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Xiang H, Zhao W, Jiang K, He J, Chen L, Cui W, Li Y. Progress in regulating inflammatory biomaterials for intervertebral disc regeneration. Bioact Mater 2024; 33:506-531. [PMID: 38162512 PMCID: PMC10755503 DOI: 10.1016/j.bioactmat.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/04/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Intervertebral disc degeneration (IVDD) is rising worldwide and leading to significant health issues and financial strain for patients. Traditional treatments for IVDD can alleviate pain but do not reverse disease progression, and surgical removal of the damaged disc may be required for advanced disease. The inflammatory microenvironment is a key driver in the development of disc degeneration. Suitable anti-inflammatory substances are critical for controlling inflammation in IVDD. Several treatment options, including glucocorticoids, non-steroidal anti-inflammatory drugs, and biotherapy, are being studied for their potential to reduce inflammation. However, anti-inflammatories often have a short half-life when applied directly and are quickly excreted, thus limiting their therapeutic effects. Biomaterial-based platforms are being explored as anti-inflammation therapeutic strategies for IVDD treatment. This review introduces the pathophysiology of IVDD and discusses anti-inflammatory therapeutics and the components of these unique biomaterial platforms as comprehensive treatment systems. We discuss the strengths, shortcomings, and development prospects for various biomaterials platforms used to modulate the inflammatory microenvironment, thus providing guidance for future breakthroughs in IVDD treatment.
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Affiliation(s)
- Honglin Xiang
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
| | - Weikang Zhao
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Orthopedic Laboratory of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, PR China
| | - Ke Jiang
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
| | - Jiangtao He
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
| | - Lu Chen
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
| | - Wenguo Cui
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai, 200025, PR China
| | - Yuling Li
- Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China
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Raftery K, Rahman T, Smith N, Schaer T, Newell N. The role of the nucleus pulposus in intervertebral disc recovery: Towards improved specifications for nucleus replacement devices. J Biomech 2024; 166:111990. [PMID: 38383232 DOI: 10.1016/j.jbiomech.2024.111990] [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: 06/07/2023] [Revised: 01/26/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024]
Abstract
Nucleus replacement devices (NRDs) have potential to treat degenerated or herniated intervertebral discs (IVDs). However, IVD height loss is a post-treatment complication. IVD height recovery involves the nucleus pulposus (NP), but the mechanism of this in response to physiological loads is not fully elucidated. This study aimed to characterise the non-linear recovery behaviour of the IVD in intact, post-nuclectomy, and post-NRD treatment states, under physiological loading. 36 bovine IVDs (12 intact, 12 post-nuclectomy, 12 post-treatment) underwent creep-recovery protocols simulating Sitting, Walking or Running, followed by 12 h of recovery. A rheological model decoupled the fluid-independent (elastic, fast) and fluid-dependent (slow) recovery phases. In post-nuclectomy and post-treatment groups, nuclectomy efficiency (ratio of NP removed to remaining NP) was quantified following post-test sectioning. Relative to intact, post-nuclectomy recovery significantly decreased in Sitting (-0.3 ± 0.4 mm, p < 0.05) and Walking (-0.6 ± 0.3 mm, p < 0.001) coupled with significant decreases to the slow response (p < 0.05). Post-nuclectomy, the fast and slow responses negatively correlated with nuclectomy efficiency (p < 0.05). In all protocols, the post-treatment group performed significantly worse in recovery (-0.5 ± 0.3 mm, p < 0.01) and the slow response (p < 0.05). Results suggest the NP mainly facilitates slow-phase recovery, linearly dependent on the amount of NP present. Failure of this NRD to recover is attributed to poor fluid imbibition. Additionally, unconfined NRD performance cannot be extrapolated to the in vitro response. This knowledge informs NRD design criteria to provide high osmotic pressure, and encourages testing standards to incorporate long-term recovery protocols.
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Affiliation(s)
- K Raftery
- Department of Bioengineering, Imperial College London, London, UK
| | - T Rahman
- Department of Bioengineering, Imperial College London, London, UK; Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, UK
| | - N Smith
- Division of Surgery and Interventional Science, University College London, Stanmore, UK
| | - T Schaer
- Department of Clinical Studies New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, USA
| | - N Newell
- Department of Bioengineering, Imperial College London, London, UK.
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Li ZL, Lu Q, Honiball JR, Wan SHT, Yeung KWK, Cheung KMC. Mechanical characterization and design of biomaterials for nucleus pulposus replacement and regeneration. J Biomed Mater Res A 2023; 111:1888-1902. [PMID: 37555381 DOI: 10.1002/jbm.a.37593] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023]
Abstract
Biomaterials for nucleus pulposus (NP) replacement and regeneration have great potential to restore normal biomechanics in degenerated intervertebral discs following nucleotomy. Mechanical characterizations are essential for assessing the efficacy of biomaterial implants for clinical applications. While traditional compression tests are crucial to quantify various modulus values, relaxation behaviors and fatigue resistance, rheological measurements should also be conducted to investigate the viscoelastic properties, injectability, and overall stability upon deformation. To recapitulate the physiological in vivo environment, the use of spinal models is necessary to evaluate the risk of implant extrusion and the restoration of biomechanics under different loading conditions. When designing devices for NP replacement, injectable materials are ideal to fully fill the nucleus cavity and prevent implant migration. In addition to achieving biocompatibility and desirable mechanical characteristics, biomaterial implants should be optimized to avoid implant extrusion or re-herniation post-operatively. This review discusses the most commonly used testing protocols for assessing mechanical properties of biomaterial implants and serves as reference material for enabling researchers to characterize NP implants through a unified approach whereby newly developed biomaterials may be compared and contrasted to existing devices.
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Affiliation(s)
- Zhuoqi Lucas Li
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, China
| | - Qiuji Lu
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, China
| | - John Robert Honiball
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, China
| | - Sandra Hiu-Tung Wan
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, China
| | - Kelvin Wai-Kwok Yeung
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Kenneth Man-Chee Cheung
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, China
- Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
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4
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Panebianco CJ, Constant C, Vernengo AJ, Nehrbass D, Gehweiler D, DiStefano TJ, Martin J, Alpert DJ, Chaudhary SB, Hecht AC, Seifert AC, Nicoll SB, Grad S, Zeiter S, Iatridis JC. Combining adhesive and nonadhesive injectable hydrogels for intervertebral disc repair in an ovine discectomy model. JOR Spine 2023; 6:e1293. [PMID: 38156055 PMCID: PMC10751969 DOI: 10.1002/jsp2.1293] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/12/2023] [Accepted: 09/20/2023] [Indexed: 12/30/2023] Open
Abstract
Background Intervertebral disc (IVD) disorders (e.g., herniation) directly contribute to back pain, which is a leading cause of global disability. Next-generation treatments for IVD herniation need advanced preclinical testing to evaluate their ability to repair large defects, prevent reherniation, and limit progressive degeneration. This study tested whether experimental, injectable, and nonbioactive biomaterials could slow IVD degeneration in an ovine discectomy model. Methods Ten skeletally mature sheep (4-5.5 years) experienced partial discectomy injury with cruciate-style annulus fibrosus (AF) defects and 0.1 g nucleus pulposus (NP) removal in the L1-L2, L2-L3, and L3-L4 lumbar IVDs. L4-L5 IVDs were Intact controls. IVD injury levels received: (1) no treatment (Injury), (2) poly (ethylene glycol) diacrylate (PEGDA), (3) genipin-crosslinked fibrin (FibGen), (4) carboxymethylcellulose-methylcellulose (C-MC), or (5) C-MC and FibGen (FibGen + C-MC). Animals healed for 12 weeks, then IVDs were assessed using computed tomography (CT), magnetic resonance (MR) imaging, and histopathology. Results All repaired IVDs retained ~90% of their preoperative disc height and showed minor degenerative changes by Pfirrmann grading. All repairs had similar disc height loss and Pfirrmann grade as Injury IVDs. Adhesive AF sealants (i.e., PEGDA and FibGen) did not herniate, although repair caused local endplate (EP) changes and inflammation. NP repair biomaterials (i.e., C-MC) and combination repair (i.e., FibGen + C-MC) exhibited lower levels of degeneration, less EP damage, and less severe inflammation; however, C-MC showed signs of herniation via biomaterial expulsion. Conclusions All repair IVDs were noninferior to Injury IVDs by IVD height loss and Pfirrmann grade. C-MC and FibGen + C-MC IVDs had the best outcomes, and may be appropriate for enhancement with bioactive factors (e.g., cells, growth factors, and miRNAs). Such bioactive factors appear to be necessary to prevent injury-induced IVD degeneration. Application of AF sealants alone (i.e., PEGDA and FibGen) resulted in EP damage and inflammation, particularly for PEGDA IVDs, suggesting further material refinements are needed.
