Based on the animal results, 36 patients with chronic low back pain (CLBP) were included in clinical trials. The control group was conservative care only, and the experimental group was platelet-rich plasma (PRP) and PBMCs intradiscal injections. We first confirmed the single lumbar disk causing the discogenic pain by provocative discography or magnetic resonance imaging (MRI). Discogenic LBP participants received one intradiscal injection of autologous PBMCs and followed for 6 months. Our clinical trial showed that patients' LBP and disability were significantly ameliorated after the PBMCs transplantation rather than PRP. These preclinical and pilot clinical studies indicate that intradiscal injection of the enriched PBMCs might be a feasible and potential cell therapy to control pain and disability in IVDD patients.
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Affiliation(s)
- Yu-Hsuan Chung
- Department of Orthopedics, Show Chwan Memorial Hospital, Changhua, Taiwan
- PhD Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Ming-Hsien Hu
- Department of Orthopedics, Show Chwan Memorial Hospital, Changhua, Taiwan
- Bachelor’s Program of Design and Materials for Medical Equipment and Devices, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
- College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Shang-Chyi Kao
- Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Ying-Hsien Kao
- Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan
| | - Fu-Hui Wang
- Duogenic StemCells Corporation, Taichung, Taiwan
| | | | - Ching-I Shen
- Duogenic StemCells Corporation, Taichung, Taiwan
| | - Chang-Han Chuang
- Department of Orthopedics, Show Chwan Memorial Hospital, Changhua, Taiwan
- PhD Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Dave Wei-Chih Chen
- Department of Orthopedic Surgery, Chang Gung Memorial Hospital-Keelung, Keelung, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Chung Kuo
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan
| | - Hong-Lin Su
- Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan
- Duogenic StemCells Corporation, Taichung, Taiwan
| | - Chih-Lung Lin
- Department of Neurosurgery, Asia University Hospital, Taichung, Taiwan
- Department of Occupational Therapy, Asia University, Taichung, Taiwan
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Lisiewski LE, Jacobsen HE, Viola DCM, Kenawy HM, Kiridly DN, Chahine NO. Intradiscal inflammatory stimulation induces spinal pain behavior and intervertebral disc degeneration in vivo. FASEB J 2024; 38:e23364. [PMID: 38091247 PMCID: PMC10795732 DOI: 10.1096/fj.202300227r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 10/30/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023]
Abstract
Degeneration of the intervertebral disc (IVD) results in a range of symptomatic (i.e., painful) and asymptomatic experiences. Components of the degenerative environment, including structural disruption and inflammatory cytokine production, often correlate with pain severity. However, the role of inflammation in the activation of pain and degenerative changes has been complex to delineate. The most common IVD injury model is puncture; however, it initiates structural damage that is not representative of the natural degenerative cascade. In this study, we utilized in vivo injection of lipopolysaccharide (LPS), a pro-inflammatory stimulus, into rat caudal IVDs using 33G needles to induce inflammatory activation without the physical tissue disruption caused by puncture using larger needles. LPS injection increased gene expression of pro-inflammatory cytokines (Tnfa, Il1b) and macrophage markers (Inos, Arg1), supported by immunostaining of macrophages (CD68, CCR7, Arg1) and systemic changes in blood cytokine and chemokine levels. Disruption of the IVD structural integrity after LPS injection was also evident through changes in histological grading, disc height, and ECM biochemistry. Ultimately, intradiscal inflammatory stimulation led to local mechanical hyperalgesia, demonstrating that pain can be initiated by inflammatory stimulation of the IVD. Gene expression of nociceptive markers (Ngf, Bdnf, Cgrp) and immunostaining for neuron ingrowth (PGP9.5) and sensitization (CGRP) in the IVD were also shown, suggesting a mechanism for the pain exhibited. To our knowledge, this rat IVD injury model is the first to demonstrate local pain behavior resulting from inflammatory stimulation of caudal IVDs. Future studies will examine the mechanistic contributions of inflammation in mediating pain.
