1
|
Nikkhoo M, Wang JL, Cheng CH, Parnianpour M, Khalaf K. Enzymatic denaturation versus excessive fatigue loading degeneration: Effects on the time-dependent response of the intervertebral disc. J Biomech 2024; 171:112159. [PMID: 38852480 DOI: 10.1016/j.jbiomech.2024.112159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 03/23/2024] [Accepted: 05/16/2024] [Indexed: 06/11/2024]
Abstract
Degenerative disc disease (DDD), regardless of its phenotype and clinical grade, is widely associated with low back pain (LBP), which remains the single leading cause of disability worldwide. This work provides a quantitative methodology for comparatively investigating artificial IVD degeneration via two popular approaches: enzymatic denaturation and fatigue loading. An in-vitro animal study was used to study the time-dependent responses of forty fresh juvenile porcine thoracic IVDs in conjunction with inverse and forward finite element (FE) simulations. The IVDs were dissected from 6-month-old-juvenile pigs and equally assigned to 5 groups (intact, denatured, low-level, medium-level, high-level fatigue loading). Upon preloading, a sinusoid cyclic load (Peak-to-peak/0.1-to-0.8 MPa) was applied (0.01-10 Hz), and dynamic-mechanical-analyses (DMA) was performed. The DMA outcomes were integrated with a robust meta-model analysis to quantify the poroelastic IVD characteristics, while specimen-specific FE models were developed to study the detailed responses. The results demonstrated that enzymatic denaturation had a more significantly pronounced effect on the resistive strength and shock attenuation capabilities of the intervertebral discs. This can be attributed to the simultaneous disruption of the collagen fibers and water-proteoglycan bonds induced by trypsin digestion. Fatigue loading, on the other hand, primarily influenced the disc's resistance to deformation in a frequency-dependent pattern, where alterations were most noticeable at low loading frequencies. This study confirms the intricate interplay between the biochemical changes induced by enzymatic processes and the mechanical behavior stemming from fatigue loading, suggesting the need for a comprehensive approach to closely mimic the interrelated multifaceted processes of human disc degeneration.
Collapse
Affiliation(s)
- Mohammad Nikkhoo
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Jaw-Lin Wang
- Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan; Center of Medical Devices, National Taiwan University, Taipei, Taiwan.
| | - Chih-Hsiu Cheng
- School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Mohamad Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Kinda Khalaf
- College of Medicine and Health Sciences, Khalifa University of Science and Technology, and Health Engineering Innovation Center, Abu Dhabi, United Arab Emirates.
| |
Collapse
|
2
|
Shnayder NA, Ashhotov AV, Trefilova VV, Novitsky MA, Medvedev GV, Petrova MM, Narodova EA, Kaskaeva DS, Chumakova GA, Garganeeva NP, Lareva NV, Al-Zamil M, Asadullin AR, Nasyrova RF. High-Tech Methods of Cytokine Imbalance Correction in Intervertebral Disc Degeneration. Int J Mol Sci 2023; 24:13333. [PMID: 37686139 PMCID: PMC10487844 DOI: 10.3390/ijms241713333] [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: 07/24/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
An important mechanism for the development of intervertebral disc degeneration (IDD) is an imbalance between anti-inflammatory and pro-inflammatory cytokines. Therapeutic and non-therapeutic approaches for cytokine imbalance correction in IDD either do not give the expected result, or give a short period of time. This explains the relevance of high-tech medical care, which is part of specialized care and includes the use of new resource-intensive methods of treatment with proven effectiveness. The aim of the review is to update knowledge about new high-tech methods based on cytokine imbalance correction in IDD. It demonstrates promise of new approaches to IDD management in patients resistant to previously used therapies, including: cell therapy (stem cell implantation, implantation of autologous cultured cells, and tissue engineering); genetic technologies (gene modifications, microRNA, and molecular inducers of IDD); technologies for influencing the inflammatory cascade in intervertebral discs mediated by abnormal activation of inflammasomes; senolytics; exosomal therapy; and other factors (hypoxia-induced factors; lysyl oxidase; corticostatin; etc.).
Collapse
Affiliation(s)
- Natalia A. Shnayder
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia; (A.V.A.); (V.V.T.)
- Shared Core Facilities “Molecular and Cell Technologies”, V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (E.A.N.); (D.S.K.)
| | - Azamat V. Ashhotov
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia; (A.V.A.); (V.V.T.)
| | - Vera V. Trefilova
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia; (A.V.A.); (V.V.T.)
- Department of Neurology, Hospital for War Veterans, 193079 Saint Petersburg, Russia;
| | - Maxim A. Novitsky
- Department of Neurology, Hospital for War Veterans, 193079 Saint Petersburg, Russia;
| | - German V. Medvedev
- R.R. Vreden National Medical Research Center for Traumatology and Orthopedics, 195427 Saint-Petersburg, Russia;
| | - Marina M. Petrova
- Shared Core Facilities “Molecular and Cell Technologies”, V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (E.A.N.); (D.S.K.)
| | - Ekaterina A. Narodova
- Shared Core Facilities “Molecular and Cell Technologies”, V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (E.A.N.); (D.S.K.)
| | - Daria S. Kaskaeva
- Shared Core Facilities “Molecular and Cell Technologies”, V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (M.M.P.); (E.A.N.); (D.S.K.)
| | - Galina A. Chumakova
- Department of Therapy and General Medical Practice with a Course of Postgraduate Professional Education, Altai State Medical University, 656038 Barnaul, Russia;
| | - Natalia P. Garganeeva
- Department of General Medical Practice and Outpatient Therapy, Siberian State Medical University, 634050 Tomsk, Russia;
| | - Natalia V. Lareva
- Department of Therapy of Faculty of Postgraduate Education, Chita State Medical Academy, 672000 Chita, Russia;
| | - Mustafa Al-Zamil
- Department of Physiotherapy, Faculty of Continuing Medical Education, Peoples’ Friendship University of Russia, 117198 Moscow, Russia;
| | - Azat R. Asadullin
- Department of Psychiatry and Addiction, Bashkir State Medical University, 450008 Ufa, Russia;
| | - Regina F. Nasyrova
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia; (A.V.A.); (V.V.T.)
- International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, 443016 Samara, Russia
| |
Collapse
|
3
|
Abstract
PURPOSE OF REVIEW Intervertebral disc degeneration is a contributor to chronic back pain. While a part of the natural aging process, early or rapid intervertebral disc degeneration is highly heritable. In this review, we summarize recent progress towards unraveling the genetics associated with this degenerative process. RECENT FINDINGS Use of large cohorts of patient data to conduct genome-wide association studies (GWAS) for intervertebral disc disease, and to lesser extent for aspects of this process, such as disc height, has resulted in a large increase in our understanding of the genetic etiology. Genetic correlation suggests that intervertebral disc disease is pleiotropic with risk factors for other diseases such as osteoporosis. The use of Mendelian Randomization is slowly establishing what are the causal relationships between intervertebral disc disease and factors previously correlated with this disease. The results from these human genetic studies highlight the complex nature of this disease and have the potential to lead to improved clinical management of intervertebral disc disease. Much additional work should now be focused on characterizing the causative relationship various co-morbid conditions have with intervertebral disc degeneration and on finding interventions to slow or halt this disease.
Collapse
Affiliation(s)
- David C Ou-Yang
- Colorado Program for Musculoskeletal Research, Department of Orthopedics, University of Colorado, Anschutz Medical Campus, 12800 E 19th Ave, MS8343, Aurora, CO, 80045, USA
| | - Christopher J Kleck
- Colorado Program for Musculoskeletal Research, Department of Orthopedics, University of Colorado, Anschutz Medical Campus, 12800 E 19th Ave, MS8343, Aurora, CO, 80045, USA
| | - Cheryl L Ackert-Bicknell
- Colorado Program for Musculoskeletal Research, Department of Orthopedics, University of Colorado, Anschutz Medical Campus, 12800 E 19th Ave, MS8343, Aurora, CO, 80045, USA.
| |
Collapse
|
4
|
Wu J, Chen Y, Liao Z, Liu H, Zhang S, Zhong D, Qiu X, Chen T, Su D, Ke X, Wan Y, Zhou T, Su P. Self-amplifying loop of NF-κB and periostin initiated by PIEZO1 accelerates mechano-induced senescence of nucleus pulposus cells and intervertebral disc degeneration. Mol Ther 2022; 30:3241-3256. [PMID: 35619555 PMCID: PMC9552911 DOI: 10.1016/j.ymthe.2022.05.021] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/05/2022] [Accepted: 05/21/2022] [Indexed: 11/21/2022] Open
Abstract
Abnormal mechanical load is a main risk factor of intervertebral disc degeneration (IDD), and cellular senescence is a pathological change in IDD. In addition, extracellular matrix (ECM) stiffness promotes human nucleus pulposus cells (hNPCs) senescence. However, the molecular mechanism underlying mechano-induced cellular senescence and IDD progression is not yet fully elucidated. First, we demonstrated that mechano-stress promoted hNPCs senescence via NF-κB signaling. Subsequently, we identified periostin as the main mechano-responsive molecule in hNPCs through unbiased sequencing, which was transcriptionally upregulated by NF-κB p65; moreover, secreted periostin by senescent hNPCs further promoted senescence and upregulated the catabolic process in hNPCs through activating NF-κB, forming a positive loop. Both Postn (encoding periostin) knockdown via siRNA and periostin inactivation via neutralizing antibodies alleviated IDD and NPCs senescence. Furthermore, we found that mechano-stress initiated the positive feedback of NF-κB and periostin via PIEZO1. PIEZO1 activation by Yoda1 induced severe IDD in rat tails without compression, and Postn knockdown alleviated the Yoda1-induced IDD in vivo. Here, we reported for the first time that self-amplifying loop of NF-κB and periostin initiated via PIEZO1 under mechano-stress accelerated NPCs senescence, leading to IDD. Furthermore, periostin neutralizing antibodies, which may serve as potential therapeutic agents for IDD, interrupted this loop.