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Affiliation(s)
- Christopher J. Panebianco
- Leni and Peter W. May Department of OrthopaedicsIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Orthopaedic SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - Andrea J. Vernengo
- AO Research Institute DavosDavosSwitzerland
- Department of Chemical EngineeringRowan UniversityGlassboroNJUSA
| | | | | | - Tyler J. DiStefano
- Leni and Peter W. May Department of OrthopaedicsIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Jesse Martin
- Department of Biomedical EngineeringThe City College of New YorkNew YorkNew YorkUSA
| | - David J. Alpert
- Department of Biomedical EngineeringThe City College of New YorkNew YorkNew YorkUSA
| | - Saad B. Chaudhary
- Leni and Peter W. May Department of OrthopaedicsIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Andrew C. Hecht
- Leni and Peter W. May Department of OrthopaedicsIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Alan C. Seifert
- Biomedical Engineering and Imaging InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Steven B. Nicoll
- Department of Biomedical EngineeringThe City College of New YorkNew YorkNew YorkUSA
| | | | | | - James C. Iatridis
- Leni and Peter W. May Department of OrthopaedicsIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
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Li W, Zhou P, Yan B, Qi M, Chen Y, Shang L, Guan J, Zhang L, Mao Y. Disc regeneration by injectable fucoidan-methacrylated dextran hydrogels through mechanical transduction and macrophage immunomodulation. J Tissue Eng 2023; 14:20417314231180050. [PMID: 37427012 PMCID: PMC10328174 DOI: 10.1177/20417314231180050] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/19/2023] [Indexed: 07/11/2023] Open
Abstract
Modulating a favorable inflammatory microenvironment that facilitates the recovery of degenerated discs is a key strategy in the treatment of intervertebral disc (IVD) degeneration (IDD). More interestingly, well-mechanized tissue-engineered scaffolds have been proven in recent years to be capable of sensing mechanical transduction to enhance the proliferation and activation of nucleus pulposus cells (NPC) and have demonstrated an increased potential in the treatment and recovery of degenerative discs. Additionally, existing surgical procedures may not be suitable for IDD treatment, warranting the requirement of new regenerative therapies for the restoration of disc structure and function. In this study, a light-sensitive injectable polysaccharide composite hydrogel with excellent mechanical properties was prepared using dextrose methacrylate (DexMA) and fucoidan with inflammation-modulating properties. Through numerous in vivo experiments, it was shown that the co-culture of this composite hydrogel with interleukin-1β-stimulated NPCs was able to promote cell proliferation whilst preventing inflammation. Additionally, activation of the caveolin1-yes-associated protein (CAV1-YAP) mechanotransduction axis promoted extracellular matrix (ECM) metabolism and thus jointly promoted IVD regeneration. After injection into an IDD rat model, the composite hydrogel inhibited the local inflammatory response by inducing macrophage M2 polarization and gradually reducing the ECM degradation. In this study, we propose a fucoidan-DexMA composite hydrogel, which provides an attractive approach for IVD regeneration.
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Affiliation(s)
- Weifeng Li
- Department of Orthopaedics and
Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical
College, Bengbu, China
- Anhui Province Key Laboratory of Tissue
Transplantation, Bengbu Medical College, Bengbu, China
- Department of Orthopedics, Lixin County
People’s Hospital, Bozhou, China
| | - Pinghui Zhou
- Department of Orthopaedics and
Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical
College, Bengbu, China
- Anhui Province Key Laboratory of Tissue
Transplantation, Bengbu Medical College, Bengbu, China
| | - Bomin Yan
- Department of Orthopaedics and
Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical
College, Bengbu, China
- Anhui Province Key Laboratory of Tissue
Transplantation, Bengbu Medical College, Bengbu, China
| | - Meiyao Qi
- Department of Orthopaedics and
Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical
College, Bengbu, China
- Anhui Province Key Laboratory of Tissue
Transplantation, Bengbu Medical College, Bengbu, China
| | - Yedan Chen
- Department of Orthopaedics and
Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical
College, Bengbu, China
| | - Lijun Shang
- School of Life Sciences, Bengbu Medical
College, Bengbu, China
| | - Jianzhong Guan
- Department of Orthopaedics and
Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical
College, Bengbu, China
- Anhui Province Key Laboratory of Tissue
Transplantation, Bengbu Medical College, Bengbu, China
| | - Li Zhang
- Department of Orthopaedics and
Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical
College, Bengbu, China
- Anhui Province Key Laboratory of Tissue
Transplantation, Bengbu Medical College, Bengbu, China
| | - Yingji Mao
- Department of Orthopaedics and
Department of Plastic Surgery, The First Affiliated Hospital of Bengbu Medical
College, Bengbu, China
- Anhui Province Key Laboratory of Tissue
Transplantation, Bengbu Medical College, Bengbu, China
- School of Life Sciences, Bengbu Medical
College, Bengbu, China
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Gao XD, Zhang XB, Zhang RH, Yu DC, Chen XY, Hu YC, Chen L, Zhou HY. Aggressive strategies for regenerating intervertebral discs: stimulus-responsive composite hydrogels from single to multiscale delivery systems. J Mater Chem B 2022; 10:5696-5722. [PMID: 35852563 DOI: 10.1039/d2tb01066f] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
As our research on the physiopathology of intervertebral disc degeneration (IVD degeneration, IVDD) has advanced and tissue engineering has rapidly evolved, cell-, biomolecule- and nucleic acid-based hydrogel grafting strategies have been widely investigated for their ability to overcome the harsh microenvironment of IVDD. However, such single delivery systems suffer from excessive external dimensions, difficult performance control, the need for surgical implantation, and difficulty in eliminating degradation products. Stimulus-responsive composite hydrogels have good biocompatibility and controllable mechanical properties and can undergo solution-gel phase transition under certain conditions. Their combination with ready-to-use particles to form a multiscale delivery system may be a breakthrough for regenerative IVD strategies. In this paper, we focus on summarizing the progress of research on the stimulus response mechanisms of regenerative IVD-related biomaterials and their design as macro-, micro- and nanoparticles. Finally, we discuss multi-scale delivery systems as bioinks for bio-3D printing technology for customizing personalized artificial IVDs, which promises to take IVD regenerative strategies to new heights.