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Affiliation(s)
- Lauren E. Lisiewski
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
- Department of Orthopedic Surgery, Columbia University, New York, NY, United States
| | - Hayley E. Jacobsen
- Department of Orthopedic Surgery, Columbia University, New York, NY, United States
| | - Dan C. M. Viola
- Department of Orthopedic Surgery, Columbia University, New York, NY, United States
| | - Hagar M. Kenawy
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
- Department of Orthopedic Surgery, Columbia University, New York, NY, United States
| | - Daniel N. Kiridly
- Department of Orthopedic Surgery, Northwell Health, Manhasset, NY, United States
| | - Nadeen O. Chahine
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
- Department of Orthopedic Surgery, Columbia University, New York, NY, United States
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Hu MH, Yang KC, Chen CW, Chu PH, Chang YL, Sun YH, Lin FH, Yang SH. Multilayer Electrospun-Aligned Fibroin/Gelatin Implant for Annulus Fibrosus Repair: An In Vitro and In Vivo Evaluation. Biomedicines 2022; 10:biomedicines10092107. [PMID: 36140208 PMCID: PMC9495938 DOI: 10.3390/biomedicines10092107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Annulus fibrosus (AF) damage is proven to prompt intervertebral disc (IVD) degeneration, and unrepaired AF lesions after surgical discectomy may boost herniation of the nucleus pulposus (NP) which may lead to further compression of neural structures. Moreover, vascular and neural ingrowth may occur within the defect which is known as a possible reason for discogenic pain. Due to a limited healing capacity, an effective strategy to repair and close the AF defect is necessary. In this study, using electrospinning technology, two nature polymers, silk fibroin and gelatin, were linked to imitate the unique lamellae structure of native AF. Our findings revealed that a multilayer electrospun-aligned fibroin/gelatin scaffold with mechanical and morphological properties mimicking those of native AF lamellae have been developed. The average diameter of the nanofiber is 162.9 ± 38.8 nm. The young’s modulus is around 6.70 MPa with an ultimate tensile strength of around 1.81 MP along preferred orientation. The in vitro test confirmed its biocompatibility and ability to maintain cell viability and colonization. Using a porcine model, we demonstrated that the multilayer-aligned scaffold offered a crucial microenvironment to induce collagen fibrous tissue production within native AF defect. In the implant-repaired AF, H&E staining showed homogeneous fibroblast-like cell infiltration at the repaired defect with very little vascular ingrowth, which was confirmed by magnetic resonance imaging findings. Picrosirius red staining and immunohistochemical staining against type I collagen revealed positively stained fibrous tissue in an aligned pattern within the implant-integrated site. Relative to the intact control group, the disc height index of the serial X-ray decreased significantly in both the injury control and implant group at 4 weeks and 8 weeks (p < 0.05) which indicated this scaffold may not reverse the degenerative process. However, the results of the discography showed that the effectiveness of annulus repair of the implant group is much superior to that of the untreated group. The scaffold, composed with nature fibroin/gelatin polymers, could potentially enhance AF healing that could prevent IVD recurrent herniation, as well as neural and neovascular ingrowth after discectomy surgeries.
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Affiliation(s)
- Ming-Hsiao Hu
- Department of Orthopedics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan
| | - Kai-Chiang Yang
- Department of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Chih-Wei Chen
- Department of Orthopedics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan
- Department of Biomedical Engineering, National Taiwan University, Taipei 106216, Taiwan
| | - Po-Han Chu
- Department of Biomedical Engineering, National Taiwan University, Taipei 106216, Taiwan
| | - Yun-Liang Chang
- Department of Orthopedics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan
| | - Yuan-Hui Sun
- Department of Orthopedics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan
| | - Feng-Huei Lin
- Department of Biomedical Engineering, National Taiwan University, Taipei 106216, Taiwan
| | - Shu-Hua Yang
- Department of Orthopedics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan
- Correspondence: ; Tel.: +886-2-2312-3456 (ext. 63981)
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Distinctive roles of tumor necrosis factor receptor type 1 and type 2 in a mouse disc degeneration model. J Orthop Translat 2021; 31:62-72. [PMID: 34934623 PMCID: PMC8648970 DOI: 10.1016/j.jot.2021.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/04/2021] [Accepted: 11/16/2021] [Indexed: 01/23/2023] Open
Abstract
Background Elevated tumor necrosis factor alpha (TNF-α) expression is correlated with the progression of intervertebral disc degeneration (IVDD). Progranulin binding to tumor necrosis factor receptor (TNFR) and its derivative Atsttrin are effective for treating inflammatory arthritis. We hypothesize that Atsttrin has a protective effect in IVDD through different roles of TNFR receptor type 1 (TNFR1) and TNFR receptor type 2 (TNFR2) in degenerated discs. Methods IVDD models were established in TNFR1−/−, TNFR2−/− mice and their control littermates. Nucleus Pulpous (NP) samples from human patients and IVDD murine models were evaluated by X-ray, micro-MRI, μCT, histological staining and immunofluorescence staining. NP cells isolated from wild-type (WT), TNFR1−/− and TNFR2−/− mice were treated with TNF-α or Atsttrin and then assayed by Western blotting, qRT–PCR, and ELISA. Results TNFR1 and TNFR2 expression was significantly elevated in the disc tissues of both human patients and IVDD murine models. TNFR1 knockout contributed to reduced disc degeneration. In contrast, TNFR2 knockout was associated with enhanced IVDD severity, including degraded cellular composition, increased cell apoptosis and elevated vertebral destruction. Atsttrin protected against IVDD in WT and TNFR1−/− mouse models but had no effect in TNFR2−/− IVDD models. Additionally, in vitro NP cell-based assays demonstrated that TNF-α-stimulated catabolism and Atsttrin-activated anabolism depended on TNFR1 and TNFR2, respectively. Conclusion TNFR1 is associated with the degenerative progression of IVDD, while TNFR2 contributes to the protective effect on the discs. Atsttrin protects against IVDD at least partially by inhibiting the TNFα/TNFR1 inflammatory/catabolic pathway and activating the TNFR2 protective/anabolic pathway. The translational potential of this article This study demonstrates that TNFR1 and TNFR2 have disparate roles in disc degeneration and hlights the potential use of Atsttrin as a therapeutic agent against IVDD in mice.