Collapse
Affiliation(s)
- Jinna Wu
- Department of Spine Surgery, Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2(nd) Road, Yuexiu District, Guangzhou 510080, China
| | - Yuyu Chen
- Department of Spine Surgery, Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2(nd) Road, Yuexiu District, Guangzhou 510080, China
| | - Zhiheng Liao
- Department of Spine Surgery, Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2(nd) Road, Yuexiu District, Guangzhou 510080, China
| | - Hengyu Liu
- Department of Spine Surgery, Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2(nd) Road, Yuexiu District, Guangzhou 510080, China
| | - Shun Zhang
- Department of Spine Surgery, Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2(nd) Road, Yuexiu District, Guangzhou 510080, China
| | - Dongmei Zhong
- Institute of Precision Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Xianjian Qiu
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510120, China
| | - Taiqiu Chen
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510120, China
| | - Deying Su
- Guangdong Provincial Key Laboratory of Proteomics and State Key Laboratory of Organ Failure Research, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China
| | - Xiaona Ke
- Department of Spine Surgery, Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2(nd) Road, Yuexiu District, Guangzhou 510080, China
| | - Yong Wan
- Department of Spine Surgery, Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2(nd) Road, Yuexiu District, Guangzhou 510080, China
| | - Taifeng Zhou
- Department of Spine Surgery, Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2(nd) Road, Yuexiu District, Guangzhou 510080, China.
| | - Peiqiang Su
- Department of Spine Surgery, Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, The First Affiliated Hospital of Sun Yat-sen University, No.58 Zhongshan 2(nd) Road, Yuexiu District, Guangzhou 510080, China.
| |
Collapse
|
5
|
Single-Cell RNA-Seq Analysis of Cells from Degenerating and Non-Degenerating Intervertebral Discs from the Same Individual Reveals New Biomarkers for Intervertebral Disc Degeneration. Int J Mol Sci 2022; 23:ijms23073993. [PMID: 35409356 PMCID: PMC8999935 DOI: 10.3390/ijms23073993] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 02/07/2023] Open
Abstract
In this study, we used single-cell transcriptomic analysis to identify new specific biomarkers for nucleus pulposus (NP) and inner annulus fibrosis (iAF) cells, and to define cell populations within non-degenerating (nD) and degenerating (D) human intervertebral discs (IVD) of the same individual. Cluster analysis based on differential gene expression delineated 14 cell clusters. Gene expression profiles at single-cell resolution revealed the potential functional differences linked to degeneration, and among NP and iAF subpopulations. GO and KEGG analyses discovered molecular functions, biological processes, and transcription factors linked to cell type and degeneration state. We propose two lists of biomarkers, one as specific cell type, including C2orf40, MGP, MSMP, CD44, EIF1, LGALS1, RGCC, EPYC, HILPDA, ACAN, MT1F, CHI3L1, ID1, ID3 and TMED2. The second list proposes predictive IVD degeneration genes, including MT1G, SPP1, HMGA1, FN1, FBXO2, SPARC, VIM, CTGF, MGST1, TAF1D, CAPS, SPTSSB, S100A1, CHI3L2, PLA2G2A, TNRSF11B, FGFBP2, MGP, SLPI, DCN, MT-ND2, MTCYB, ADIRF, FRZB, CLEC3A, UPP1, S100A2, PRG4, COL2A1, SOD2 and MT2A. Protein and mRNA expression of MGST1, vimentin, SOD2 and SYF2 (p29) genes validated our scRNA-seq findings. Our data provide new insights into disc cells phenotypes and biomarkers of IVD degeneration that could improve diagnostic and therapeutic options.
Collapse
|
6
|
Wang C, Li Z, Zhang K, Zhang C. Self-assembling peptides with hBMP7 biological activity promote the differentiation of ADSCs into nucleus pulposus-like cells. J Orthop Surg Res 2022; 17:197. [PMID: 35366936 PMCID: PMC8976972 DOI: 10.1186/s13018-022-03102-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 03/17/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractFunctionalized self-assembling peptides, which display functional growth-factor bioactivity, can be designed by connecting the C-terminus of a pure self-assembling peptide with a short functional motif. In this study, we designed a novel functionalized peptide (RADA16-SNVI) in which an SNVI motif with hBMP-7 activity was conjugated onto the C-terminus of the RADA16 peptide via solid-phase synthesis. A mix of RADA16-SNVI and RADA16 solutions was used to create a functionalized peptide nanofiber scaffold (SNVI-RADA16). The hydrogels were analyzed by atomic force microscopy, circular dichroism, and scanning electron microscopy. The results showed that the SNVI-RADA16 solution effectively formed hydrogel. Next, we seeded the SNVI-RADA16 scaffold with adipose-derived stem cells (ADSCs) and investigated whether it displayed biological properties of nucleus pulposus tissue. SNVI-RADA16 displayed good biocompatibility with the ADSCs and induced their expression. Cells in SNVI-RADA16 gel had a greater secretion of the extracellular matrix marker collagen type II and aggrecan compared to ADSCs grown in monolayer and control gel (p < 0.05). The ratio of the aggrecan to collagen in cells in SNVI-RADA16 gel is approximately 29:1 after culture for 21 days. ADSCs in SNVI-RADA16 gels expressed the hypoxia-inducible factor 1α(HIF-1α) mRNA by real-time PCR. However, HIF-1 mRNA is absence in control gel and monolayer. The results suggested that the functionalized self-assembled peptide promotes the differentiation of ADSCs into nucleus pulposus-like cells. Thus, the designed SNVI-RADA16 self-assembling peptide hydrogel scaffolds may be suitable for application in nucleus pulposus tissue regeneration.
Collapse
|
7
|
Interleukin-38 in Health and Disease. Cytokine 2022; 152:155824. [DOI: 10.1016/j.cyto.2022.155824] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 12/13/2022]
|
8
|
Zoetebier B, Schmitz T, Ito K, Karperien M, Tryfonidou MA, Paez J. Injectable hydrogels for articular cartilage and nucleus pulposus repair: Status quo and prospects. Tissue Eng Part A 2022; 28:478-499. [PMID: 35232245 DOI: 10.1089/ten.tea.2021.0226] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Osteoarthritis (OA) and chronic low back pain due to degenerative (intervertebral) disc disease (DDD) are two of the major causes of disabilities worldwide, affecting hundreds of millions of people and leading to a high socioeconomic burden. Although OA occurs in synovial joints and DDD occurs in cartilaginous joints, the similarities are striking, with both joints showing commonalities in the nature of the tissues and in the degenerative processes during disease. Consequently, repair strategies for articular cartilage (AC) and nucleus pulposus (NP), the core of the intervertebral disc, in the context of OA and DDD share common aspects. One of such tissue engineering approaches is the use of injectable hydrogels for AC and NP repair. In this review, the state-of-the-art and recent developments in injectable hydrogels for repairing, restoring, and regenerating AC tissue suffering from OA and NP tissue in DDD are summarized focusing on cell-free approaches. The various biomaterial strategies exploited for repair of both tissues are compared, and the synergies that could be gained by translating experiences from one tissue to the other are identified.
Collapse
Affiliation(s)
- Bram Zoetebier
- University of Twente Faculty of Science and Technology, 207105, Developmental BioEngineering , Drienerlolaan 5, Enschede, Netherlands, 7500 AE;
| | - Tara Schmitz
- Eindhoven University of Technology, 3169, Department of Biomedical Engineering, Eindhoven, Noord-Brabant, Netherlands;
| | - Keita Ito
- Eindhoven University of Technology, Department of Biomedical Engineering, P.O. Box 513, GEMZ 4.115, Eindhoven, Netherlands, 5600 MB;
| | | | - Marianna A Tryfonidou
- Utrecht University, Faculty of Veterinary Medicine, Clinical Sciences of Companion Animals, Yalelaan 108, Utrecht, Netherlands, 3584 CM;
| | - Julieta Paez
- University of Twente Faculty of Science and Technology, 207105, Developmental Bioengineering, University of Twente P.O. Box 217, Enschede The Netherlands, Enschede, Netherlands, 7500 AE;
| |
Collapse
|
9
|
Volz M, Elmasry S, Jackson AR, Travascio F. Computational Modeling Intervertebral Disc Pathophysiology: A Review. Front Physiol 2022; 12:750668. [PMID: 35095548 PMCID: PMC8793742 DOI: 10.3389/fphys.2021.750668] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/15/2021] [Indexed: 12/31/2022] Open
Abstract
Lower back pain is a medical condition of epidemic proportion, and the degeneration of the intervertebral disc has been identified as a major contributor. The etiology of intervertebral disc (IVD) degeneration is multifactorial, depending on age, cell-mediated molecular degradation processes and genetics, which is accelerated by traumatic or gradual mechanical factors. The complexity of such intertwined biochemical and mechanical processes leading to degeneration makes it difficult to quantitatively identify cause–effect relationships through experiments. Computational modeling of the IVD is a powerful investigative tool since it offers the opportunity to vary, observe and isolate the effects of a wide range of phenomena involved in the degenerative process of discs. This review aims at discussing the main findings of finite element models of IVD pathophysiology with a special focus on the different factors contributing to physical changes typical of degenerative phenomena. Models presented are subdivided into those addressing role of nutritional supply, progressive biochemical alterations stemming from an imbalance between anabolic and catabolic processes, aging and those considering mechanical factors as the primary source that induces morphological change within the disc. Limitations of the current models, as well as opportunities for future computational modeling work are also discussed.
Collapse
Affiliation(s)
- Mallory Volz
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, United States
| | - Shady Elmasry
- Department of Biomechanics, Hospital for Special Surgery, New York, NY, United States
| | - Alicia R. Jackson
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL, United States
| | - Francesco Travascio
- Department of Mechanical and Aerospace Engineering, University of Miami, Coral Gables, FL, United States
- Department of Orthopaedic Surgery, University of Miami, Miami, FL, United States
- Max Biedermann Institute for Biomechanics, Mount Sinai Medical Center, Miami Beach, FL, United States
- *Correspondence: Francesco Travascio,
| |
Collapse
|
10
|
Ma X, Su J, Wang B, Jin X. Identification of Characteristic Genes in Whole Blood of Intervertebral Disc Degeneration Patients by Weighted Gene Coexpression Network Analysis (WGCNA). COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:6609901. [PMID: 35069789 PMCID: PMC8776439 DOI: 10.1155/2022/6609901] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 12/12/2022]
Abstract
Intervertebral disc degeneration (IDD) is a major cause of lower back pain. However, to date, the molecular mechanism of the IDD remains unclear. Gene expression profiles and clinical traits were downloaded from the Gene Expression Omnibus (GEO) database. Firstly, weighted gene coexpression network analysis (WGCNA) was used to screen IDD-related genes. Moreover, least absolute shrinkage and selection operator (LASSO) logistic regression and support vector machine (SVM) algorithms were used to identify characteristic genes. Furthermore, we further investigated the immune landscape by the Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) algorithm and the correlations between key characteristic genes and infiltrating immune cells. Finally, a competing endogenous RNA (ceRNA) network was established to show the regulatory mechanisms of characteristic genes. A total of 2458 genes were identified by WGCNA, and 48 of them were disordered. After overlapping the genes obtained by LASSO and SVM-RFE algorithms, genes including LINC01347, ASAP1-IT1, lnc-SEPT7L-1, B3GNT8, CHRNB3, CLEC4F, LOC102724000, SERINC2, and LOC102723649 were identified as characteristic genes of IDD. Moreover, differential analysis further identified ASAP1-IT1 and SERINC2 as key characteristic genes. Furthermore, we found that the expression of both ASAP1-IT1 and SERINC2 was related to the proportions of T cells gamma delta and Neutrophils. Finally, a ceRNA network was established to show the regulatory mechanisms of ASAP1-IT1 and SERINC2. In conclusion, the present study identified ASAP1-IT1 and SERINC2 as the key characteristic genes of IDD through integrative bioinformatic analyses, which may contribute to the diagnosis and treatment of IDD.