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Affiliation(s)
- Xi-Dan Gao
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, P. R. China.
| | - Xiao-Bo Zhang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao tong University, Shaanxi 710000, P. R. China.
| | - Rui-Hao Zhang
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, P. R. China.
| | - De-Chen Yu
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, P. R. China.
| | - Xiang-Yi Chen
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, P. R. China.
| | - Yi-Cun Hu
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, P. R. China.
| | - Lang Chen
- Department of Gastrointestinal Surgery, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, P. R. China
| | - Hai-Yu Zhou
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu 730000, P. R. China.
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Yamada K, Iwasaki N, Sudo H. Biomaterials and Cell-Based Regenerative Therapies for Intervertebral Disc Degeneration with a Focus on Biological and Biomechanical Functional Repair: Targeting Treatments for Disc Herniation. Cells 2022; 11:602. [PMID: 35203253 PMCID: PMC8870062 DOI: 10.3390/cells11040602] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/22/2022] [Accepted: 02/07/2022] [Indexed: 12/11/2022] Open
Abstract
Intervertebral disc (IVD) degeneration is a common cause of low back pain and most spinal disorders. As IVD degeneration is a major obstacle to the healthy life of so many individuals, it is a major issue that needs to be overcome. Currently, there is no clinical treatment for the regeneration of degenerated IVDs. However, recent advances in regenerative medicine and tissue engineering suggest the potential of cell-based and/or biomaterial-based IVD regeneration therapies. These treatments may be indicated for patients with IVDs in the intermediate degenerative stage, a point where the number of viable cells decreases, and the structural integrity of the disc begins to collapse. However, there are many biological, biomechanical, and clinical challenges that must be overcome before the clinical application of these IVD regeneration therapies can be realized. This review summarizes the basic research and clinical trials literature on cell-based and biomaterial-based IVD regenerative therapies and outlines the important role of these strategies in regenerative treatment for IVD degenerative diseases, especially disc herniation.
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Affiliation(s)
- Katsuhisa Yamada
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (K.Y.); (N.I.)
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (K.Y.); (N.I.)
| | - Hideki Sudo
- Department of Advanced Medicine for Spine and Spinal Cord Disorders, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan
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Liu Y, Du J, Peng P, Cheng R, Lin J, Xu C, Yang H, Cui W, Mao H, Li Y, Geng D. Regulation of the inflammatory cycle by a controllable release hydrogel for eliminating postoperative inflammation after discectomy. Bioact Mater 2021; 6:146-157. [PMID: 32817921 PMCID: PMC7426539 DOI: 10.1016/j.bioactmat.2020.07.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/03/2020] [Accepted: 07/17/2020] [Indexed: 12/25/2022] Open
Abstract
Surgery is the final choice for most patients with intervertebral disc degeneration (IDD). Operation-caused trauma will cause inflammation in the intervertebral disc. Serious inflammation will cause tissue defects and induce tissue degeneration, IDD recurrence and the occurrence of other diseases. Therefore, we proposed a scheme to treat recurrence after discectomy by inhibiting inflammation with an aspirin (ASP)-loaded hydrogel to restore the mechanical stability of the spine and relieve local inflammation. ASP-liposomes (ASP-Lips) were incorporated into a photocrosslinkable gelatin-methacryloyl (GelMA) via mixing. This material can effectively alleviate inflammation by inhibiting the release of high mobility group box 1 (HMGB1) from the nucleus to the cytoplasm. We further assessed the expression of inflammatory cytokines, such as interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α), and degeneration-related factors, such as type II collagen (COL-2), Aggrecan, matrix metallopeptidases-3 (MMP-3), MMP-13, a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS-4) and ADAMTS-5 in rat nucleus pulpous cells. The level of IDD was analyzed through H&E, safranin-O staining and immunohistochemistry in rabbit samples. In vitro, we found that ASP-Lip@GelMA treatment significantly decreased inflammatory cytokines, MMP-3 and -13, and ADAMTS-4 and -5 and up-regulated COL-2 and Aggrecan via the inhibited release of HMGB-1 from the nucleus. In vivo, ASP-Lip@GelMA can effectively inhibit inflammation of local tissue after disc surgery and fill local tissue defects. This composite hydrogel system is a promising way to treat the recurrence of IDD after surgery without persistent complications.
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Affiliation(s)
- Yu Liu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
| | - Jiacheng Du
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
| | - Peng Peng
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
| | - Ruoyu Cheng
- Shanghai Institute of Traumatology and Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, PR China
| | - Jiayi Lin
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
| | - Congxin Xu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
| | - Huilin Yang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
| | - Wenguo Cui
- Shanghai Institute of Traumatology and Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, PR China
| | - Haiqing Mao
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
| | - Yuling Li
- Shanghai Institute of Traumatology and Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, PR China
- Department of Orthopaedics, Affiliated Hospital of North Sichuan Medical College, No.63 Wenhua Road, Nanchong, Sichuan, 637000, PR China
| | - Dechun Geng
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, PR China
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9
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Zhang C, Gullbrand SE, Schaer TP, Boorman S, Elliott DM, Chen W, Dodge GR, Mauck RL, Malhotra NR, Smith LJ. Combined Hydrogel and Mesenchymal Stem Cell Therapy for Moderate-Severity Disc Degeneration in Goats. Tissue Eng Part A 2020; 27:117-128. [PMID: 32546053 DOI: 10.1089/ten.tea.2020.0103] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Intervertebral disc degeneration is a cascade of cellular, structural, and biomechanical changes that is strongly implicated as a cause of low-back pain. Current treatment strategies have poor long-term efficacy as they seek only to alleviate symptoms without preserving or restoring native tissue structure and function. The objective of this study was to evaluate the efficacy of a combined triple interpenetrating network hydrogel (comprising dextran, chitosan, and teleostean) and mesenchymal stem cell (MSC) therapy targeting moderate-severity disc degeneration in a clinically relevant goat model. Degeneration was induced in lumbar discs of 10 large frame goats by injection of chondroitinase ABC. After 12 weeks, degenerate discs were treated by injection of either hydrogel alone or hydrogel seeded with allogeneic, bone marrow-derived MSCs. Untreated healthy and degenerate discs served as controls, and animals were euthanized 2 weeks after treatment. Discs exhibited a significant loss of disc height 12 weeks after degeneration was induced. Two weeks after treatment, discs that received the combined hydrogel and MSC injection exhibited a significant, 10% improvement in disc height index, as well as improvements in histological condition. Discs that were treated with hydrogel alone exhibited reduced tumor necrosis factor-α expression in the nucleus pulposus (NP). Microcomputed tomography imaging revealed that the hydrogel remained localized to the central NP region of all treated discs after 2 weeks of unrestricted activity. These encouraging findings motivate further, longer term studies of therapeutic efficacy of hydrogel and MSC injections in this large animal model. Impact statement Low-back pain is the leading cause of disability worldwide, and degeneration of the intervertebral discs is considered to be one of the most common reasons for low-back pain. Current treatment strategies focus solely on alleviation of symptoms, and there is a critical need for new treatments that also restore disc structure and function. In this study, using a clinically relevant goat model of moderate-severity disc degeneration, we demonstrate that a combined interpenetrating network hydrogel and mesenchymal stem cell therapy provides acute improvements in disc height, histological condition, and local inflammation.