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Wang Y, Kang J, Guo X, Zhu D, Liu M, Yang L, Zhang G, Kang X. Intervertebral Disc Degeneration Models for Pathophysiology and Regenerative Therapy -Benefits and Limitations. J INVEST SURG 2021; 35:935-952. [PMID: 34309468 DOI: 10.1080/08941939.2021.1953640] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Aim:This review summarized the recent intervertebral disc degeneration (IDD) models and described their advantages and potential disadvantages, aiming to provide an overview for the current condition of IDD model establishment and new ideas for new strategies development of the treatment and prevention of IDD.Methods:The database of PubMed was searched up to May 2021 with the following search terms: nucleus pulposus, annulus fibrosus, cartilage endplate, intervertebral disc(IVD), intervertebral disc degeneration, animal model, organ culture, bioreactor, inflammatory reaction, mechanical stress, pathophysiology, epidemiology. Any IDD model-related articles were collected and summarized.Results:The best IDD model should have the features of repeatability, measurability and controllability. There are a lot of aspects to be considered in the selection of animals. Mice, rats and rabbits are low-cost and easy to access. However, their IVD size and shape are more different from human anatomy than pigs, cattle, sheep and goats. Organ culture models and animal models are two options in model establishment for IDD. The IVD organ culture model can put the studying variables into the controllable system for transitional research. Unlike the animal model, the organ culture model can only be used to evaluate the short-term effects and it is not applicable in simulating the complex process of IDD. Similarly, the animal models induced by different methods also have their advantages and disadvantages. For studying the mechanism of IDD and the corresponding treatment and prevention strategies, the selection of model should be individualized based on the purpose of each study.Conclusions:Various models have different characteristics and scope of application due to their different rationales and methods of construction. Currently, there is no experimental model that can perfectly mimic the degenerative process of human IVD. Personalized selection of appropriate model based on study purpose and experimental designing can enhance the possibility to obtain reliable and real results.
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Affiliation(s)
- Yidian Wang
- The Second Clinical Medical College, Lanzhou University, Lanzhou, P.R. China
| | - Jihe Kang
- The Second Clinical Medical College, Lanzhou University, Lanzhou, P.R. China
| | - Xudong Guo
- The Second Clinical Medical College, Lanzhou University, Lanzhou, P.R. China
| | - Daxue Zhu
- The Second Clinical Medical College, Lanzhou University, Lanzhou, P.R. China
| | - Mingqiang Liu
- The Second Clinical Medical College, Lanzhou University, Lanzhou, P.R. China
| | - Liang Yang
- The Second Clinical Medical College, Lanzhou University, Lanzhou, P.R. China
| | - Guangzhi Zhang
- The Second Clinical Medical College, Lanzhou University, Lanzhou, P.R. China
| | - Xuewen Kang
- The Second Clinical Medical College, Lanzhou University, Lanzhou, P.R. China.,Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, P.R. China.,The International Cooperation Base of Gansu Province for The Pain Research in Spinal Disorders, Gansu, P.R. China
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Promoting Nrf2/Sirt3-Dependent Mitophagy Suppresses Apoptosis in Nucleus Pulposus Cells and Protects against Intervertebral Disc Degeneration. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:6694964. [PMID: 34211633 PMCID: PMC8211502 DOI: 10.1155/2021/6694964] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/11/2021] [Accepted: 04/29/2021] [Indexed: 12/22/2022]
Abstract
One of the causes of intervertebral disc degeneration (IVDD) is nucleus pulposus cell (NPC) death, possibly apoptosis. In this study, we explored the role of the Nrf2/Sirt3 pathway and tert-butylhydroquinone (t-BHQ) in IVDD and elucidated the potential working mechanism. Reactive oxygen species (ROS) assay kits and malondialdehyde (MDA) assay kits were used to assess oxidative stress. Western blot and TUNEL staining were used to examine apoptosis. After siRNA against Nrf2 or lentivirus against Sirt3 was transfected into NPCs, the mechanism of the effect of the Nrf2/Sirt3 pathway on NPCs was assessed. The interaction between t-BHQ and its potential interacting protein NRF2 was further investigated through protein docking analysis. ChIP examined the binding affinity between Nrf2 and Sirt3 promoter. In vivo experiments, X-ray, hematoxylin-eosin (HE) staining, Safranin O staining, and immunohistochemistry were used to evaluate IVDD grades. The results demonstrated that activation of the Nrf2/Sirt3 pathway inhibited tert-butyl hydroperoxide- (TBHP-) induced apoptosis and mitochondrial dysfunction in vitro. In addition to apoptosis, upregulation of the Nrf2/Sirt3 pathway induced by t-BHQ restored TBHP-induced autophagic flux disturbances. However, its protective effect was reversed by chloroquine and Si-ATG5. Furthermore, t-BHQ ameliorated IVDD development in a rat model. In conclusion, our findings indicate that the Nrf2/Sirt3 pathway and its agonist represent a potential candidate for treating IVDD.