Collapse
Affiliation(s)
- Xiaobo Ma
- Department of Orthopaedics, Yuncheng Central Hospital, Shanxi University, Yuncheng, China 044000
| | - Junqiang Su
- Department of Orthopaedics, Yuncheng Central Hospital, Shanxi University, Yuncheng, China 044000
| | - Bo Wang
- Department of Orthopaedics, Yuncheng Central Hospital, Shanxi University, Yuncheng, China 044000
| | - Xiasheng Jin
- Department of Orthopaedics, Yuncheng Central Hospital, Shanxi University, Yuncheng, China 044000
| |
Collapse
|
11
|
Ekram S, Khalid S, Salim A, Khan I. Regulating the fate of stem cells for regenerating the intervertebral disc degeneration. World J Stem Cells 2021; 13:1881-1904. [PMID: 35069988 PMCID: PMC8727226 DOI: 10.4252/wjsc.v13.i12.1881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/12/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
Lower back pain is a leading cause of disability and is one of the reasons for the substantial socioeconomic burden. The etiology of intervertebral disc (IVD) degeneration is complicated, and its mechanism is still not completely understood. Factors such as aging, systemic inflammation, biochemical mediators, toxic environmental factors, physical injuries, and genetic factors are involved in the progression of its pathophysiology. Currently, no therapy for restoring degenerated IVD is available except pain management, reduced physical activities, and surgical intervention. Therefore, it is imperative to establish regenerative medicine-based approaches to heal and repair the injured disc, repopulate the cell types to retain water content, synthesize extracellular matrix, and strengthen the disc to restore normal spine flexion. Cellular therapy has gained attention for IVD management as an alternative therapeutic option. In this review, we present an overview of the anatomical and molecular structure and the surrounding pathophysiology of the IVD. Modern therapeutic approaches, including proteins and growth factors, cellular and gene therapy, and cell fate regulators are reviewed. Similarly, small molecules that modulate the fate of stem cells for their differentiation into chondrocytes and notochordal cell types are highlighted.
Collapse
Affiliation(s)
- Sobia Ekram
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Sindh, Pakistan
| | - Shumaila Khalid
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Sindh, Pakistan
| | - Asmat Salim
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Sindh, Pakistan
| | - Irfan Khan
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi 75270, Sindh, Pakistan
| |
Collapse
|
12
|
Marshall SL, Jacobsen TD, Emsbo E, Murali A, Anton K, Liu JZ, Lu HH, Chahine NO. Three-Dimensional-Printed Flexible Scaffolds Have Tunable Biomimetic Mechanical Properties for Intervertebral Disc Tissue Engineering. ACS Biomater Sci Eng 2021; 7:5836-5849. [PMID: 34843224 DOI: 10.1021/acsbiomaterials.1c01326] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The intervertebral disc (IVD) exhibits complex structure and biomechanical function, which supports the weight of the body and permits motion. Surgical treatments for IVD degeneration (e.g., lumbar fusion, disc replacement) often disrupt the mechanical environment of the spine which lead to adjacent segment disease. Alternatively, disc tissue engineering strategies, where cell-seeded hydrogels or fibrous biomaterials are cultured in vitro to promote matrix deposition, do not recapitulate the complex IVD mechanical properties. In this study, we use 3D printing of flexible polylactic acid (FPLA) to fabricate a viscoelastic scaffold with tunable biomimetic mechanics for whole spine motion segment applications. We optimized the mechanical properties of the scaffolds for equilibrium and dynamic moduli in compression and tension by varying fiber spacing or porosity, generating scaffolds with de novo mechanical properties within the physiological range of spine motion segments. The biodegradation analysis of the 3D printed scaffolds showed that FPLA exhibits lower degradation rate and thus has longer mechanical stability than standard PLA. FPLA scaffolds were biocompatible, supporting viability of nucleus pulposus (NP) cells in 2D and in FPLA+hydrogel composites. Composite scaffolds cultured with NP cells maintained baseline physiological mechanical properties and promoted matrix deposition up to 8 weeks in culture. Mesenchymal stromal cells (MSCs) cultured on FPLA adhered to the scaffold and exhibited fibrocartilaginous differentiation. These results demonstrate for the first time that 3D printed FPLA scaffolds have de novo viscoelastic mechanical properties that match the native IVD motion segment in both tension and compression and have the potential to be used as a mechanically stable and biocompatible biomaterial for engineered disc replacement.
Collapse
Affiliation(s)
- Samantha L Marshall
- Department of Orthopedic Surgery, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States
| | - Timothy D Jacobsen
- Department of Orthopedic Surgery, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States.,Department of Biomedical Engineering, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States
| | - Erik Emsbo
- Department of Biomedical Engineering, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States
| | - Archana Murali
- Department of Biomedical Engineering, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States
| | - Kevin Anton
- Department of Biomedical Engineering, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States
| | - Jessica Z Liu
- Department of Biomedical Engineering, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States
| | - Helen H Lu
- Department of Biomedical Engineering, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States
| | - Nadeen O Chahine
- Department of Orthopedic Surgery, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States.,Department of Biomedical Engineering, Columbia University, 650 West 168th Street, 1410, New York, New York 10031, United States
| |
Collapse
|
13
|
Lo WC, Chiou CS, Tsai FC, Chan CH, Mao S, Deng YH, Wu CY, Peng BY, Deng WP. Platelet-Derived Biomaterials Inhibit Nicotine-Induced Intervertebral Disc Degeneration Through Regulating IGF-1/AKT/IRS-1 Signaling Axis. Cell Transplant 2021; 30:9636897211045319. [PMID: 34586895 PMCID: PMC8485278 DOI: 10.1177/09636897211045319] [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] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Apart from aging process, adult intervertebral disc (IVD) undergoes various degenerative processes. However, the nicotine has not been well identified as a contributing etiology. According to a few studies, nicotine ingestion through smoking, air or clothing may significantly accumulate in active as well as passive smokers. Since nicotine has been demonstrated to adversely impact various physiological processes, such as sympathetic nervous system, leading to impaired vasculature and cellular apoptosis, we aimed to investigate whether nicotine could induce IVD degeneration. In particular, we evaluated dose-dependent impact of nicotine in vitro to simulate its chronic accumulation, which was later treated by platelet-derived biomaterials (PDB). Further, during in vivo studies, mice were subcutaneously administered with nicotine to examine IVD-associated pathologic changes. The results revealed that nicotine could significantly reduce chondrocytes and chondrogenic indicators (Sox, Col II and aggrecan). Mice with nicotine treatment also exhibited malformed IVD structure with decreased Col II as well as proteoglycans, which was significantly increased after PDB administration for 4 weeks. Mechanistically, PDB significantly restored the levels of IGF-1 signaling proteins, particularly pIGF-1 R, pAKT, and IRS-1, modulating ECM synthesis by chondrocytes. Conclusively, the PDB impart reparative and tissue regenerative processes by inhibiting nicotine-initiated IVD degeneration, through regulating IGF-1/AKT/IRS-1 signaling axis.
Collapse
Affiliation(s)
- Wen-Cheng Lo
- School of Medicine, College of Medicine, Taipei Medical University, Taipei.,Department of Neurosurgery, Taipei Medical University Hospital, Taipei
| | - Chi-Sheng Chiou
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei
| | - Feng-Chou Tsai
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301.,Division of Plastic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City
| | - Chun-Hao Chan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei
| | - Samantha Mao
- Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei
| | - Yue-Hua Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei
| | - Chia-Yu Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei
| | - Bou-Yue Peng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Division of Oral and Maxillofacial Surgery, Department of Dentistry, Taipei Medical University Hospital, Taipei
| | - Win-Ping Deng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei.,Stem Cell Research Center, College of Oral Medicine, Taipei Medical University, Taipei.,Graduate Institute of Basic Medicine, Fu Jen Catholic University, New Taipei City.,Department of Life Science, Tunghai University, Taichung
| |
Collapse
|
14
|
Wang X, Gawri R, Lei C, Lee J, Sowa G, Kandel R, Vo N. Inorganic polyphosphates stimulates matrix production in human annulus fibrosus cells. JOR Spine 2021; 4:e1143. [PMID: 34337332 PMCID: PMC8313173 DOI: 10.1002/jsp2.1143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 01/20/2021] [Accepted: 02/13/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Ubiquitously found in all life forms, inorganic polyphosphates (polyP) are linear polymers of repeated orthophosphate units. Present in intervertebral disc tissue, polyP was previously shown to increase extracellular matrix production in nucleus pulposus (NP) cells. However, the effects of polyP on human annulus fibrosus (hAF) cell metabolism is not known. METHODS AND RESULTS Here, hAF cells cultured in the presence of 0.5 to 1 mM polyP, chain length 22 (polyP-22), showed an increase in glycosaminoglycan content, proteoglycan and collagen synthesis, and aggrecan and collagen type 1 gene expression. Gene expression level of matrix metalloproteinases 1 was reduced while matrix metalloproteinases 3 level was increased in hAF cells treated with 1 mM polyP. Adenosine triphosphate (ATP) synthesis was also significantly increased in hAF cell culture 72 hours after the exposure to 1 mM polyP-22. CONCLUSIONS PolyP thus has both anabolic and bioenergetic effects in AF cells, similar to that observed in NP cells. Together, these results suggest polyP as a potential energy source and a metabolic regulator of disc cells.
Collapse
Affiliation(s)
- Xiangjiang Wang
- McGowan Institute for Regenerative MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryThe Sixth Affiliated Hospital of Guangzhou Medical UniversityQingyuanChina
- Department of OrthopedicsThe Third Affiliated Hospital of Southern Medical UniversityGuangzhouChina
| | - Rahul Gawri
- Lunenfeld‐Tanenbaum Research InstituteMount Sinai HospitalTorontoCanada
- Pathology and Laboratory MedicineMount Sinai HospitalTorontoCanada
- Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada
- Institute of Biomaterials and Biomedical EngineeringUniversity of TorontoTorontoCanada
| | - Changbin Lei
- Department of Orthopaedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryAffiliated Hospital of Xiangnan UniversityChenzhouChina
- Department of Clinical Medical Research CenterAffiliated Hospital of Xiangnan UniversityChenzhouChina
| | - Joon Lee
- McGowan Institute for Regenerative MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Gwendolyn Sowa
- Department of Orthopaedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Physical Medicine and RehabilitationUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Rita Kandel
- Lunenfeld‐Tanenbaum Research InstituteMount Sinai HospitalTorontoCanada
- Pathology and Laboratory MedicineMount Sinai HospitalTorontoCanada
- Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada
| | - Nam Vo
- McGowan Institute for Regenerative MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of PathologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
| |
Collapse
|
15
|
McMorran JG, Gregory DE. The effect of compressive loading rate on annulus fibrosus strength following endplate fracture. Med Eng Phys 2021; 93:17-26. [PMID: 34154771 DOI: 10.1016/j.medengphy.2021.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 04/14/2021] [Accepted: 05/18/2021] [Indexed: 02/07/2023]
Abstract
Intervertebral disc degeneration poses a considerable healthcare challenge, although the process is not well understood. Endplate fracture marks severe biomechanical compromise in a segment and may be correlated with degeneration of the disc. The purpose of this experiment was to investigate the relationship between endplate fracture velocity and damage to the annulus fibrosus. Following overnight-thawing, 27 frozen porcine cervical spines were dissected into motion segments (vertebra-disc-vertebra) and compressed until fracture at one of three loading rates (fast=15 mm/s, medium=1.5 mm/s, and slow=0.15 mm/s), or remained unfractured (control). Two annular samples were extracted and mechanically tested from each segment: 1) Bilayer samples underwent uniaxial tension to a stretch-ratio of 1.5; 2) Multilayer samples were delaminated with a 180° peel test configuration. All three rates of compression resulted in specimen fracture observed in the endplate and/or vertebra with varying degree of severity. Significant differences were detected in compressive strength and stiffness of motion segments when loaded at different rates of compression; interestingly these differences were not observed in the mechanical properties of the annulus fibrosus suggesting that at slow rates of loading, fracture of the endplate precedes destruction of the annulus fibrosus. In corroboration of these findings, gross and histological analysis reported no signs of annular disruption, strengthening assertions that annular damage did not occur.