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Affiliation(s)
- Chenghao Zhang
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sarah E Gullbrand
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Thomas P Schaer
- Comparative Orthopaedic Research Laboratory, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Sophie Boorman
- Comparative Orthopaedic Research Laboratory, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Dawn M Elliott
- Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA
| | - Weiliam Chen
- Department of Surgery, New York University School of Medicine, New York, New York, USA
| | - George R Dodge
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert L Mauck
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Neil R Malhotra
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lachlan J Smith
- Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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10
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Yang L, Fan X, Zhang J, Ju J. Preparation and Characterization of Thermoresponsive Poly( N-Isopropylacrylamide) for Cell Culture Applications. Polymers (Basel) 2020; 12:E389. [PMID: 32050412 PMCID: PMC7077488 DOI: 10.3390/polym12020389] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/07/2020] [Accepted: 01/17/2020] [Indexed: 12/20/2022] Open
Abstract
Poly(N-isopropylacrylamide) (PNIPAAm) is a typical thermoresponsive polymer used widely and studied deeply in smart materials, which is attractive and valuable owing to its reversible and remote "on-off" behavior adjusted by temperature variation. PNIPAAm usually exhibits opposite solubility or wettability across lower critical solution temperature (LCST), and it is readily functionalized making it available in extensive applications. Cell culture is one of the most prospective and representative applications. Active attachment and spontaneous detachment of targeted cells are easily tunable by surface wettability changes and volume phase transitions of PNIPAAm modified substrates with respect to ambient temperature. The thermoresponsive culture platforms and matching thermal-liftoff method can effectively substitute for the traditional cell harvesting ways like enzymatic hydrolysis and mechanical scraping, and will improve the stable and high quality of recovered cells. Therefore, the establishment and detection on PNIPAAm based culture systems are of particular importance. This review covers the important developments and recommendations for future work of the preparation and characterization of temperature-responsive substrates based on PNIPAAm and analogues for cell culture applications.
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Affiliation(s)
- Lei Yang
- College of Chemistry, Chemical Engineering and Environmental Engineering, Liaoning Shihua University, Fushun 113001, China; (J.Z.); (J.J.)
| | - Xiaoguang Fan
- College of Engineering, Shenyang Agricultural University, Shenyang 110866, China
| | - Jing Zhang
- College of Chemistry, Chemical Engineering and Environmental Engineering, Liaoning Shihua University, Fushun 113001, China; (J.Z.); (J.J.)
| | - Jia Ju
- College of Chemistry, Chemical Engineering and Environmental Engineering, Liaoning Shihua University, Fushun 113001, China; (J.Z.); (J.J.)
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11
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Ji X, Lei Z, Yuan M, Zhu H, Yuan X, Liu W, Pu H, Jiang J, Zhang Y, Jiang X, Xiao J. Cartilage repair mediated by thermosensitive photocrosslinkable TGFβ1-loaded GM-HPCH via immunomodulating macrophages, recruiting MSCs and promoting chondrogenesis. Theranostics 2020; 10:2872-2887. [PMID: 32194841 PMCID: PMC7052899 DOI: 10.7150/thno.41622] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/14/2020] [Indexed: 12/22/2022] Open
Abstract
Repairing cartilage defects using thermosensitive hydrogels is an attractive treatment strategy, but the poor mechanical properties and limited understanding of the interactions between hydrogels and cells limit their application. Methods: In this study, a thermosensitive hydroxypropyl chitin hydrogel (HPCH) was functionalized with methacrylate groups to synthesize photocrosslinkable glycidyl methacrylate-modified HPCH (GM-HPCH). GM-HPCH could form a gel in situ through a thermosensitive sol-gel transition and its mechanical properties can be improved by UV irradiation. Cell viability, cell adhesion and anti-apoptosis activity of GM-HPCH were evaluated. Transforming growth factor-β1 (TGFβ1) was introduced into the GM-HPCH hydrogel to fabricate the composite hydrogel. The macrophage immunomodulation, MSC recruitment and chondrogenesis of the composite hydrogel were evaluated. Results: With high biocompatibility, GM-HPCH could protect chondrocytes from apoptosis. Both the in vitro and in vivo experiments showed that GM-HPCH + TGFβ1 shifted the recruited macrophages from M1 to M2 and promoted chondrogenic gene expression. Additionally, the composite hydrogel could promote the migration of marrow stromal cells (MSCs) in the Transwell test and increase migrated gene expression. The fluorescent tracking of MSCs confirmed MSC homing in the rat chondral defect with the help of GM-HPCH. The macroscopic evaluation and histological results at 6 weeks and 12 weeks postsurgery showed that GM-HPCH + TGFβ1 can achieve superior cartilage healing. Conclusions: The GM-HPCH + TGFβ1 hydrogel effectively promoted cartilage repair via immunomodulating macrophages, recruiting MSCs and promoting chondrogenesis; thus it is a promising injectable hydrogel for cartilage regeneration.
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Affiliation(s)
- Xiongfa Ji
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Department of Orthopedics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, PR China
| | - Zehua Lei
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Meng Yuan
- Key Laboratory of Biomedical Polymers of Ministry of Education & Department of Chemistry, Wuhan University, Wuhan, 430072, China
| | - Hao Zhu
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xi Yuan
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wenbin Liu
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hongxu Pu
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jiawei Jiang
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yu Zhang
- Department of Orthopedics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, PR China
| | - Xulin Jiang
- Key Laboratory of Biomedical Polymers of Ministry of Education & Department of Chemistry, Wuhan University, Wuhan, 430072, China
| | - Jun Xiao
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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12
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Leone G, Consumi M, Lamponi S, Bonechi C, Tamasi G, Donati A, Rossi C, Magnani A. Thixotropic PVA hydrogel enclosing a hydrophilic PVP core as nucleus pulposus substitute. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 98:696-704. [PMID: 30813074 DOI: 10.1016/j.msec.2019.01.039] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 11/29/2018] [Accepted: 01/08/2019] [Indexed: 12/18/2022]
Abstract
A thixotropic polyvinyl alcohol (PVA) hydrogel, containing a hydrophilic poly-vinyl pyrrolidone (PVP) core, was obtained in order to develop a preformed 3D network able to maintain injectability. PVA was mixed with PVP in two different molar ratios (1:1 and 1:3) and chemically cross-linked using trisodium trimetaphosphate (STMP), which is able to react only with PVA component. A combination of Time of Flight- Secondary Ion Mass Spectrometry (ToF-SIMS), elemental analysis and UV spectroscopy permitted to determine both the cross-linking arm length and the crosslinking degree. Hydrogels were characterized in terms of swelling pressurization, rheological and mechanical behaviour. In particular, the viscoelastic behaviour of the hydrogel was analysed in shear and compression stress under dynamic conditions and compared with the performance of healthy human nucleus pulposus. In conclusion, the study demonstrated that the scaffold obtained mixing PVA and PVP in a molar ratio 1:1 can be considered a promising material to be utilised in the replacement of nucleus pulposus.