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Wu T, Li X, Jia X, Zhu Z, Lu J, Feng H, Shen B, Guo K, Li Y, Wang Q, Gao Z, Yu B, Ba Z, Huang Y, Wu D. Krüppel like factor 10 prevents intervertebral disc degeneration via TGF-β signaling pathway both in vitro and in vivo. J Orthop Translat 2021; 29:19-29. [PMID: 34094855 PMCID: PMC8141503 DOI: 10.1016/j.jot.2021.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 01/07/2023] Open
Abstract
Background Krüppel like factor 10 (KLF10), which is also known as TGF-β Inducible Early Gene-1 (TIEG1), plays a crucial role in regulating cell proliferation, cell apoptosis and inflammatory reaction in human carcinoma cells. Moreover, KLF10 knockout in mice leads to severe defects associated with muscle, skeleton and heart etc. However, the function of KLF10 in intervertebral disc degeneration (IVDD) has not been reported yet. Methods The relationship between KLF10 and IVDD were investigated in nucleus pulposus (NP) tissues from human and rats. The role of KLF10 in NP cells was explored via loss or gain of function experiments. IVDD rat models were constructed through needle puncture and the effects of KLF10 in IVDD model of rats were investigated via intradiscal injection of KLF10. Results We first found that KLF10 was lowly expressed in degenerative NP tissues and the level of KLF10 showed negative correlation with the disc grades of IVDD patients. Loss or gain of function experiments demonstrated that KLF10 could inhibit apoptosis and enhance migration and proliferation of IL-1β induced NP cells. And KLF10 overexpression reduced extracellular matrix (ECM) degeneration and enhanced ECM synthesis, whereas knockdown of KLF10 resulted in adverse effects. These positive effects of KLF10 could be reversed by the inhibition of TGF-β signaling pathway. In vivo, KLF10 overexpression alleviated IVDD. Conclusions This is the first study to reveal that KLF10 was dysregulated in IVDD and overexpressed KLF10 could alleviate IVDD by regulating TGF-β signaling pathway both in vitro and in vivo, which were involved in prohibiting apoptosis, promoting proliferation and migration of NP cells.The translational potential of this article: Overexpression of KLF10 might be an effective therapeutic strategy in the treatment of IVDD.
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Affiliation(s)
- Tongde Wu
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Xinhua Li
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Xuebing Jia
- Cancer Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Ziqi Zhu
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Jiawei Lu
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Hang Feng
- Department of Surgery of Spine and Spinal Cord, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, 450003, Henan, China
| | - Beiduo Shen
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Kai Guo
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Yuzhi Li
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Qiang Wang
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Zhiqiang Gao
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Bin Yu
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Zhaoyu Ba
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Yufeng Huang
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
| | - Desheng Wu
- Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China
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The Application of Mesenchymal Stromal Cells and Their Homing Capabilities to Regenerate the Intervertebral Disc. Int J Mol Sci 2021; 22:ijms22073519. [PMID: 33805356 PMCID: PMC8036861 DOI: 10.3390/ijms22073519] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/12/2022] Open
Abstract
Chronic low back pain (LBP) remains a challenging condition to treat, and especially to cure. If conservative treatment approaches fail, the current “gold standard” for intervertebral disc degeneration (IDD)-provoked back pain is spinal fusion. However, due to its invasive and destructive nature, the focus of orthopedic research related to the intervertebral disc (IVD) has shifted more towards cell-based therapeutic approaches. They aim to reduce or even reverse the degenerative cascade by mimicking the human body’s physiological healing system. The implementation of progenitor and/or stem cells and, in particular, the delivery of mesenchymal stromal cells (MSCs) has revealed significant potential to cure the degenerated/injured IVD. Over the past decade, many research groups have invested efforts to find ways to utilize these cells as efficiently and sustainably as possible. This narrative literature review presents a summary of achievements made with the application of MSCs for the regeneration of the IVD in recent years, including their preclinical and clinical applications. Moreover, this review presents state-of-the-art strategies on how the homing capabilities of MSCs can be utilized to repair damaged or degenerated IVDs, as well as their current limitations and future perspectives.