Collapse
Affiliation(s)
- John G McMorran
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Ave West, Waterloo N2L3C5, ON Canada
| | - Diane E Gregory
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Ave West, Waterloo N2L3C5, ON Canada; Department of Health Sciences, Wilfrid Laurier University, 75 University Ave West, Waterloo N2L3C5, Ontario, Canada.
| |
Collapse
|
16
|
McMorran JG, Gregory DE. The Influence of Axial Compression on the Cellular and Mechanical Function of Spinal Tissues; Emphasis on the Nucleus Pulposus and Annulus Fibrosus: A Review. J Biomech Eng 2021; 143:1096334. [PMID: 33454730 DOI: 10.1115/1.4049749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Indexed: 11/08/2022]
Abstract
In light of the correlation between chronic back pain and intervertebral disc (IVD) degeneration, this literature review seeks to illustrate the importance of the hydraulic response across the nucleus pulposus (NP)-annulus fibrosus (AF) interface, by synthesizing current information regarding injurious biomechanics of the spine, stemming from axial compression. Damage to vertebrae, endplates (EPs), the NP, and the AF, can all arise from axial compression, depending on the segment's posture, the manner in which it is loaded, and the physiological state of tissue. Therefore, this movement pattern was selected to illustrate the importance of the bracing effect of a pressurized NP on the AF, and how injuries interrupting support to the AF may contribute to IVD degeneration.
Collapse
Affiliation(s)
- John G McMorran
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON N2 L 3C5
| | - Diane E Gregory
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON N2 L 3C5; Department of Health Sciences, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON N2 L 3C5
| |
Collapse
|
17
|
Kirnaz S, Capadona C, Lintz M, Kim B, Yerden R, Goldberg JL, Medary B, Sommer F, McGrath LB, Bonassar LJ, Härtl R. Pathomechanism and Biomechanics of Degenerative Disc Disease: Features of Healthy and Degenerated Discs. Int J Spine Surg 2021; 15:10-25. [PMID: 34376493 DOI: 10.14444/8052] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The human intervertebral disc (IVD) is a complex organ composed of fibrous and cartilaginous connective tissues, and it serves as a boundary between 2 adjacent vertebrae. It provides a limited range of motion in the torso as well as stability during axial compression, rotation, and bending. Adult IVDs have poor innate healing potential due to low vascularity and cellularity. Degenerative disc disease (DDD) generally arises from the disruption of the homeostasis maintained by the structures of the IVD, and genetic and environmental factors can accelerate the progression of the disease. Impaired cell metabolism due to pH alteration and poor nutrition may lead to autophagy and disruption of the homeostasis within the IVD and thus plays a key role in DDD etiology. To develop regenerative therapies for degenerated discs, future studies must aim to restore both anatomical and biomechanical properties of the IVDs. The objective of this review is to give a detailed overview about anatomical, radiological, and biomechanical features of the IVDs as well as discuss the structural and functional changes that occur during the degeneration process.
Collapse
Affiliation(s)
- Sertac Kirnaz
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Charisse Capadona
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Marianne Lintz
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York
| | - Byumsu Kim
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York
| | - Rachel Yerden
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York
| | - Jacob L Goldberg
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Branden Medary
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Fabian Sommer
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Lynn B McGrath
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| | - Lawrence J Bonassar
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York.,Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York
| | - Roger Härtl
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York
| |
Collapse
|
18
|
Singh S, Patel AA, Singh JR. Intervertebral Disc Degeneration: The Role and Evidence for Non-Stem-Cell-Based Regenerative Therapies. Int J Spine Surg 2021; 15:54-67. [PMID: 34376496 DOI: 10.14444/8055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The use of non-stem-cell-based regenerative medicine therapies for lumbar discogenic pain is an area of growing interest. Although the intervertebral disc is a largely avascular structure, cells located within the nucleus pulposus as well as annulus fibrosis could be targeted for regenerative and restorative treatments. Degenerative disc disease is caused by an imbalance of catabolic and anabolic events within the nucleus pulposus. As catabolic processes overwhelm the environment within the nucleus pulposus, proinflammatory cytokines increase in concentration and lead to further disc degeneration. Non-stem-cell-based therapies, which include growth factor therapy and other proteins, can lead to an increased production of collagen and proteoglycans within the disc.
Collapse
Affiliation(s)
- Saarang Singh
- Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Ankur A Patel
- Department of Physical Medicine and Rehabilitation, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York
| | - Jaspal R Singh
- Department of Rehabilitation Medicine, Weill Cornell Medical Center, New York, New York
| |
Collapse
|
19
|
De Pieri A, Byerley AM, Musumeci CR, Salemizadehparizi F, Vanderhorst MA, Wuertz‐Kozak K. Electrospinning and 3D bioprinting for intervertebral disc tissue engineering. JOR Spine 2020; 3:e1117. [PMID: 33392454 PMCID: PMC7770193 DOI: 10.1002/jsp2.1117] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022] Open
Abstract
Intervertebral disc (IVD) degeneration is a major cause of low back pain and represents a massive socioeconomic burden. Current conservative and surgical treatments fail to restore native tissue architecture and functionality. Tissue engineering strategies, especially those based on 3D bioprinting and electrospinning, have emerged as possible alternatives by producing cell-seeded scaffolds that replicate the structure of the IVD extracellular matrix. In this review, we provide an overview of recent advancements and limitations of 3D bioprinting and electrospinning for the treatment of IVD degeneration, focusing on future areas of research that may contribute to their clinical translation.
Collapse
Affiliation(s)
- Andrea De Pieri
- Department of Biomedical EngineeringRochester Institute of Technology (RIT)RochesterNew YorkUSA
| | - Ann M. Byerley
- Department of Biomedical EngineeringRochester Institute of Technology (RIT)RochesterNew YorkUSA
| | - Catherine R. Musumeci
- Department of Biomedical EngineeringRochester Institute of Technology (RIT)RochesterNew YorkUSA
| | | | - Maya A. Vanderhorst
- Department of Biomedical EngineeringRochester Institute of Technology (RIT)RochesterNew YorkUSA
| | - Karin Wuertz‐Kozak
- Department of Biomedical EngineeringRochester Institute of Technology (RIT)RochesterNew YorkUSA
- Schön Clinic Munich Harlaching, Spine CenterAcademic Teaching Hospital and Spine Research Institute of the Paracelsus Medical University Salzburg (AU)MunichGermany
| |
Collapse
|
20
|
Fernandes LM, Khan NM, Trochez CM, Duan M, Diaz-Hernandez ME, Presciutti SM, Gibson G, Drissi H. Single-cell RNA-seq identifies unique transcriptional landscapes of human nucleus pulposus and annulus fibrosus cells. Sci Rep 2020; 10:15263. [PMID: 32943704 PMCID: PMC7499307 DOI: 10.1038/s41598-020-72261-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/19/2020] [Indexed: 12/29/2022] Open
Abstract
Intervertebral disc (IVD) disease (IDD) is a complex, multifactorial disease. While various aspects of IDD progression have been reported, the underlying molecular pathways and transcriptional networks that govern the maintenance of healthy nucleus pulposus (NP) and annulus fibrosus (AF) have not been fully elucidated. We defined the transcriptome map of healthy human IVD by performing single-cell RNA-sequencing (scRNA-seq) in primary AF and NP cells isolated from non-degenerated lumbar disc. Our systematic and comprehensive analyses revealed distinct genetic architecture of human NP and AF compartments and identified 2,196 differentially expressed genes. Gene enrichment analysis showed that SFRP1, BIRC5, CYTL1, ESM1 and CCNB2 genes were highly expressed in the AF cells; whereas, COL2A1, DSC3, COL9A3, COL11A1, and ANGPTL7 were mostly expressed in the NP cells. Further, functional annotation clustering analysis revealed the enrichment of receptor signaling pathways genes in AF cells, while NP cells showed high expression of genes related to the protein synthesis machinery. Subsequent interaction network analysis revealed a structured network of extracellular matrix genes in NP compartments. Our regulatory network analysis identified FOXM1 and KDM4E as signature transcription factor of AF and NP respectively, which might be involved in the regulation of core genes of AF and NP transcriptome.
Collapse
Affiliation(s)
- Lorenzo M Fernandes
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, 30033, USA.,Atlanta VA Medical Center, Decatur, GA, USA
| | - Nazir M Khan
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, 30033, USA.,Atlanta VA Medical Center, Decatur, GA, USA
| | - Camila M Trochez
- Center for Integrative Genomics, Georgia Institute of Technology, Atlanta, GA, USA
| | - Meixue Duan
- Center for Integrative Genomics, Georgia Institute of Technology, Atlanta, GA, USA
| | - Martha E Diaz-Hernandez
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, 30033, USA.,Atlanta VA Medical Center, Decatur, GA, USA
| | - Steven M Presciutti
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, 30033, USA.,Atlanta VA Medical Center, Decatur, GA, USA
| | - Greg Gibson
- Center for Integrative Genomics, Georgia Institute of Technology, Atlanta, GA, USA
| | - Hicham Drissi
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, 30033, USA. .,Atlanta VA Medical Center, Decatur, GA, USA.
| |
Collapse
|
21
|
Akar E, Gemici AA. ROLE OF FACET JOINT ORIENTATION AND FACET TROPISM IN NONSPESIFIC LOW BACK PAIN. SANAMED 2020. [DOI: 10.24125/sanamed.v15i2.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
22
|
Molladavoodi S, McMorran J, Gregory D. Mechanobiology of annulus fibrosus and nucleus pulposus cells in intervertebral discs. Cell Tissue Res 2019; 379:429-444. [PMID: 31844969 DOI: 10.1007/s00441-019-03136-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 11/03/2019] [Indexed: 02/07/2023]
Abstract
Low back pain (LBP) is a chronic condition that can affect up to 80% of the global population. It is the number one cause of disability worldwide and has enormous socioeconomic consequences. One of the main causes of this condition is intervertebral disc (IVD) degeneration. IVD degenerative processes and inflammation associated with it has been the subject of many studies in both tissue and cell level. It is believed that the phenotype of the resident cells within the IVD directly affects homeostasis of the tissue. At the same time, IVDs located between vertebral bodies of spine are under various mechanical loading conditions in vivo. Therefore, investigating how mechanical loading can affect the behaviour of IVD cells has been a subject of many research articles. In this review paper, following a brief explanation of the anatomy of the IVD and its resident cells, we compiled mechanobiological studies of IVD cells (specifically, annulus fibrosus and nucleus pulposus cells) and synthesized and discussed the key findings of the field.