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Affiliation(s)
- Gemma Leone
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, via A. Moro 2, Siena 53100, Italy; INSTM, via G. Giusti 9, 50121 Firenze, Italy.
| | - Marco Consumi
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, via A. Moro 2, Siena 53100, Italy; INSTM, via G. Giusti 9, 50121 Firenze, Italy
| | - Stefania Lamponi
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, via A. Moro 2, Siena 53100, Italy; INSTM, via G. Giusti 9, 50121 Firenze, Italy
| | - Claudia Bonechi
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, via A. Moro 2, Siena 53100, Italy; CSGI, via della Lastruccia 3, 50019 Sesto Fiorentino, Italy
| | - Gabriella Tamasi
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, via A. Moro 2, Siena 53100, Italy; CSGI, via della Lastruccia 3, 50019 Sesto Fiorentino, Italy
| | - Alessandro Donati
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, via A. Moro 2, Siena 53100, Italy; CSGI, via della Lastruccia 3, 50019 Sesto Fiorentino, Italy
| | - Claudio Rossi
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, via A. Moro 2, Siena 53100, Italy; CSGI, via della Lastruccia 3, 50019 Sesto Fiorentino, Italy
| | - Agnese Magnani
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, via A. Moro 2, Siena 53100, Italy; INSTM, via G. Giusti 9, 50121 Firenze, Italy.
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13
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Tom B, Witko J, Lemay M, Singh A. Effects of bioengineered scaffold loaded with neurotrophins and locomotor training in restoring H-reflex responses after spinal cord injury. Exp Brain Res 2018; 236:3077-3084. [PMID: 30132039 DOI: 10.1007/s00221-018-5344-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 07/24/2018] [Indexed: 02/02/2023]
Abstract
The combinational effects of a bioengineered scaffold loaded with neurotrophins and rehabilitation training on spasticity observed after spinal cord injury (SCI) has not been studied. We used an animal model of moderate contusion injury at T9/T10 that received bioengineered scaffold poly N-isopropylacrylamide-g-poly ethylene glycol (PNIPAAm-g-PEG) loaded with BDNF/NT3 followed by body weight supported treadmill training (BWSTT) and assessed the efficacy of the combinational bioengineered approaches in treating spasticity. Five animal groups were included: Group 1: Sham, Group 2: Injury (SCI), Group 3: SCI + BWSTT (BWSTT), Group 4: SCI + PNIPAAm-g-PEG loaded with BDNF/NT3 (Transplant), and Group 5: SCI + PNIPAAm-g-PEG loaded with BDNF/NT3 + BWSTT (Combinational). Results indicate no significant changes in the BBB scores of animals among various groups, however, a significant restoration in the rate depression property of H-reflex was observed in both BWSTT and Combinational animals. Transplant group reported no improvement in the rate depression property of H-reflex and were similar to SCI only group. Histological findings report restoration of the chloride cotransporter (KCC2) labeling in both BWSTT and Combinational animals and down-regulation of KCC2 in both SCI and Transplant only animals. Findings from this study confirm that rehabilitation training is critical in restoring H-reflex responses and transplantation therapies alone cannot restore these responses after SCI. Also, although no significant difference was observed between the BWSTT and Combinational animals, comparable improvements in the two groups does open new pathways to exploring unique tissue-engineering approaches with promising clinical application for individuals with SCI.
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Affiliation(s)
- Babitha Tom
- Biomedical Engineering, Widener University, One University Place, Chester, PA, USA
| | - Jaclyn Witko
- Mechanical Engineering, Rowan University, Glassboro, NJ, USA
| | - Michel Lemay
- Bioengineering, College of Engineering, Temple University, 1947 North 12th St., Philadelphia, PA, USA
| | - Anita Singh
- Biomedical Engineering, Widener University, One University Place, Chester, PA, USA.
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14
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Stocco TD, Bassous NJ, Zhao S, Granato AEC, Webster TJ, Lobo AO. Nanofibrous scaffolds for biomedical applications. NANOSCALE 2018; 10:12228-12255. [PMID: 29947408 DOI: 10.1039/c8nr02002g] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Tissue engineering is an emergent and very interesting research field, providing potential solutions for a myriad of challenges in healthcare. Fibrous scaffolds specifically have shown promise as an effective tissue engineering method, as their high length-to-width ratio mimics that of extracellular matrix components, which in turn guides tissue formation, promotes cellular adhesion and improves mechanical properties. In this review paper, we discuss in detail both the importance of fibrous scaffolds for the promotion of tissue growth and the different methods to produce fibrous biomaterials to possess favorable and unique characteristics. Here, we focus on the pressing need to develop biomimetic structures that promote an ideal environment to encourage tissue formation. In addition, we discuss different biomedical applications in which fibrous scaffolds can be useful, identifying their importance, relevant aspects, and remaining significant challenges. In conclusion, we provide comments on the future direction of fibrous scaffolds and the best way to produce them, proposed in light of recent technological advances and the newest and most promising fabrication techniques.
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Affiliation(s)
- Thiago D Stocco
- Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil
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15
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Varma DM, Lin HA, Long RG, Gold GT, Hecht AC, Iatridis JC, Nicoll SB. Thermoresponsive, redox-polymerized cellulosic hydrogels undergo in situ gelation and restore intervertebral disc biomechanics post discectomy. Eur Cell Mater 2018; 35:300-317. [PMID: 29845998 PMCID: PMC6016390 DOI: 10.22203/ecm.v035a21] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Back and neck pain are commonly associated with intervertebral disc (IVD) degeneration. Structural augmentation of diseased nucleus pulposus (NP) tissue with biomaterials could restore degeneration-related IVD height loss and degraded biomechanical behaviors; however, effective NP replacement biomaterials are not commercially available. This study developed a novel, crosslinked, dual-polymer network (DPN) hydrogel comprised of methacrylated carboxymethylcellulose (CMC) and methylcellulose (MC), and used in vitro, in situ and in vivo testing to assess its efficacy as an injectable, in situ gelling, biocompatible material that matches native NP properties and restores IVD biomechanical behaviors. Thermogelling MC was required to enable consistent and timely gelation of CMC in situ within whole IVDs. The CMC-MC hydrogel was tuned to match compressive and swelling NP tissue properties. When injected into whole IVDs after discectomy injury, CMC-MC restored IVD height and compressive biomechanical behaviors, including range of motion and neutral zone stiffness, to intact levels. Subcutaneous implantation of the hydrogels in rats further demonstrated good biocompatibility of CMC-MC with a relatively thin fibrous capsule, similar to comparable biomaterials. In conclusion, CMC-MC is an injectable, tunable and biocompatible hydrogel with strong potential to be used as an NP replacement biomaterial since it can gel in situ, match NP properties, and restore IVD height and biomechanical function. Future investigations will evaluate herniation risk under severe loading conditions and assess long-term in vivo performance.