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Glaeser JD, Salehi K, Kanim LE, NaPier Z, Kropf MA, Cuéllar JM, Perry TG, Bae HW, Sheyn D. NF-κB inhibitor, NEMO-binding domain peptide attenuates intervertebral disc degeneration. Spine J 2020; 20:1480-1491. [PMID: 32413485 PMCID: PMC7494571 DOI: 10.1016/j.spinee.2020.04.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/16/2020] [Accepted: 04/28/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Nonphysiological mechanical loading and inflammation are both critically involved in intervertebral disc (IVD) degeneration, which is characterized by an increase in cytokines and matrix metalloproteases (MMPs) in the nucleus pulposus (NP). This process is known to be mediated by the NF-κB pathway. CLINICAL SIGNIFICANCE Current clinical treatments for IVD degeneration focus on the alleviation of symptoms rather than targeting the underlying mechanism. Injection of an NF-κB inhibitor may attenuate the progression of IVD degeneration. PURPOSE To investigate the ability of the NF-κB inhibitor, NEMO binding domain peptide (NBD), to alter IVD degeneration processes by reducing IL-1β- and mechanically-induced cytokine and MMP levels in human nucleus pulposus cells in vitro, and by attenuating IVD degeneration in an in vivo rat model for disc degeneration. STUDY DESIGN Experimental in vitro and animal model. PATIENT SAMPLE Discarded specimens of lumbar disc from 21 patients, and 12 Sprague Dawley rats. OUTCOME MEASURES Gene and protein expression, cell viability, µMRI and histology. METHODS IL-1β-prestimulated human nucleus pulposus cells embedded into fibrin constructs were loaded in the Flexcell FX-5000 compression system at 5 kPa and 1 Hz for 48 hours in the presence and absence of NBD. Unloaded hNPC/fibrin constructs served as controls. Cell viability in loaded and unloaded constructs was quantified, and gene and protein expression levels determined. For in vivo testing, a rat needle disc puncture model was employed. Experimental groups included injured discs with and without NBD injection and uninjured controls. Levels of disc degeneration were determined via µMRI, qPCR and histology. Funding sources include $48,874 NASS Young Investigator Research Grant and $119,174 NIH 5K01AR071512-02. There were no applicable financial relationships or conflicts of interest. RESULTS Mechanical compression of hNPC/fibrin constructs resulted in upregulation of MMP-3 and IL-8. Supplementation of media with 10 μM NBD during loading increased cell viability, and decreased MMP-3 gene and protein levels. IVD injury in rat resulted in an increase in MMP-3, IL-1β and IL-6 gene expression. Injections of 250 µg of NBD during disc injury resulted in decreased IL-6 gene expression. µMRI analysis demonstrated a reduction of disc hydration in response to disc needle injury, which was attenuated in NBD-treated IVDs. Histological evaluation showed NP and AF lesion in injured discs, which was attenuated by NBD injection. CONCLUSIONS The results of this study show NBD peptide's capacity to reduce IL-1β- and loading-induced MMP-3 levels in hNPC/fibrin constructs while increasing the cells' viability, and to attenuate IVD degeneration in rat, involving downregulation of IL-6. Therefore, NBD may be a potential therapeutic agent to treat IVD degeneration.
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Affiliation(s)
- Juliane D. Glaeser
- Orthopedic Stem Cell Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA,Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA,Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Khosrowdad Salehi
- Orthopedic Stem Cell Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA,Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA,Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Linda E.A. Kanim
- Orthopedic Stem Cell Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Zachary NaPier
- Orthopedic Stem Cell Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA,Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Michael A. Kropf
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jason M. Cuéllar
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Tiffany G. Perry
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Hyun W. Bae
- Orthopedic Stem Cell Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA,Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA,Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Dmitriy Sheyn
- Orthopedic Stem Cell Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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13
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The circular RNA circ-GRB10 participates in the molecular circuitry inhibiting human intervertebral disc degeneration. Cell Death Dis 2020; 11:612. [PMID: 32792505 PMCID: PMC7426430 DOI: 10.1038/s41419-020-02882-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 01/06/2023]
Abstract
Intervertebral disc degeneration (IDD) is the most common degenerative disease all over the word. Our previous study confirmed that the downregulated circ-GRB10 directly interacts with miR-328-5p, which modulate ERBB2 and leads to the degeneration of intervertebral disc; however, the underpinning mechanism of circ-GRB10 dysregulation remains unclear. We identified that FUS and demonstrated that circ-GBR10 biosynthesis in nucleus pulposus (NP) cells was promoted by FUS, whose expression was controlled by miR-141-3p. In addition, ERBB2 downregulation led to decreased Erk1/2 phosphorylation which enhanced miR-141-3p production in NP cells. In vivo data indicated that circ-GRB10 inhibited IDD in rat model. The present study revealed that miR-141-3p and FUS are key factors that regulate circ-GRB10 synthesis in NP cells. In addition, circ-GBR10 participates in the molecular circuitry that controls human IDD development. These findings provide a basis for further functional, diagnostic and therapeutic studies of circ-GRB10 in IDD.
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Glaeser JD, Tawackoli W, Ju DG, Yang JH, Kanim LEA, Salehi K, Yu V, Saidara E, Vit J, Khnkoyan Z, NaPier Z, Stone LS, Bae HW, Sheyn D. Optimization of a rat lumbar IVD degeneration model for low back pain. JOR Spine 2020; 3:e1092. [PMID: 32613167 PMCID: PMC7323460 DOI: 10.1002/jsp2.1092] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/16/2020] [Accepted: 05/03/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Intervertebral disc (IVD) degeneration is often associated with low back pain and radiating leg pain. The purpose of this study is to develop a reproducible and standardized preclinical model of painful lumbar IVD degeneration by evaluation of structural and behavioral changes in response to IVD injury with increasing needle sizes. This model can be used to develop new therapies for IVD degeneration. METHODS Forty-five female Sprague Dawley rats underwent anterior lumbar disc needle puncture at levels L4-5 and L5-6 under fluoroscopic guidance. Animals were randomly assigned to four different experimental groups: needle sizes of 18 Gauge (G), 21G, 23G, and sham control. To monitor the progression of IVD degeneration and pain, the following methods were employed: μMRI, qRT-PCR, histology, and biobehavioral analysis. RESULTS T1- and T2-weighted μMRI analysis showed a correlation between the degree of IVD degeneration and needle diameter, with the most severe degeneration in the 18G group. mRNA expression of markers for IVD degeneration markers were dysregulated in the 18G and 21G groups, while pro-nociceptive markers were increased in the 18G group only. Hematoxylin and Eosin (H&E) and Alcian Blue/Picrosirius Red staining confirmed the most pronounced IVD degeneration in the 18G group. Randall-Selitto and von Frey tests showed increased hindpaw sensitivity in the 18G group. CONCLUSION Our findings demonstrate that anterior disc injury with an 18G needle creates severe IVD degeneration and mechanical hypersensitivity, while the 21G needle results in moderate degeneration with no increased pain sensitivity. Therefore, needle sizes should be selected depending on the desired phenotype for the pre-clinical model.