Collapse
Affiliation(s)
- Sara Molladavoodi
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada.,Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - John McMorran
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Diane Gregory
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada. .,Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada.
| |
Collapse
|
23
|
Biczo A, Szita J, McCall I, Varga PP, Lazary A. Association of vitamin D receptor gene polymorphisms with disc degeneration. 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 2019; 29:596-604. [PMID: 31768839 DOI: 10.1007/s00586-019-06215-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 09/23/2019] [Accepted: 11/07/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Numerous candidate genes and single-nucleotide polymorphisms (SNPs) have been identified in the background of lumbar disc degeneration (LDD). However, in most of these underpowered studies, definitions of LDD are inconsistent; moreover, many of the findings have not been replicated and are contradictory. Our aim was to characterize LDD by well-defined phenotypes and possible endophenotypes and analyse the association between these and candidate vitamin D receptor (VDR) gene polymorphisms on a large (N = 1426) dataset. METHODS Seven candidate VDR SNPs were genotyped. Individual association, haplotype and gene-gene interaction analyses were performed. All degenerative endophenotypes were significantly associated with one or more candidate VDR gene variants. RESULTS Haplotype analyses confirmed the association between the 3'-end VDR variants (BsmI, ApaI, TaqI) and Modic changes as well as the relationship of 5'-end variants (Cdx2, A1012G) with endplate defects. We also found significant interactions between the 3'- and 5'-end regulatory regions and endplate defects. Based on our results, VDR and its gene variants are highly associated with specific degenerative LDD endophenotypes. CONCLUSION Understanding relationships between phenotype and gene variants is crucial for describing the pathways leading to the multifactorial, polygenic degeneration process and LDD-related conditions. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Adam Biczo
- National Center for Spinal Disorders, Kiralyhago Street 1, Budapest, 1126, Hungary.,Semmelweis University School of Ph.D. Studies, Ulloi Street 26, Budapest, 1086, Hungary
| | - Julia Szita
- National Center for Spinal Disorders, Kiralyhago Street 1, Budapest, 1126, Hungary.,Semmelweis University School of Ph.D. Studies, Ulloi Street 26, Budapest, 1086, Hungary
| | - Iain McCall
- Department of Diagnostic Imaging, The Robert Jones & Agnes Hunt Orthopaedic and District Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - Peter Pal Varga
- National Center for Spinal Disorders, Kiralyhago Street 1, Budapest, 1126, Hungary
| | | | - Aron Lazary
- National Center for Spinal Disorders, Kiralyhago Street 1, Budapest, 1126, Hungary.
| |
Collapse
|
24
|
Penolazzi L, Lambertini E, Bergamin LS, Roncada T, De Bonis P, Cavallo M, Piva R. MicroRNA-221 silencing attenuates the degenerated phenotype of intervertebral disc cells. Aging (Albany NY) 2019; 10:2001-2015. [PMID: 30130742 PMCID: PMC6128426 DOI: 10.18632/aging.101525] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 08/08/2018] [Indexed: 02/07/2023]
Abstract
The aim of this study was to investigate the role of an antichondrogenic factor, MIR221 (miR-221), in intervertebral disc degeneration (IDD), and provide basic information for the development of a therapeutic strategy for the disc repair based on specific nucleic acid based drugs, such as miR-221 silencing. We established a relatively quick protocol to minimize artifacts from extended in vitro culture, without selecting the different types of cells from intervertebral disc (IVD) or completely disrupting extracellular matrix (ECM), but by using the whole cell population with a part of resident ECM. During the de-differentiation process miR-221 expression significantly increased. We demonstrated the effectiveness of miR-221 silencing in driving the cells towards chondrogenic lineage. AntagomiR-221 treated cells showed in fact a significant increase of expression of typical chondrogenic markers including COL2A1, ACAN and SOX9, whose loss is associated with IDD. Moreover, antagomiR-221 treatment restored FOXO3 expression and increased TRPS1 expression levels attenuating the severity grade of degeneration, and demonstrating in a context of tissue degeneration and inflammation not investigated before, that FOXO3 is target of miR-221. Data of present study are promising in the definition of new molecules useful as potential intradiscal injectable biological agents.
Collapse
Affiliation(s)
- Letizia Penolazzi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Elisabetta Lambertini
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Tosca Roncada
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Pasquale De Bonis
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
| | - Michele Cavallo
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
| | - Roberta Piva
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| |
Collapse
|
25
|
Li X, Lou Z, Liu J, Li H, Lei Y, Zhao X, Zhang F. Upregulation of the long noncoding RNA lncPolE contributes to intervertebral disc degeneration by negatively regulating DNA polymerase epsilon. Am J Transl Res 2019; 11:2843-2854. [PMID: 31217858 PMCID: PMC6556648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 03/08/2019] [Indexed: 06/09/2023]
Abstract
Long noncoding RNAs (lncRNAs) are critical regulators of gene transcription. Our previous results have demonstrated that iron deficiency accelerates intervertebral disc degeneration (IDD) by affecting the stability of the DNA polymerase epsilon (Polε) complex. Here, we discovered that the novel lncRNA lncPolE functions as a negative regulator of Polε. The expression of lncPolE in IDD tissues was upregulated compared to its expression in healthy control tissues, and this was in contrast to the PolE1 expression levels. The increased lncPolE level was significantly correlated with the severity of IDD. Ectopic expression of lncPolE in human nucleus pulposus cells (hNPCs) was able to decrease PolE1 levels and cause apoptosis, while the specific knockdown of lncPolE in primary NP cells (pNPCs) from IDD patients can restore PolE1 levels. Interestingly, iron depletion or supplementation can affect the expression of lncPolE. Further analyses indicated that the downregulation of DNA methylation in the promoter region of lncPolE caused its overexpression. Collectively, our results suggest that the aberrant expression of lncPolE contributes to the pathogenesis of IDD by negatively regulating PolE1 in iron deficient conditions, and this may provide a new avenue to alleviate IDD progression in clinical treatment.
Collapse
Affiliation(s)
- Xingguo Li
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical UniversityKunming 650032, Yunnan, China
| | - Zhenkai Lou
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical UniversityKunming 650032, Yunnan, China
| | - Jie Liu
- Department of Orthopedics, The First People’s Hospital of YunnanKunming 650032, Yunnan, China
| | - Hongkun Li
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical UniversityKunming 650032, Yunnan, China
| | - Yu Lei
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical UniversityKunming 650032, Yunnan, China
| | - Xueling Zhao
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical UniversityKunming 650032, Yunnan, China
| | - Fan Zhang
- Department of Orthopedics, The First Affiliated Hospital of Kunming Medical UniversityKunming 650032, Yunnan, China
| |
Collapse
|
26
|
Chen Z, Han Y, Deng C, Chen W, Jin L, Chen H, Wang K, Shen H, Qian L. Inflammation‐dependent downregulation of miR‐194‐5p contributes to human intervertebral disc degeneration by targeting CUL4A and CUL4B. J Cell Physiol 2019; 234:19977-19989. [PMID: 30945295 DOI: 10.1002/jcp.28595] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/07/2019] [Accepted: 03/19/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Zhi Chen
- Department of Spine Surgery Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
| | - Yingchao Han
- Department of Spine Surgery Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
| | - Chao Deng
- Department of Spine Surgery Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
| | - Wei Chen
- Department of Spine Surgery Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
| | - Linyu Jin
- Department of Spine Surgery Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
| | - Hao Chen
- Department of Spine Surgery Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
| | - Kun Wang
- Department of Spine Surgery Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
| | - Hongxing Shen
- Department of Spine Surgery Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
| | - Lie Qian
- Department of Spine Surgery Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
| |
Collapse
|
27
|
Rider SM, Mizuno S, Kang JD. Molecular Mechanisms of Intervertebral Disc Degeneration. Spine Surg Relat Res 2018; 3:1-11. [PMID: 31435545 PMCID: PMC6690117 DOI: 10.22603/ssrr.2017-0095] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 01/24/2018] [Indexed: 12/25/2022] Open
Abstract
Intervertebral disc degeneration is a well-known cause of disability, the result of which includes neck and back pain with associated mobility limitations. The purpose of this article is to provide an overview of the known molecular mechanisms through which intervertebral disc degeneration occurs as a result of complex interactions of exogenous and endogenous stressors. This review will focus on some of the identified molecular changes leading to the deterioration of the extracellular matrix of both the annulus fibrosus and nucleus pulposus. In addition, we will provide a summation of our current knowledge supporting the role of associated DNA and intracellular damage, cellular senescence's catabolic effects, oxidative stress, and the cell's inappropriate response to damage in contributing to intervertebral disc degeneration. Our current understanding of the molecular mechanisms through which intervertebral disc degeneration occurs provides us with abundant insight into how physical and chemical changes exacerbate the degenerative process of the entire spine. Furthermore, we will describe some of the related molecular targets and therapies that may contribute to intervertebral repair and regeneration.
Collapse
Affiliation(s)
- Sean M Rider
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shuichi Mizuno
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - James D Kang
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
28
|
Understanding the molecular biology of intervertebral disc degeneration and potential gene therapy strategies for regeneration: a review. Gene Ther 2018; 25:67-82. [DOI: 10.1038/s41434-018-0004-0] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/30/2017] [Accepted: 01/03/2018] [Indexed: 12/13/2022]
|
29
|
Actis JA, Nolasco LA, Gates DH, Silverman AK. Lumbar loads and trunk kinematics in people with a transtibial amputation during sit-to-stand. J Biomech 2018; 69:1-9. [DOI: 10.1016/j.jbiomech.2017.12.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 12/20/2017] [Accepted: 12/28/2017] [Indexed: 11/16/2022]
|
30
|
Wiet MG, Piscioneri A, Khan SN, Ballinger MN, Hoyland JA, Purmessur D. Mast Cell-Intervertebral disc cell interactions regulate inflammation, catabolism and angiogenesis in Discogenic Back Pain. Sci Rep 2017; 7:12492. [PMID: 28970490 PMCID: PMC5624870 DOI: 10.1038/s41598-017-12666-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/19/2017] [Indexed: 01/07/2023] Open
Abstract
Low back pain (LBP) is a widespread debilitating disorder of significant socio-economic importance and intervertebral disc (IVD) degeneration has been implicated in its pathogenesis. Despite its high prevalence the underlying causes of LBP and IVD degeneration are not well understood. Recent work in musculoskeletal degenerative diseases such as osteoarthritis have revealed a critical role for immune cells, specifically mast cells in their pathophysiology, eluding to a potential role for these cells in the pathogenesis of IVD degeneration. This study sought to characterize the presence and role of mast cells within the IVD, specifically, mast cell-IVD cell interactions using immunohistochemistry and 3D in-vitro cell culture methods. Mast cells were upregulated in painful human IVD tissue and induced an inflammatory, catabolic and pro-angiogenic phenotype in bovine nucleus pulposus and cartilage endplate cells at the gene level. Healthy bovine annulus fibrosus cells, however, demonstrated a protective role against key inflammatory (IL-1β and TNFα) and pro-angiogenic (VEGFA) genes expressed by mast cells, and mitigated neo-angiogenesis formation in vitro. In conclusion, mast cells can infiltrate and elicit a degenerate phenotype in IVD cells, enhancing key disease processes that characterize the degenerate IVD, making them a potential therapeutic target for LBP.
Collapse
Affiliation(s)
- Matthew G Wiet
- Department of Biomedical Engineering, The Ohio State University, Columbus Ohio, 201 Davis Heart and Lung Research Institute, 473 W 12th Avenue, Columbus, Ohio, 43210, USA
| | - Andrew Piscioneri
- Department of Biomedical Engineering, The Ohio State University, Columbus Ohio, 201 Davis Heart and Lung Research Institute, 473 W 12th Avenue, Columbus, Ohio, 43210, USA
| | - Safdar N Khan
- Department of Orthopedics, The Ohio State University Wexner Medical Center, 1070 OSU CarePoint East, 543 Taylor Avenue, Columbus, Ohio, 43203, USA
| | - Megan N Ballinger
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University, 201 Davis Heart and Lung Research Institute, 473 West 12th Avenue, Columbus, Ohio, 43210, USA
| | - Judith A Hoyland
- Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom
- NIHR Manchester Musculoskeletal Biomedical Research Centre, Manchester Academic Health Science Centre, Central Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Devina Purmessur
- Department of Biomedical Engineering, The Ohio State University, Columbus Ohio, 201 Davis Heart and Lung Research Institute, 473 W 12th Avenue, Columbus, Ohio, 43210, USA.