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Affiliation(s)
| | | | | | | | | | | | - S B Nicoll
- Department of Biomedical Engineering, The City College of New York, Steinman Hall, Room 401, 160 Convent Avenue, New York, NY 10031,
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16
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van Uden S, Silva-Correia J, Oliveira JM, Reis RL. Current strategies for treatment of intervertebral disc degeneration: substitution and regeneration possibilities. Biomater Res 2017; 21:22. [PMID: 29085662 PMCID: PMC5651638 DOI: 10.1186/s40824-017-0106-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/05/2017] [Indexed: 02/06/2023] Open
Abstract
Background Intervertebral disc degeneration has an annual worldwide socioeconomic impact masked as low back pain of over 70 billion euros. This disease has a high prevalence over the working age class, which raises the socioeconomic impact over the years. Acute physical trauma or prolonged intervertebral disc mistreatment triggers a biochemical negative tendency of catabolic-anabolic balance that progress to a chronic degeneration disease. Current biomedical treatments are not only ineffective in the long-run, but can also cause degeneration to spread to adjacent intervertebral discs. Regenerative strategies are desperately needed in the clinics, such as: minimal invasive nucleus pulposus or annulus fibrosus treatments, total disc replacement, and cartilaginous endplates decalcification. Main body Herein, it is reviewed the state-of-the-art of intervertebral disc regeneration strategies from the perspective of cells, scaffolds, or constructs, including both popular and unique tissue engineering approaches. The premises for cell type and origin selection or even absence of cells is being explored. Choice of several raw materials and scaffold fabrication methods are evaluated. Extensive studies have been developed for fully regeneration of the annulus fibrosus and nucleus pulposus, together or separately, with a long set of different rationales already reported. Recent works show promising biomaterials and processing methods applied to intervertebral disc substitutive or regenerative strategies. Facing the abundance of studies presented in the literature aiming intervertebral disc regeneration it is interesting to observe how cartilaginous endplates have been extensively neglected, being this a major source of nutrients and water supply for the whole disc. Conclusion Several innovative avenues for tackling intervertebral disc degeneration are being reported – from acellular to cellular approaches, but the cartilaginous endplates regeneration strategies remain unaddressed. Interestingly, patient-specific approaches show great promise in respecting patient anatomy and thus allow quicker translation to the clinics in the near future.
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Affiliation(s)
- Sebastião van Uden
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR Gandra, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga Portugal.,Present Address: Bioengineering Laboratories Srl, Viale Brianza 8, Meda, Italy.,Present Address: Politecnico di Milano, Piazza Leonardo da Vinci, 32 Milan, Italy
| | - Joana Silva-Correia
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR Gandra, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga Portugal
| | - Joaquim Miguel Oliveira
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR Gandra, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga Portugal.,The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, 4805-017 Barco Guimarães, Portugal
| | - Rui Luís Reis
- 3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco GMR Gandra, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga Portugal.,The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, 4805-017 Barco Guimarães, Portugal
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17
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Functional compressive mechanics and tissue biocompatibility of an injectable SF/PU hydrogel for nucleus pulposus replacement. Sci Rep 2017; 7:2347. [PMID: 28539658 PMCID: PMC5443820 DOI: 10.1038/s41598-017-02497-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 04/10/2017] [Indexed: 11/08/2022] Open
Abstract
In spinal degenerative disease, an injectable liquid hydrogel can fill in defect entirely, lessen the danger of implant relocation and following loss of disc height, minimizing the operative trauma. Here, we propose an injectable in-situ chemically cross-linked hydrogel by a two-component reaction of liquid silk fibroin with liquid polyurethane at physiological temperature conditions. Confined compression tests and fatigue tests were reported to assess physical properties of the hydrogel. Impact of different diameter on the biomechanical behaviours was tested to evaluate the clinical potentiality of the hydrogel for replacing nucleus pulposus. Degradation behaviours in different solutions and animal experiments were also investigated to examine the tissue biocompatibility of the hydrogel. The hydrogel modulus was affected by the hydrogel geometrical (diameter) parameters. SF/PU composite hydrogel can survive a million cycles, unconstrained fatigue resistance. More importantly, in vivo biocompatibility using New Zealand white rabbits, showed good biocompatibility over a three-month period in culture. Particularly, they showed the significant clinical merit of providing stronger axial compressive stiffness on confined compression test. Based on the outcomes of the present research, the SF/PU composite hydrogel may provide significant advantages for use in future clinical application in replacing nucleus pulposus field.
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18
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Bowles RD, Setton LA. Biomaterials for intervertebral disc regeneration and repair. Biomaterials 2017; 129:54-67. [PMID: 28324865 DOI: 10.1016/j.biomaterials.2017.03.013] [Citation(s) in RCA: 216] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/05/2017] [Accepted: 03/10/2017] [Indexed: 12/11/2022]
Abstract
The intervertebral disc contributes to motion, weight bearing, and flexibility of the spine, but is susceptible to damage and morphological changes that contribute to pathology with age and injury. Engineering strategies that rely upon synthetic materials or composite implants that do not interface with the biological components of the disc have not met with widespread use or desirable outcomes in the treatment of intervertebral disc pathology. Here we review bioengineering advances to treat disc disorders, using cell-supplemented materials, or acellular, biologically based materials, that provide opportunity for cell-material interactions and remodeling in the treatment of intervertebral disc disorders. While a field still in early development, bioengineering-based strategies employing novel biomaterials are emerging as promising alternatives for clinical treatment of intervertebral disc disorders.
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Affiliation(s)
- Robert D Bowles
- Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA.
| | - Lori A Setton
- Department of Biomedical Engineering & Orthopedic Surgery, Washington University in St. Louis, St. Louis, MO 63130, USA.
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19
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Illien-Jünger S, Sedaghatpour DD, Laudier DM, Hecht AC, Qureshi SA, Iatridis JC. Development of a bovine decellularized extracellular matrix-biomaterial for nucleus pulposus regeneration. J Orthop Res 2016; 34:876-88. [PMID: 26509556 PMCID: PMC4898647 DOI: 10.1002/jor.23088] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/22/2015] [Indexed: 02/04/2023]
Abstract
Painful intervertebral disc (IVD) degeneration is a common cause for spinal surgery. There is a clinical need to develop injectable biomaterials capable of promoting IVD regeneration, yet many available biomaterials do not mimic the native extracellular matrix (ECM) or promote matrix production. This study aimed to develop a decellularized injectable bovine ECM material that maintains structural and compositional features of native tissue and promotes nucleus pulposus (NP) cell (NPC) and mesenchymal stem cell (MSC) adaption. Injectable decellularized ECM constructs were created using 3 NP tissue decellularization methods (con.A: sodium deoxycholate, con.B: sodium deoxycholate & sodium dodecyl sulfate, con.C: sodium deoxycholate, sodium dodecyl sulfate & TritonX-100) and evaluated for protein, microstructure, and for cell adaptation in 21 day human NPC and MSC culture experiments. Con.A was most efficient at DNA depletion, preserved best collagen microstructure and content, and maintained the highest glycosaminoglycan (GAG) content. NPCs in decellularized constructs of con.A&B demonstrated newly synthesized GAG production, which was apparent from "halos" of GAG staining surrounding seeded NPCs. Con.A also promoted MSC adaption with high cell viability and ECM production. The injectable decellularized NP biomaterial that used sodium deoxycholate without additional decellularization steps maintained native NP tissue structure and composition closest to natural ECM and promoted cellular adaptation of NP cells and MSCs. This natural decellularized biomaterial warrants further investigation for its potential as an injectable cell seeded supplement to augment NP replacement biomaterials and deliver NPCs or MSCs. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:876-888, 2016.