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Affiliation(s)
- Juliane D. Glaeser
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Wafa Tawackoli
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of SurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Biomedical Imaging Research InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Derek G. Ju
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Jae H. Yang
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of Orthopedic SurgeryKorea University Guro HospitalSeoulSouth Korea
| | - Linda EA Kanim
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Khosrowdad Salehi
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Victoria Yu
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Evan Saidara
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Jean‐Phillipe Vit
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Zhanna Khnkoyan
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Zachary NaPier
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Laura S. Stone
- McGill University, Faculty of DentistryAlan Edwards Centre for Research on PainMontrealCanada
| | - Hyun W. Bae
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Dmitriy Sheyn
- Orthopaedic Stem Cell Research LaboratoryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Board of Governors Regenerative Medicine InstituteCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of OrthopedicsCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of SurgeryCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
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15
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Ohnishi T, Novais EJ, Risbud MV. Alterations in ECM signature underscore multiple sub-phenotypes of intervertebral disc degeneration. Matrix Biol Plus 2020; 6-7:100036. [PMID: 33543030 PMCID: PMC7852332 DOI: 10.1016/j.mbplus.2020.100036] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 12/18/2022] Open
Abstract
The intervertebral disc is a specialized connective tissue critical for absorption of mechanical loads and providing flexibility to the spinal column. The disc ECM is complex and plays a vital role in imparting tissue its biomechanical function. The central NP is primarily composed of large aggregating proteoglycans (PGs) while surrounding AF is composed of fibrillar collagens, I and II. Aggrecan and versican in particular, due to their high concentration of sulfated GAG chains form large aggregates with hyaluronic acid (HA) and provide water binding capacity to the disc. Degradation of aggrecan core protein due to aggrecanase and MMP activity, SNPs that affect number of chondroitin sulfate (CS) substitutions and alteration in enzymes critical in synthesis of CS chains can impair the aggrecan functionality. Similarly, levels of many matrix and matrix-related molecules e.g. Col2, Col9, HAS2, ccn2 are dysregulated during disc degeneration and genetic animal models have helped establish causative link between their expression and disc health. In the degenerating and herniated discs, increased levels of inflammatory cytokines such as TNF-α, IL-1β and IL-6 are shown to promote matrix degradation through regulating expression and activity of critical proteases and stimulate immune cell activation. Recent studies of different mouse strains have better elucidated the broader impact of spontaneous degeneration on disc matrix homeostasis. SM/J mice showed an increased cell apoptosis, loss of cell phenotype, and cleavage of aggrecan during early stages followed by tissue fibrosis evident by enrichment of several collagens, SLRPs and fibronectin. In summary, while disc degeneration encompasses wide spectrum of degenerative phenotypes extensive matrix degradation and remodeling underscores all of them. The intervertebral disc absorbs loads and provides flexibility to the spine. The ECM is complex and vital for imparting tissue its biomechanical function. Numerous types of proteoglycans and collagens designate the quality of the disc. Many matrix and matrix-related molecules are dysregulated during disc degeneration. Matrix degradation and remodeling underscores wide spectrum of phenotype.
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Affiliation(s)
- Takashi Ohnishi
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.,Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Emanuel J Novais
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.,Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga, Portugal
| | - Makarand V Risbud
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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16
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He M, Pang J, Sun H, Zheng G, Lin Y, Ge W. P14ARF inhibits regional inflammation and vascularization in intervertebral disc degeneration by upregulating TIMP3. Am J Physiol Cell Physiol 2020; 318:C751-C761. [PMID: 32023075 DOI: 10.1152/ajpcell.00271.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In this study, we identified P14 alternate reading frame (P14ARF) as a novel regulator of inflammation and vascularization in intervertebral disk degeneration (IVDD). We collected IVD tissues from IVDD patients and normal individuals for analysis of P14ARF expression. We also induced experimental IVDD by needle puncture injuries in the caudal intervertebral disks of Sprague-Dawley (SD) rats and achieved recombinant adenovirus-mediated P14ARF overexpression in experimental IVDD rats. Regulation relationships between P14ARF and tissue inhibitors of metalloproteinases-3 (TIMP3) were confirmed in P14ARF-overexpressed and TIMP3-depleted nucleus pulposus (NP) cells. Tube formation in vitro was evaluated in coculture systems of human umbilical vein endothelial cells (HUVECs) and rat degenerated NP cells (DNPCs). Inflammatory response was assessed from levels of TNF-α, IL-1β, and IL-6 and neovascularization from expression of endothelial growth factor (VEGF). The P14ARF and TIMP3 were downregulated in degenerated IVD tissue derived from patients and experimental IVDD rats. Overexpressed P14ARF suppressed inflammatory cytokine levels and vascularization. There was decreased in vitro tube formation in response to P14ARF overexpression and TIMP3 elevation. Finally, attenuated inflammatory responses and suppression of VEGF were achieved by P14ARF-mediated promotion of TIMP3 in rat DNPCs. Taken together, the present study reveals that P14ARF/TIMP3 modulation of inflammatory response and vascularization in the context of IVDD highlights a potential target for future therapeutic strategies.