- Department of Orthopedics, The Ohio State University Wexner Medical Center, 1070 OSU CarePoint East, 543 Taylor Avenue, Columbus, Ohio, 43203, USA.
| |
Collapse
|
31
|
Abstract
STUDY DESIGN Experimental in vivo and in vitro study of intervertebral disc (IVD) degeneration and the mechanism exploration. OBJECTIVE This report aims to verify the expression of Sirt1 in IVD degeneration of different grades and explore its potential mechanism in human nucleus pulposus cells. SUMMARY OF BACKGROUND DATA Silent mating type information regulator 2 homolog 1 (Sirt1) has draw immense attention because of its influence on a variety of aging-related diseases. The present study is a continuation and complement of our former in vivo study of Sirt1 and its role in puncture-induced rodent disc degeneration model. METHODS Sirt1 protein expression level and histological morphology were evaluated in the discs of different degeneration levels, which is graded according to the Pfirrmann grading scale. Then the mRNA and protein expression levels of type II collagen, MMP-13, ADAMTS-5, p21, p16, cell proliferation, and apoptosis ratio were tested in vitro nucleus pulposus cells that expressed different levels of Sirt1 by reverse transcription polymerase chain reaction, western blot analysis, CCK-8 assay, and flow cytometry analysis. RESULTS Sirt1 protein expression level decreased in the discs of high Pfirrmann grade and the score of histological morphology of human intervertebral disc is consistent with the Pfirrmann grade. Besides, when resveratrol activated Sirt1, nucleus pulposus cells proliferation increased while the cell apoptosis ratio decreased; the expression of type II collagen increased while MMP-13, ADAMTS-5 decreased. It showed the opposite results when the cells were transfected by Sirt1 siRNA. In addition, the expression of both p21 and p16 decreased when Sirt1 was activated. CONCLUSION Sirt1 is a protective mediator in IVD degeneration and the expression of Sirt1 decreases in degenerative disc. Activation of Sirt1 works on suppressing cellular senescence, promoting cell proliferation, and restraining the apoptosis of nucleus pulposus cells. LEVEL OF EVIDENCE N/A.
Collapse
|
32
|
Multimodal Medical Imaging Fusion for Patient Specific Musculoskeletal Modeling of the Lumbar Spine System in Functional Posture. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0243-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
33
|
Olivencia O, Shamash K, Kreymer B, Kolber MJ. Post-Rehabilitation Considerations for Clients With a Cervical Disc Herniation. Strength Cond J 2017. [DOI: 10.1519/ssc.0000000000000237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
34
|
Biomechanical Effects of Human Lumbar Discography: In Vitro Experiments and Their Finite Element Validation. Clin Spine Surg 2017; 30:E219-E225. [PMID: 28323703 DOI: 10.1097/bsd.0000000000000077] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
STUDY DESIGN An experimental and computational finite element analysis of human lumbar spine discography and its resulting effects on disk biomechanics. OBJECTIVE To characterize the changes in stress and displacement of the human lumbar spine disks after puncture due to discography. SUMMARY OF BACKGROUND DATA Discography of the intervertebral disk (IVD) may be used to diagnose pathology of the disk and determine whether it may be a source for chronic back pain. It has recently been suggested that discography may lead to IVD degeneration, and has been a cause of controversy among spine care physicians. MATERIALS AND METHODS Both in vivo experiment using cadaveric specimens and a finite element model of the same L3-L5 lumbar spine was developed using computed tomography scans. Discography was simulated in the model as an area in the disk affected by needle puncture. The material properties in the nucleus pulposus were adjusted to match experimental data both before and after puncture. RESULTS Puncture of the IVD leads to increased deformation and increased stresses in the annulus fibrosis region of the disk. Pressure in the nucleus pulposus was found to decrease after puncture. Experimental and computational results correlated well. CONCLUSIONS Puncturing the IVD changes disk biomechanics and hence may lead to progressive spine degenerations in particular in the punctured disks.
Collapse
|
35
|
Miller SL, Coughlin DG, Waldorff EI, Ryaby JT, Lotz JC. Pulsed electromagnetic field (PEMF) treatment reduces expression of genes associated with disc degeneration in human intervertebral disc cells. Spine J 2016; 16:770-6. [PMID: 26780754 DOI: 10.1016/j.spinee.2016.01.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 11/17/2015] [Accepted: 01/01/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Pulsed electromagnetic field (PEMF) therapies have been applied to stimulate bone healing and to reduce the symptoms of arthritis, but the effects of PEMF on intervertebral disc (IVD) biology is unknown. PURPOSE The purpose of this study was to determine how PEMF affects gene expression of IVD cells in normal and inflammatory environments. STUDY DESIGN/SETTING This was an in vitro human cell culture and microarray gene expression study. METHODS Human annulus fibrosus (AF) and nucleus pulposus (NP) cells were separately encapsulated in alginate beads and exposed to interleukin 1α (IL-1α) (10 ng/mL) to stimulate the inflammatory environment associated with IVD degeneration and/or stimulated by PEMF for 4 hours daily for up to 7 days. RNA was isolated from each treatment group and analyzed via microarray to assess IL-1α- and PEMF-induced changes in gene expression. RESULTS Although PEMF treatment did not completely inhibit the effects of IL-1α, PEMF treatment lessened the IL-1α-induced upregulation of genes expressed in degenerated IVDs. Consistent with our previous results, after 4 days, PEMF tended to reduce IL-1α-associated gene expression of IL-6 (25%, p=.07) in NP cells and MMP13 (26%, p=.10) in AF cells. Additionally, PEMF treatment significantly diminished IL-1α-induced gene expression of IL-17A (33%, p=.01) and MMP2 (24%, p=.006) in NP cells and NFκB (11%, p=.04) in AF cells. CONCLUSIONS These results demonstrate that IVD cells are responsive to PEMF and motivate future studies to determine whether PEMF may be helpful for patients with IVD degeneration.
Collapse
Affiliation(s)
- Stephanie L Miller
- Department of Orthopaedic Surgery, University of California, 513 Parnassus Ave, S-1161, Box 0514, San Francisco, CA, 94143, USA
| | - Dezba G Coughlin
- Department of Orthopaedic Surgery, University of California, 513 Parnassus Ave, S-1161, Box 0514, San Francisco, CA, 94143, USA
| | - Erik I Waldorff
- Orthofix, Inc., 3451 Plano Parkway, Lewisville, TX 75056, USA
| | - James T Ryaby
- Orthofix, Inc., 3451 Plano Parkway, Lewisville, TX 75056, USA
| | - Jeffrey C Lotz
- Department of Orthopaedic Surgery, University of California, 513 Parnassus Ave, S-1161, Box 0514, San Francisco, CA, 94143, USA.
| |
Collapse
|
36
|
Stolworthy DK, Bowden AE, Roeder BL, Robinson TF, Holland JG, Christensen SL, Beatty AM, Bridgewater LC, Eggett DL, Wendel JD, Stieger-Vanegas SM, Taylor MD. MRI evaluation of spontaneous intervertebral disc degeneration in the alpaca cervical spine. J Orthop Res 2015; 33:1776-83. [PMID: 26135031 DOI: 10.1002/jor.22968] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 06/16/2015] [Indexed: 02/04/2023]
Abstract
Animal models have historically provided an appropriate benchmark for understanding human pathology, treatment, and healing, but few animals are known to naturally develop intervertebral disc degeneration. The study of degenerative disc disease and its treatment would greatly benefit from a more comprehensive, and comparable animal model. Alpacas have recently been presented as a potential large animal model of intervertebral disc degeneration due to similarities in spinal posture, disc size, biomechanical flexibility, and natural disc pathology. This research further investigated alpacas by determining the prevalence of intervertebral disc degeneration among an aging alpaca population. Twenty healthy female alpacas comprised two age subgroups (5 young: 2-6 years; and 15 older: 10+ years) and were rated according to the Pfirrmann-grade for degeneration of the cervical intervertebral discs. Incidence rates of degeneration showed strong correlations with age and spinal level: younger alpacas were nearly immune to developing disc degeneration, and in older animals, disc degeneration had an increased incidence rate and severity at lower cervical levels. Advanced disc degeneration was present in at least one of the cervical intervertebral discs of 47% of the older alpacas, and it was most common at the two lowest cervical intervertebral discs. The prevalence of intervertebral disc degeneration encourages further investigation and application of the lower cervical spine of alpacas and similar camelids as a large animal model of intervertebral disc degeneration.
Collapse
Affiliation(s)
- Dean K Stolworthy
- Department of Mechanical Engineering, Brigham Young University, Provo, Utah
| | - Anton E Bowden
- Department of Mechanical Engineering, Brigham Young University, Provo, Utah
| | | | - Todd F Robinson
- Department of Plant and Wildlife Sciences, Brigham Young University, Provo, Utah
| | - Jacob G Holland
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, Utah
| | - S Loyd Christensen
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, Utah
| | - Amanda M Beatty
- Department of Mechanical Engineering, Brigham Young University, Provo, Utah
| | - Laura C Bridgewater
- Department of Microbiology and Molecular Biology, Brigham Young University, Provo, Utah
| | - Dennis L Eggett
- Department of Statistics, Brigham Young University, Provo, Utah
| | | | | | - Meredith D Taylor
- Department of Electrical Engineering, Brigham Young University, Provo, Utah
| |
Collapse
|
37
|
Croonenborghs H, Peeters L, De Schepper J. Relationship between somatic dysfunction of the lumbosacral joint and changes in the gait pattern. INT J OSTEOPATH MED 2015. [DOI: 10.1016/j.ijosm.2014.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
38
|
SIRT1 Plays a Protective Role in Intervertebral Disc Degeneration in a Puncture-induced Rodent Model. Spine (Phila Pa 1976) 2015; 40:E515-24. [PMID: 25646749 DOI: 10.1097/brs.0000000000000817] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Experimental animal study of treatment of intervertebral disc (IVD) degeneration. OBJECTIVE This report aims to evaluate the in vivo effects of SIRT1 on IVD biology and to explore its potential mechanism. SUMMARY OF BACKGROUND DATA Silent mating type information regulator 2 homolog 1 (SIRT1) has attracted immense attention because of its functions in a variety of aging-related diseases. Despite previous studies indicated that SIRT1 showed a unique expression with degeneration in some in vitro study, there is no in vivo research on the role SIRT1 plays in IVD and its mechanism. METHODS Coccygeal discs were punctured to induce disc degeneration. Sixteen C57BL/6J mice received either Carboxy methocel (Vehicle) or Resveratrol (RES) gavage. Eight SIRT1 mice and their SIRT1 littermates were also used in this study. At 2 and 6 weeks after puncture, magnetic resonance images were obtained. The mice were subsequently killed, and the spine was extracted for further evaluation. RESULTS Coccygeal disc puncture caused IVD degeneration in the mice. A SIRT1 activator, RES, markedly ameliorated this pathological change, as demonstrated by stronger signal intensity in the T2-weighted images, as well as a significantly lower magnetic resonance imaging grade (at 2 wk vs. Vehicle group P < 0.001). Histological analysis also revealed an improvement in the RES group compared with the Vehicle group (P < 0.05). Genetic ablation of 1 allele significantly enhanced the level of damage relative to the wild-type mice. In addition, SIRT1 activation suppressed the expression of p16 and at the same time, promoted proliferating cell nuclear antigen and type II collagen expression in disc cells, whereas genetic ablation of 1 allele SIRT1 exhibited the opposite consequence. CONCLUSION The SIRT1 activator RES protects against puncture-induced disc injury whereas SIRT1 deficiency aggravates tissue injury; the protective role of SIRT1 is partly mediated by suppressing p16, which plays a role in elevating the decreased proliferative ability of the senescent nucleus pulposus cells. LEVEL OF EVIDENCE N/A.