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Affiliation(s)
- Svenja Illien-Jünger
- Leni & Peter W. May Department of Orthopaedics; Icahn School of Medicine at Mount Sinai; New York New York
| | - Dillon D. Sedaghatpour
- Leni & Peter W. May Department of Orthopaedics; Icahn School of Medicine at Mount Sinai; New York New York
| | - Damien M. Laudier
- Leni & Peter W. May Department of Orthopaedics; Icahn School of Medicine at Mount Sinai; New York New York
| | - Andrew C. Hecht
- Leni & Peter W. May Department of Orthopaedics; Icahn School of Medicine at Mount Sinai; New York New York
| | - Sheeraz A. Qureshi
- Leni & Peter W. May Department of Orthopaedics; Icahn School of Medicine at Mount Sinai; New York New York
| | - James C. Iatridis
- Leni & Peter W. May Department of Orthopaedics; Icahn School of Medicine at Mount Sinai; New York New York
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20
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Phase behavior, microstructure and cytotoxicity in mixtures of a charged triblock copolymer and an ionic surfactant. Eur Polym J 2016. [DOI: 10.1016/j.eurpolymj.2016.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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21
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Oehme D, Goldschlager T, Rosenfeld JV, Ghosh P, Jenkin G. The role of stem cell therapies in degenerative lumbar spine disease: a review. Neurosurg Rev 2015; 38:429-45. [PMID: 25749802 DOI: 10.1007/s10143-015-0621-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 06/23/2014] [Accepted: 01/18/2015] [Indexed: 02/06/2023]
Abstract
Degenerative conditions of the lumbar spine are extremely common. Ninety percent of people over the age of 60 years have degenerative change on imaging; however, only a small minority of people will require spine surgery (Hicks et al. Spine (Phila Pa 1976) 34(12):1301-1306, 2009). This minority, however, constitutes a core element of spinal surgery practice. Whilst the patient outcomes from spinal surgeries have improved in recent years, some patients will remain with pain and disability despite technically successful surgery. Advances in regenerative medicine and stem cell therapies, particularly the use of mesenchymal stem cells and allogeneic mesenchymal precursor cells, have led to numerous clinical trials utilising these cell-based therapies to treat degenerative spinal conditions. Through cartilage formation and disc regeneration, fusion enhancement or via modification of pain pathways, stem cells are well suited to enhance spinal surgery practice. This review will focus on the outcomes of lumbar spinal procedures and the role of stem cells in the treatment of degenerative lumbar conditions to enhance clinical practice. The current status of clinical trials utilising stem cell therapies will be discussed, providing clinicians with an overview of the various cell-based treatments likely to be available to patients in the near future.
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Affiliation(s)
- David Oehme
- The Ritchie Centre, MIM-PHI Institute of Medical Research, Monash University Clayton Victoria, PO Box 6178, Clayton, VIC, 3141, Australia,
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Abstract
The recent research progress in biological and biomedical applications of hyperbranched polymers has been summarized in this review.
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Affiliation(s)
- Dali Wang
- School of Chemistry and Chemical Engineering
- State Key Laboratory of Metal Matrix Composites
- Shanghai Jiao Tong University
- 200240 Shanghai
- P. R. China
| | - Tianyu Zhao
- Charles Institute of Dermatology
- School of Medicine and Medical Science
- University College Dublin
- Dublin 4
- Ireland
| | - Xinyuan Zhu
- School of Chemistry and Chemical Engineering
- State Key Laboratory of Metal Matrix Composites
- Shanghai Jiao Tong University
- 200240 Shanghai
- P. R. China
| | - Deyue Yan
- School of Chemistry and Chemical Engineering
- State Key Laboratory of Metal Matrix Composites
- Shanghai Jiao Tong University
- 200240 Shanghai
- P. R. China
| | - Wenxin Wang
- Charles Institute of Dermatology
- School of Medicine and Medical Science
- University College Dublin
- Dublin 4
- Ireland
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Han X, Xiao P, Zhao H, Zeng C, Zhou J. Response mechanism of the phase transitions of poly(n-isopropylacrylamide-co-benzo-18-crown-6-acrylamide) using infrared spectroscopy. APPLIED SPECTROSCOPY 2014; 68:879-889. [PMID: 25061789 DOI: 10.1366/13-07437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The thermal and ionic effects on the phase transitions of poly(N-isopropylacrylamide) (PNIPAAm) and its copolymer with benzo-18-crown-6-acrylamide, poly(N-isopropylacrylamide-co-benzo-18-crown-6-acrylamide) (PNIPAAm-co-BCAm), were investigated using infrared (IR) spectral variations of methyl (CH3), C=O, and amine (NH) groups. Subsequently, perturbation correlation moving-window two-dimensional correlation infrared spectroscopy (PCMW 2D-IR) was applied to clarify the differences in the phase-transition mechanisms of the polymers. The dominant influence on the phase-transition mechanism of PNIPAAm is whether the anion is evenly distributed in the bulk solution. The results show that the phase transition shifts to a lower temperature with increasing barium chloride (BaCl2) concentrations. In addition, the effect of the anion on the chemical group is homogeneous upon heating. As a result, the relevant transition temperature ranges have remain approximately constant. In contrast, the dominant influence on the phase-transition mechanism of PNIPAAm-co-BCAm is the interactions of the polymer chains with barium ions (Ba(2+)). The hydrophilic BCAm-Ba(2+) complexes distributed in the PNIPAAm-co-BCAm chain prevent the water molecules from leaving the polymer chains, which leads to an increase in the transition temperature and the complicated variation of the transition temperature range, as environmental stimuli-response behavior, with increasing BaCl2 concentrations.
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Affiliation(s)
- Xiaoyan Han
- Xiangtan University, School of Chemical Engineering, Xiangtan 411105, China
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Hunt JA, Chen R, van Veen T, Bryan N. Hydrogels for tissue engineering and regenerative medicine. J Mater Chem B 2014; 2:5319-5338. [DOI: 10.1039/c4tb00775a] [Citation(s) in RCA: 242] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Injectable hydrogels have become an incredibly prolific area of research in the field of tissue engineering and regenerative medicine, because of their high water content, mechanical similarity to natural tissues, and ease of surgical implantation, hydrogels are at the forefront of biomedical scaffold and drug carrier design.