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Affiliation(s)
- Mingwei He
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jinlei Pang
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Haiyan Sun
- Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Guanrong Zheng
- Department of Pain, Shengli Oilfield Central Hospital, Dongying, People’s Republic of China
| | - Yan Lin
- Department of Pain, Shengli Oilfield Central Hospital, Dongying, People’s Republic of China
| | - Weipeng Ge
- Department of Pain, Shengli Oilfield Central Hospital, Dongying, People’s Republic of China
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17
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Wang Y, Chen J, Ge J, Yan Q, Wu C, Yu H, Yang H, Zou J. Puncture Intervertebral Disc Degeneration Model: A Standard on Rabbit. J HARD TISSUE BIOL 2020. [DOI: 10.2485/jhtb.29.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Yingjie Wang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Jie Chen
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Jun Ge
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Qi Yan
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Cenhao Wu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Hao Yu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Huilin Yang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
| | - Jun Zou
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University
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18
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Hom WW, Tschopp M, Lin HA, Nasser P, Laudier DM, Hecht AC, Nicoll SB, Iatridis JC. Composite biomaterial repair strategy to restore biomechanical function and reduce herniation risk in an ex vivo large animal model of intervertebral disc herniation with varying injury severity. PLoS One 2019; 14:e0217357. [PMID: 31136604 PMCID: PMC6538241 DOI: 10.1371/journal.pone.0217357] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/09/2019] [Indexed: 12/14/2022] Open
Abstract
Back pain commonly arises from intervertebral disc (IVD) damage including annulus fibrosus (AF) defects and nucleus pulposus (NP) loss. Poor IVD healing motivates developing tissue engineering repair strategies. This study evaluated a composite injectable IVD biomaterial repair strategy using carboxymethylcellulose-methylcellulose (CMC-MC) and genipin-crosslinked fibrin (FibGen) that mimic NP and AF properties, respectively. Bovine ex vivo caudal IVDs were evaluated in cyclic compression-tension, torsion, and compression-to-failure tests to determine IVD biomechanical properties, height loss, and herniation risk following experimentally-induced severe herniation injury and discectomy (4 mm biopsy defect with 20% NP removed). FibGen with and without CMC-MC had failure strength similar to discectomy injury suggesting no increased risk compared to surgical procedures, yet no biomaterials improved axial or torsional biomechanical properties suggesting they were incapable of adequately restoring AF tension. FibGen had the largest failure strength and was further evaluated in additional discectomy injury models with varying AF defect types (2 mm biopsy, 4 mm cruciate, 4 mm biopsy) and NP removal volume (0%, 20%). All simulated discectomy defects significantly compromised failure strength and biomechanical properties. The 0% NP removal group had mean values of axial biomechanical properties closer to intact levels than defects with 20% NP removed but they were not statistically different and 0% NP removal also decreased failure strength. FibGen with and without CMC-MC failed at super-physiological stress levels above simulated discectomy suggesting repair with these tissue engineered biomaterials may perform better than discectomy alone, although restored biomechanical function may require additional healing with the potential application of these biomaterials as sealants and cell/drug delivery carriers.