Collapse
|
39
|
Jamison D, Marcolongo MS. The effect of creep on human lumbar intervertebral disk impact mechanics. J Biomech Eng 2014; 136:031006. [PMID: 24292391 DOI: 10.1115/1.4026107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 11/25/2013] [Indexed: 11/08/2022]
Abstract
The intervertebral disk (IVD) is a highly hydrated tissue, with interstitial fluid making up 80% of the wet weight of the nucleus pulposus (NP), and 70% of the annulus fibrosus (AF). It has often been modeled as a biphasic material, consisting of both a solid and fluid phase. The inherent porosity and osmotic potential of the disk causes an efflux of fluid while under constant load, which leads to a continuous displacement phenomenon known as creep. IVD compressive stiffness increases and NP pressure decreases as a result of creep displacement. Though the effects of creep on disk mechanics have been studied extensively, it has been limited to nonimpact loading conditions. The goal of this study is to better understand the influence of creep and fluid loss on IVD impact mechanics. Twenty-four human lumbar disk samples were divided into six groups according to the length of time they underwent creep (tcreep = 0, 3, 6, 9, 12, 15 h) under a constant compressive load of 400 N. At the end of tcreep, each disk was subjected to a sequence of impact loads of varying durations (timp = 80, 160, 320, 400, 600, 800, 1000 ms). Energy dissipation (ΔE), stiffness in the toe (ktoe) and linear (klin) regions, and neutral zone (NZ) were measured. Analyzing correlations with tcreep, there was a positive correlation with ΔE and NZ, along with a negative correlation with ktoe. There was no strong correlation between tcreep and klin. The data suggest that the IVD mechanical response to impact loading conditions is altered by fluid content and may result in a disk that exhibits less clinical stability and transfers more load to the AF. This could have implications for risk of diskogenic pain as a function of time of day or tissue hydration.
Collapse
|
40
|
Gregory DE, Bae WC, Sah RL, Masuda K. Disc degeneration reduces the delamination strength of the annulus fibrosus in the rabbit annular disc puncture model. Spine J 2014; 14:1265-71. [PMID: 24594442 PMCID: PMC4063999 DOI: 10.1016/j.spinee.2013.07.489] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 06/01/2013] [Accepted: 07/25/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Degenerative disc disease is a common pathologic disorder accompanied by both structural and biochemical changes. Changes in stress distribution across the disc can lead to annulus fibrosus (AF) damage that can affect the strength and integrity of the disc. Given that some present degeneration therapies incorporate biological regrowth of the nucleus pulposus (NP), it is crucial that the AF remains capable of containing this newly grown material. PURPOSE To examine the resistance of AF to delamination using an adhesive peel test in experimentally degenerated rabbit discs. STUDY DESIGN Experimentally induced disc degeneration; excised AF tissue study. METHODS Disc degeneration was induced in eight New Zealand white rabbits by annular puncture; four additional rabbits served as controls. In experimental rabbits, an 18-gauge needle was inserted into the anterolateral AF region of levels L2-L3 and L4-L5, and disc height was monitored by X-ray. Animals were sacrificed at 4 and 12 weeks postsurgery and magnetic resonance images and X-rays were taken. Four discs were excised from the experimental animals; two punctured (L2-L3 and L4-L5) and two controls (L3-L4 and L6-L7). The same four discs were also excised from the age-matched control animals and served as nonpunctured control discs. To determine resistance to delamination, AF samples were dissected from each disc and subjected to a mechanical peel test at 0.5 mm/s. RESULTS Magnetic resonance imaging and X-ray images confirmed dehydration of the NP and reduced disc height, similar to that found in clinical degeneration. Resistance to delamination was significantly lower in punctured/degenerated discs compared with both the nonpunctured discs from the same animal (27% lower) and the nonpunctured control discs (30% lower) (p=.024). CONCLUSIONS The findings of this study suggest that degeneration increases the potential for delamination between AF layers. Given this substantial change to the integrity of the AF after degeneration, clinical treatments should not only target rehydration or regrowth of the NP, but should also target repair and strengthening of the AF to confine the NP.
Collapse
Affiliation(s)
- Diane E. Gregory
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Canada
| | - Won C. Bae
- Department of Radiology, University of California San Diego, USA
| | - Robert L. Sah
- Department of Bioengineering, University of California San Diego, USA
,Department of Orthopaedic Surgery, University of California San Diego, USA
| | - Koichi Masuda
- Department of Radiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
| |
Collapse
|
41
|
Tao H, Zhang Y, Wang CF, Zhang C, Wang XM, Wang DL, Bai XD, Wen TY, Xin HK, Wu JH, Liu Y, He Q, Ruan D. Biological Evaluation of Human Degenerated Nucleus Pulposus Cells in Functionalized Self-Assembling Peptide Nanofiber Hydrogel Scaffold. Tissue Eng Part A 2014; 20:1621-31. [PMID: 24450796 DOI: 10.1089/ten.tea.2013.0279] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Hui Tao
- The Third Affiliated Hospital of Southern Medical University, Guangzhou, People's Republic of China
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Yan Zhang
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Chao-feng Wang
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Chao Zhang
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Xiu-mei Wang
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing, People's Republic of China
| | - De-li Wang
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Xue-dong Bai
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Tian-yong Wen
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Hong-kui Xin
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Jian-hong Wu
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Yue Liu
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Qin He
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| | - Dike Ruan
- Department of Orthopaedic Surgery, Navy General Hospital, Beijing, People's Republic of China
| |
Collapse
|
42
|
Zirbel SA, Stolworthy DK, Howell LL, Bowden AE. Intervertebral disc degeneration alters lumbar spine segmental stiffness in all modes of loading under a compressive follower load. Spine J 2013; 13:1134-47. [PMID: 23507531 DOI: 10.1016/j.spinee.2013.02.010] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 01/24/2013] [Accepted: 02/08/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Previous studies have investigated the relationship between the degeneration grade of the intervertebral disc (IVD) and the flexibility of the functional spinal unit (FSU) but were completed at room temperature without the presence of a compressive follower load. This study builds on previous work by performing the testing under more physiological conditions of a compressive follower load at body temperature and at near 100% humidity. PURPOSE The present work evaluates the effects of IVD degeneration on segmental stiffness, range of motion (ROM), hysteresis area, and normalized hysteresis (hysteresis area/ROM). This study also briefly evaluates the effect of the segment level, temperature, and follower load on the same parameters. STUDY DESIGN In vitro human cadaveric biomechanical investigation. METHODS Twenty-one FSUs were tested in the three primary modes of loading at both body temperature and room temperature in a near 100% humidity environment. A compressive follower load of 440 N was applied to simulate the physiological conditions. Fifteen of the 21 segments were also tested without the follower load to determine the effects of the follower load on segmental biomechanics. The grade of degeneration for each segment was determined using the Thompson scale, and the torque-rotation curves were fit with the Dual-Inflection-Point Boltzmann sigmoid curve. RESULTS Intervertebral disc degeneration resulted in statistically significant changes in segmental stiffness, ROM, and hysteresis area in axial rotation (AR) and lateral bending (LB) and statistically significant changes in ROM and normalized hysteresis in flexion-extension (FE). The progression of these changes with increased degeneration is nonlinear, with changes in the FE and LB tending to respond in concert and opposite to the changes in AR. The lumbosacral joint was significantly stiffer and demonstrated a decreased ROM and hysteresis area as compared with other lumbar segments in AR and LB. Temperature had a significant effect on the stiffness and hysteresis area in AR and on the hysteresis area in LB. Application of a compressive follower load increased the stiffness in all three modes of loading but was significant only in AR and LB. It also reduced the ROM and increased normalized hysteresis in all three modes of loading. CONCLUSIONS The results from this testing quantify the effects of degeneration on spinal biomechanics. Because the testing was conducted under physiological conditions (including a compressive follower load and at body temperature), we expect the measured response to closely match the in vivo response. The testing results can be used to guide the selection of appropriate surgical treatments in the context of IVD degeneration and to validate the mathematical and engineering models of the lumbar spine, including finite element models.
Collapse
Affiliation(s)
- Shannon A Zirbel
- Department of Mechanical Engineering, Brigham Young University, Provo, UT 84602, USA
| | | | | | | |
Collapse
|
43
|
Jamison D, Cannella M, Pierce EC, Marcolongo MS. A Comparison of the Human Lumbar Intervertebral Disc Mechanical Response to Normal and Impact Loading Conditions. J Biomech Eng 2013; 135:91009. [DOI: 10.1115/1.4024828] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 06/17/2013] [Indexed: 11/08/2022]
Abstract
Thirty-four percent of U.S. Navy high speed craft (HSC) personnel suffer from lower back injury and low back pain, compared with 15 to 20% of the general population. Many of these injuries are specifically related to the intervertebral disc, including discogenic pain and accelerated disc degeneration. Numerous studies have characterized the mechanical behavior of the disc under normal physiological loads, while several have also analyzed dynamic loading conditions. However, the effect of impact loads on the lumbar disc—and their contribution to the high incidence of low back pain among HSC personnel—is still not well understood. An ex vivo study on human lumbar anterior column units was performed in order to investigate disc biomechanical response to impact loading conditions. Samples were subjected to a sequence of impact events of varying duration (Δt = 80, 160, 320, 400, 600, 800, and 1000 ms) and the level of displacement (0.2, 0.5, and 0.8 mm), stiffness k, and energy dissipation ΔE were measured. Impacts of Δt = 80 ms saw an 18–21% rise in k and a 3–7% drop in ΔE compared to the 1000 ms baseline, signaling an abrupt change in disc mechanics. The altered disc mechanical response during impact likely causes more load to be transferred directly to the endplates, vertebral bodies, and surrounding soft tissues and can help begin to explain the high incidence of low back pain among HSC operators and other individuals who typically experience similar loading environments. The determination of a “safety range” for impacts could result in a refinement of design criteria for shock mitigating systems on high-speed craft, thus addressing the low back injury problem among HSC personnel.