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Affiliation(s)
- Warren W. Hom
- Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Melanie Tschopp
- Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Huizi A. Lin
- Department of Biomedical Engineering, The City College of New York, New York, New York, United States of America
| | - Philip Nasser
- Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Damien M. Laudier
- Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Andrew C. Hecht
- Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Steven B. Nicoll
- Department of Biomedical Engineering, The City College of New York, New York, New York, United States of America
| | - James C. Iatridis
- Leni & Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
- * E-mail:
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19
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Ji ML, Jiang H, Zhang XJ, Shi PL, Li C, Wu H, Wu XT, Wang YT, Wang C, Lu J. Preclinical development of a microRNA-based therapy for intervertebral disc degeneration. Nat Commun 2018; 9:5051. [PMID: 30487517 PMCID: PMC6262020 DOI: 10.1038/s41467-018-07360-1] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 10/22/2018] [Indexed: 12/13/2022] Open
Abstract
Understanding the molecular mechanisms regulating the maintenance and destruction of intervertebral disc may lead to the development of new therapies for intervertebral disc degeneration (IDD). Here we present evidence from miRNA microarray analyses of clinical data sets along with in vitro and in vivo experiments that miR-141 is a key regulator of IDD. Gain- and loss-of-function studies show that miR-141 drives IDD by inducing nucleus pulposus (NP) apoptosis. Furthermore, miR-141 KO in mice attenuated spontaneous and surgically induced IDD. Mechanistically, miR-141 promotes IDD development by targeting and depleting SIRT1, a negative regulator of NF-κB pathway. Therapeutically, upregulation or downregulation of miR-141 by nanoparticle delivery in IDD model aggravated or alleviated experimental IDD, respectively. Our findings reveal a novel mechanism by which miR-141, in part, promotes IDD progression by interacting with SIRT1/NF-κB pathway. Blockade of miR-141 in vivo may serve as a potential therapeutic approach in the treatment of IDD. Intervertebral disk degeneration (IDD) is characterized by changes in the nucleus pulposus (NP) extra cellular matrix that compromise disk structural integrity. In a miRNA screen of human IDD patient NP tissue, the authors identify deregulated miR-141 and show that direct injection of nanoparticle-coupled miR-141 into the NP alleviates IDD in mice.
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Affiliation(s)
- Ming-Liang Ji
- Department of Orthopaedic Surgery, Zhongda Hospital, School of Medicine, Southeast University, 210009, Nanjing, China
| | - Hua Jiang
- Department of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530000, China
| | - Xue-Jun Zhang
- Department of Orthopaedic Surgery, Zhongda Hospital, School of Medicine, Southeast University, 210009, Nanjing, China
| | - Pei-Liang Shi
- Key Laboratory of Model Animal for Disease Study of Ministry of Education, Model Animal Research Center, Collaborative Innovation Center of Genetics and Development, Nanjing University, Nanjing, 210093, China
| | - Chao Li
- Department of Orthopaedic Surgery, Zhongda Hospital, School of Medicine, Southeast University, 210009, Nanjing, China
| | - Hao Wu
- Department of Orthopaedic Surgery, Zhongda Hospital, School of Medicine, Southeast University, 210009, Nanjing, China
| | - Xiao-Tao Wu
- Department of Orthopaedic Surgery, Zhongda Hospital, School of Medicine, Southeast University, 210009, Nanjing, China
| | - Yun-Tao Wang
- Department of Orthopaedic Surgery, Zhongda Hospital, School of Medicine, Southeast University, 210009, Nanjing, China
| | - Chen Wang
- Department of Orthopaedic Surgery, Zhongda Hospital, School of Medicine, Southeast University, 210009, Nanjing, China
| | - Jun Lu
- Department of Orthopaedic Surgery, Zhongda Hospital, School of Medicine, Southeast University, 210009, Nanjing, China.
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20
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Frauchiger DA, Chan SCW, Benneker LM, Gantenbein B. Intervertebral disc damage models in organ culture: a comparison of annulus fibrosus cross-incision versus punch model under complex loading. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:1785-1797. [PMID: 29789921 DOI: 10.1007/s00586-018-5638-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 05/10/2018] [Accepted: 05/14/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Comparison of two annulus fibrosus injury models that mimic intervertebral disc (IVD) herniation, enabling the study of IVD behaviour under three loading regimes in a bovine organ culture model. METHODS An injury was induced by custom-designed cross-incision tool or a 2-mm biopsy punch in IVDs. Discs were cultured for 14 days under (1) complex (compression and torsion), (2) static, and (3) no load. Disc height, mitochondrial activity, DNA and glycosaminoglycan (GAG) contents, and disc stiffness under complex load were determined. Further, gene expression and histology analysis were performed. RESULTS While both injury models did not change the compressional stiffness of IVDs, cross-incision decreased disc height under complex load. Moreover, under complex load, the biopsy punch injury induced down-regulation of several anabolic, catabol ic, and inflammatory genes, whereas cross-incision did not significantly differ from control discs. However, DNA and GAG contents were in the range of the healthy control discs for both injury models but did show lower contents under no load and static load. Injury side and contralateral side of the IVD showed a similar behaviour on the biochemical assays tested. CONCLUSION Compressional stiffness, GAG and DNA contents, did not differ between injury models under complex load. This behaviour was partially attributed to the positive influence of complex loading on matrix regeneration and cell viability. However, disc height was reduced for the cross-incision. Relative gene expression changes of the inflammatory and anabolic genes for the biopsy punch approach might indicate that induced damage was too intense to trigger any inflammatory or repair response. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Daniela A Frauchiger
- Tissue and Organ Mechanobiology, Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, 3014, Bern, Switzerland
| | - Samantha C W Chan
- Tissue and Organ Mechanobiology, Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, 3014, Bern, Switzerland
| | - Lorin M Benneker
- Department of Orthopedic Surgery and Traumatology, Insel University Hospital, University of Bern, Freiburgstrasse 4, 3010, Bern, Switzerland
| | - Benjamin Gantenbein
- Tissue and Organ Mechanobiology, Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, 3014, Bern, Switzerland.
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