Collapse
Affiliation(s)
- David Jamison
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA 19104
| | - Marco Cannella
- Department of Physical Therapy, Drexel University, Philadelphia, PA 19104
| | | | - Michele S. Marcolongo
- Department of Materials Science and Engineering, Drexel University, Philadelphia, PA 19104 e-mail:
| |
Collapse
|
44
|
Ohta R, Tanaka N, Nakanishi K, Kamei N, Nakamae T, Izumi B, Fujioka Y, Ochi M. Heme oxygenase-1 modulates degeneration of the intervertebral disc after puncture in Bach 1 deficient mice. 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 2012; 21:1748-57. [PMID: 22832873 DOI: 10.1007/s00586-012-2442-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 07/06/2012] [Accepted: 07/07/2012] [Indexed: 01/08/2023]
Abstract
PURPOSE Intervertebral disc degeneration is considered to be a major feature of low back pain. Furthermore, oxidative stress has been shown to be an important factor in degenerative diseases such as osteoarthritis and is considered a cause of intervertebral disc degeneration. The purpose of this study was to clarify the correlation between oxidative stress and intervertebral disc degeneration using Broad complex-Tramtrack-Bric-a-brac and cap'n'collar homology 1 deficient (Bach 1-/-) mice which highly express heme oxygenase-1 (HO-1). HO-1 protects cells from oxidative stress. METHODS Caudal discs of 12-week-old and 1-year-old mice were evaluated as age-related models. Each group and period, 5 mice (a total of 20 mice, a total of 20 discs) were evaluated as age-related model. C9-C10 caudal discs in 12-week-old Bach 1-/- and wild-type mice were punctured using a 29-gauge needle as annulus puncture model. Each group and period, 5 mice (a total of 60 mice, a total of 60 discs) were evaluated. The progress of disc degeneration was evaluated at pre-puncture, 1, 2, 4, 8 and 12 weeks post-puncture. Radiographic, histologic and immunohistologic analysis were performed to compare between Bach 1-/- and wild-type mice. RESULTS In the age-related model, there were no significant differences between Bach 1-/- and wild-type mice radiologically and histologically. However, in the annulus puncture model, histological scoring revealed significant difference at 8 and 12 weeks post-puncture. The number of HO-1 positive cells was significantly greater in Bach 1-/- mice at every period. The apoptosis rate was significantly lower at 1 and 2 weeks post-puncture in Bach 1-/- mice. CONCLUSIONS Oxidative stress prevention may avoid the degenerative process of the intervertebral disc after puncture, reducing the number of apoptosis cells. High HO-1 expression may also inhibit oxidative stress and delay the process of intervertebral disc degeneration.
Collapse
Affiliation(s)
- Ryo Ohta
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi, Hiroshima, 734-8551, Japan,
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Wu CC, Yang SH, Huang TL, Liu CC, Lu DH, Yang KC, Lin FH. The interaction between co-cultured human nucleus pulposus cells and mesenchymal stem cells in a bioactive scaffold. Process Biochem 2012. [DOI: 10.1016/j.procbio.2012.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
46
|
Buser Z, Liu J, Thorne KJ, Coughlin D, Lotz JC. Inflammatory response of intervertebral disc cells is reduced by fibrin sealant scaffold in vitro. J Tissue Eng Regen Med 2012; 8:77-84. [PMID: 22610998 DOI: 10.1002/term.1503] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 11/10/2011] [Accepted: 01/24/2012] [Indexed: 02/06/2023]
Abstract
Intervertebral disc (IVD) degeneration is a complex process characterized by elevated concentrations of proinflammatory cytokines and proteolytic enzymes. Because of pro-healing constituents, we hypothesized that fibrin sealant (FS) can reduce inflammation and augment soft tissue healing within the damaged or degenerative IVD. To test this, human and porcine nucleus pulposus (NP) and annulus fibrosus (AF) cells were extracted from tissues and encapsulated into alginate beads (NP cells) and type I collagen sponges (AF cells). Half of the alginate and collagen scaffolds were embedded in FS. To provoke inflammatory behaviours, the constructs were cultured with and without continuous IL-1α (10 ng/ml) for 4, 7 and 14 days. ELISA was used to quantify the cellular synthesis (ng/µg DNA) of clinically relevant cytokines, proteolytic enzymes and growth factors. In NP cell constructs with IL-1α, the syntheses of TNFα, IL-1β, IL-6, IL-8 was elevated at all culture durations. In the presence of FS, secretion of several pro-inflammatory cytokines were significantly reduced [IL-6 and IL-8 (porcine); and TNFα, IL-1β, IL-6, IL-8 (human)]. Consistent with these reductions, human NP cultures exposed to FS and FS + IL-1α synthesized significantly reduced amounts of MMP-1 and -3 compared to constructs with IL-1α. For porcine and human AF cells, there were no significant differences in the synthesis of the inflammatory or proteolytic cytokines relative to controls (without IL-1α) at any culture duration. However, the porcine AF cells exposed to FS synthesized elevated amounts of the anti-inflammatory cytokine IL-4. The results suggest that FS may have beneficial effects for patients with degenerated intervertebral discs.
Collapse
Affiliation(s)
- Zorica Buser
- Department of Orthopaedic Surgery, University of California, San Francisco, CA, 94143, USA
| | | | | | | | | |
Collapse
|
47
|
Di Martino A, Papapietro N, Lanotte A, Russo F, Vadalà G, Denaro V. Spondylodiscitis: standards of current treatment. Curr Med Res Opin 2012; 28:689-99. [PMID: 22435926 DOI: 10.1185/03007995.2012.678939] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Spinal infections are an important clinical problem that often require aggressive medical therapy, and sometimes even surgery. Known risk factors are advanced age, diabetes mellitus, rheumatoid arthritis, immunosuppression, alcoholism, long-term steroid use, concomitant infections, poly-trauma, malignant tumor, and previous surgery or invasive procedures (discography, chemonucleolysis, and surgical procedures involving or adjacent to the intervertebral disc space). The most common level of involvement is at the lumbar spine, followed by the thoracic, cervical and sacral levels: lesions at the thoracic spine tend to lead more frequently to neurological symptoms. OBJECTIVE The aim of the current paper is to describe current evidence-based standards of therapy in the management of SD by emphasizing pharmacological therapy and principles and indications for bracing and surgery. METHODS A PubMed and Google Scholar search using various forms and combinations of the key words: spondylodiscitis, spine, infection, therapy, surgery, radiology, treatment. Reference citations from publications identified in the literature search were reviewed. Publications highlighted in this article were extracted based on relevancy to established, putative, and emerging diagnostic and therapeutic standards, either conservative (antibiotic therapy and bracing) or surgical. FINDINGS To date, conservative therapy, based on targeted antibiotic therapy plus bracing, represents the mainstay in the management of SD. Proper diagnosis and tailored therapy can improve clinical results and decrease the chance of failure. Surgery should be an option only for patients with complications of this disease, namely deformity, neural compression and neurological compromise. Current standards in the setting of SD are continuously evolving, as can be seen in the recent advances in the field of radiological diagnostics, and the use of growth factors and cell-therapy strategies to promote infection eradication and bone healing after surgery.
Collapse
Affiliation(s)
- Alberto Di Martino
- Center for Integrated Research, Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, Via Alvaro del Portillo, 200 Rome 00128, Italy.
| | | | | | | | | | | |
Collapse
|
48
|
Zhang Y, Chee A, Thonar EJMA, An HS. Intervertebral disk repair by protein, gene, or cell injection: a framework for rehabilitation-focused biologics in the spine. PM R 2011; 3:S88-94. [PMID: 21703587 DOI: 10.1016/j.pmrj.2011.04.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Accepted: 04/28/2011] [Indexed: 11/21/2022]
Abstract
Low back pain carries an enormous socioeconomic burden. Current treatment modalities for symptomatic intervertebral disk (IVD) degeneration have limited and often inconsistent clinical benefits. Novel approaches with the potential to halt or even reverse disk degeneration and restore physiologic disk function, such as biological treatments, are therefore very attractive. The following barriers are impeding the development of successful therapeutic interventions: (1) the biology and pathophysiology of disk degeneration are not well understood, and (2) the precise relationship between IVD degeneration and low back pain remains unclear. This article reviews the structural changes that take place during IVD degeneration and their relationship to diskogenic back pain. It also presents treatment modalities that currently are under laboratory investigation and are being studied in clinical trials. The authors of recent studies have shown that the content of large proteoglycans, such as aggrecan and versican, decreases with aging and IVD degeneration, whereas the content of certain small proteoglycans, such as biglycan, increases. Proinflammatory cytokines such as interleukin-1 and tumor necrosis factor-α also are associated with IVD degeneration and are potential biomarkers of IVD degeneration and repair. Our group of investigators and others have developed in vitro models of IVD cell and explant culture in addition to in vivo animal models to study IVD degeneration and repair. With the use of these models, we have tested candidate therapeutic agents to assess their therapeutic potential for matrix restoration. When a rabbit annular puncture model of IVD degeneration was used, injections of either bone morphogenetic protein-7 (also known as osteogenic protein-1) or bone morphogenetic protein-14 (also known as growth differentiation factor-5) were shown to be effective in restoring IVD structures. On the basis of these data, the Food and Drug Administration has recently allowed the initiation of Investigational New Drug clinical trials on osteogenic protein-1 and growth differentiation factor-5 in the United States. Protein therapies such as other growth factors, inhibitors of degradation enzymes or cytokines, and cell therapies also are being investigated in laboratory settings with the goal of restoring disk function and alleviating back pain symptoms. These therapies may be used by physiatrists with the skills required to administer intradiskal injections and supervise a comprehensive rehabilitation program after the procedures. Ultimately, the clinical use of any biological treatment discussed in this article would require the collective efforts of clinicians and researchers.
Collapse
Affiliation(s)
- Yejia Zhang
- Departments of Physical Medicine & Rehabilitation, Orthopedic Surgery, and Biochemistry, Rush University Medical Center, Chicago, IL, USA.
| | | | | | | |
Collapse
|
49
|
Reddi AH. Inhibition of cell death in the intervertebral disc by caspase 3 small interfering RNA. ACTA ACUST UNITED AC 2011; 63:1477-8. [DOI: 10.1002/art.30252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
50
|
Kim JS, Ellman MB, An HS, van Wijnen AJ, Borgia JA, Im HJ. Insulin-like growth factor 1 synergizes with bone morphogenetic protein 7-mediated anabolism in bovine intervertebral disc cells. ACTA ACUST UNITED AC 2011; 62:3706-15. [PMID: 20812336 DOI: 10.1002/art.27733] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE We undertook this study to assess the therapeutic benefits of intervertebral disc matrix repair and regeneration by evaluating the potential synergistic effect of insulin-like growth factor 1 (IGF-1) and bone morphogenetic protein 7 (BMP-7) on bovine spine discs and by elucidating the relevant molecular/cellular mechanisms. METHODS Bovine nucleus pulposus (NP) cells were treated with BMP-7 and IGF-1. The subsequent anabolic effects driven by NP cells were assessed for proteoglycan (PG) synthesis by (35) S-sulfate incorporation and for PG accumulation by dimethylmethylene blue assays. Matrix formation was visualized by particle exclusion assay. Key matrix components and transcription factors were analyzed by real-time reverse transcription-polymerase chain reaction to determine the signaling pathways by which IGF-1 suppresses noggin, a potent inhibitor of BMP-7. Western blotting and nuclear translocation experiments were performed to assess the activation of Smad proteins. RESULTS Stimulation of bovine NP cells by both IGF-1 and BMP-7 greatly potentiated anabolism through complementary and synergistic mechanisms on matrix formation compared with treatment with either growth factor alone. The exogenously added decoy ligand, noggin, attenuated the anabolic effects of BMP-7, and noggin was substantially increased by BMP-7, suggesting a negative feedback regulatory mechanism. In contrast, IGF-1 significantly suppressed noggin expression via the phosphatidylinositol 3-kinase/Akt pathway and thus potentiated BMP-7 signaling in bovine NP cells. Upon combination treatment, IGF-1 activated Smad2, while BMP-7 activated Smad1/5/8 and Smad3, thus inducing all Smad signaling pathways and mimicking the effects of the combination of transforming growth factor β and BMP-7 CONCLUSION Combination growth factor therapy using BMP-7 and IGF-1 may have considerable promise in the treatment of spine disc degeneration.
Collapse
Affiliation(s)
- Jae-Sung Kim
- Rush University Medical Center, Chicago, Illinois, USA
| | | | | | | | | | | |
Collapse
|