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Affiliation(s)
- John A. Hunt
- Clinical Engineering
- Institute of Ageing and Chronic Disease
- University of Liverpool
- Liverpool, UK
| | - Rui Chen
- Clinical Engineering
- Institute of Ageing and Chronic Disease
- University of Liverpool
- Liverpool, UK
| | - Theun van Veen
- Clinical Engineering
- Institute of Ageing and Chronic Disease
- University of Liverpool
- Liverpool, UK
| | - Nicholas Bryan
- Clinical Engineering
- Institute of Ageing and Chronic Disease
- University of Liverpool
- Liverpool, UK
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Alimada B, Yamamoto SI, Moriya O. Synthesis of thermo- and photoresponsive polysilsesquioxane containing tetraethylene glycol chains and an azobenzene group. Polym J 2013. [DOI: 10.1038/pj.2013.92] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Silva-Correia J, Correia SI, Oliveira JM, Reis RL. Tissue engineering strategies applied in the regeneration of the human intervertebral disk. Biotechnol Adv 2013; 31:1514-31. [DOI: 10.1016/j.biotechadv.2013.07.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 07/12/2013] [Accepted: 07/26/2013] [Indexed: 01/03/2023]
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Malda J, Visser J, Melchels FP, Jüngst T, Hennink WE, Dhert WJA, Groll J, Hutmacher DW. 25th anniversary article: Engineering hydrogels for biofabrication. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2013; 25:5011-28. [PMID: 24038336 DOI: 10.1002/adma.201302042] [Citation(s) in RCA: 1090] [Impact Index Per Article: 99.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 06/19/2013] [Indexed: 05/19/2023]
Abstract
With advances in tissue engineering, the possibility of regenerating injured tissue or failing organs has become a realistic prospect for the first time in medical history. Tissue engineering - the combination of bioactive materials with cells to generate engineered constructs that functionally replace lost and/or damaged tissue - is a major strategy to achieve this goal. One facet of tissue engineering is biofabrication, where three-dimensional tissue-like structures composed of biomaterials and cells in a single manufacturing procedure are generated. Cell-laden hydrogels are commonly used in biofabrication and are termed "bioinks". Hydrogels are particularly attractive for biofabrication as they recapitulate several features of the natural extracellular matrix and allow cell encapsulation in a highly hydrated mechanically supportive three-dimensional environment. Additionally, they allow for efficient and homogeneous cell seeding, can provide biologically-relevant chemical and physical signals, and can be formed in various shapes and biomechanical characteristics. However, despite the progress made in modifying hydrogels for enhanced bioactivation, cell survival and tissue formation, little attention has so far been paid to optimize hydrogels for the physico-chemical demands of the biofabrication process. The resulting lack of hydrogel bioinks have been identified as one major hurdle for a more rapid progress of the field. In this review we summarize and focus on the deposition process, the parameters and demands of hydrogels in biofabrication, with special attention to robotic dispensing as an approach that generates constructs of clinically relevant dimensions. We aim to highlight this current lack of effectual hydrogels within biofabrication and initiate new ideas and developments in the design and tailoring of hydrogels. The successful development of a "printable" hydrogel that supports cell adhesion, migration, and differentiation will significantly advance this exciting and promising approach for tissue engineering.
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Affiliation(s)
- Jos Malda
- Department of Orthopaedics, University Medical Center Utrecht, P.O. Box 85500, 3508, GA Utrecht, The Netherlands; Institute of Health and Biomedical Innovation, Queensland University of TechnologyKelvin Grove Urban Village, Brisbane, QLD 4059, Australia; Department of Equine Sciences, Faculty of Veterinary Sciences, Utrecht University, Yalelaan 112, 3584 CM, Utrecht, The Netherlands
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Abdullah-Al-Nahain, Lee KS, Mosaiab T, Park SY. pH and thermo-responsive poly(N-isopropylacrylamide) copolymer grafted to poly(ethylene glycol). J Appl Polym Sci 2013. [DOI: 10.1002/app.39150] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Iatridis JC, Nicoll SB, Michalek AJ, Walter BA, Gupta MS. Role of biomechanics in intervertebral disc degeneration and regenerative therapies: what needs repairing in the disc and what are promising biomaterials for its repair? Spine J 2013; 13:243-62. [PMID: 23369494 PMCID: PMC3612376 DOI: 10.1016/j.spinee.2012.12.002] [Citation(s) in RCA: 219] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 07/26/2012] [Accepted: 12/09/2012] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Degeneration and injuries of the intervertebral disc (IVD) result in large alterations in biomechanical behaviors. Repair strategies using biomaterials can be optimized based on the biomechanical and biological requirements of the IVD. PURPOSE To review the present literature on the effects of degeneration, simulated degeneration, and injury on biomechanics of the IVD, with special attention paid to needle puncture injuries, which are a pathway for diagnostics and regenerative therapies and the promising biomaterials for disc repair with a focus on how those biomaterials may promote biomechanical repair. STUDY DESIGN A narrative review to evaluate the role of biomechanics on disc degeneration and regenerative therapies with a focus on what biomechanical properties need to be repaired and how to evaluate and accomplish such repairs using biomaterials. Model systems for the screening of such repair strategies are also briefly described. METHODS Articles were selected from two main PubMed searches using keywords: intervertebral AND biomechanics (1,823 articles) and intervertebral AND biomaterials (361 articles). Additional keywords (injury, needle puncture, nucleus pressurization, biomaterials, hydrogel, sealant, tissue engineering) were used to narrow the articles down to the topics most relevant to this review. RESULTS Degeneration and acute disc injuries have the capacity to influence nucleus pulposus (NP) pressurization and annulus fibrosus (AF) integrity, which are necessary for an effective disc function and, therefore, require repair. Needle injection injuries are of particular clinical relevance with the potential to influence disc biomechanics, cellularity, and metabolism, yet these effects are localized or small and more research is required to evaluate and reduce the potential clinical morbidity using such techniques. NP replacement strategies, such as hydrogels, are required to restore the NP pressurization or the lost volume. AF repair strategies including cross-linked hydrogels, fibrous composites, and sealants offer promise for regenerative therapies to restore AF integrity. Tissue engineered IVD structures, as a single implantable construct, may promote greater tissue integration due to the improved repair capacity of the vertebral bone. CONCLUSIONS IVD height, neutral zone characteristics, and torsional biomechanics are sensitive to specific alterations in the NP pressurization and AF integrity and must be addressed for an effective functional repair. Synthetic and natural biomaterials offer promise for NP replacement, AF repair, as an AF sealant, or whole disc replacement. Meeting mechanical and biological compatibilities are necessary for the efficacy and longevity of the repair.
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Affiliation(s)
- James C. Iatridis
- Leni and Peter W. May Department of Orthopaedics, Mount Sinai School of Medicine, New York, NY
| | - Steven B. Nicoll
- Department of Biomedical Engineering, The City College of New York, New York, NY
| | - Arthur J. Michalek
- Department of Molecular Physiology and Biophysics, University of Vermont, Burlington, VT
| | - Benjamin A. Walter
- Leni and Peter W. May Department of Orthopaedics, Mount Sinai School of Medicine, New York, NY,Department of Biomedical Engineering, The City College of New York, New York, NY
| | - Michelle S. Gupta
- Department of Biomedical Engineering, The City College of New York, New York, NY
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Fluorine-containing thermo-sensitive core/shell microgel particles: Preparation, characterization, and their applications in controlled drug release. J Fluor Chem 2012. [DOI: 10.1016/j.jfluchem.2011.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hu J, Chen B, Guo F, Du J, Gu P, Lin X, Yang W, Zhang H, Lu M, Huang Y, Xu G. Injectable silk fibroin/polyurethane composite hydrogel for nucleus pulposus replacement. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2012; 23:711-22. [PMID: 22231270 DOI: 10.1007/s10856-011-4533-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Accepted: 12/10/2011] [Indexed: 05/07/2023]
Abstract
In degenerative disc disease, an injectable hydrogel can fill a degenerate area completely, reduce the risk of implant migration and subsequent loss of height of the intervertebral disc, and minimise surgical defects. Here, we propose a method of preparing an injectable silk fibroin/polyurethane (SF/PU) composite hydrogel by chemical cross-linking under physiological conditions. Mechanical testing was used to determine the mechanical strength of the hydrogel. The impact of hydrogel height on the biomechanical properties was discussed to estimate the working capacity of the hydrogel for further clinical application. Rheological properties were also examined to assess the practical ability of the hydrogel for clinical application. Hydrogel injection and cell assessment is also of interest for clinical application. An SF/PU composite hydrogel can be injected through a small incision. A cell proliferation assay using bone marrow stromal cells showed positive cell viability and increased proliferation over a seven-day period in culture. Importantly, the hydrogel can be monitored in real-time using X-ray fluoroscopy during and after surgery according to the results of X-ray fluoroscopy examination, and shows good visibility based on X-ray assays. In particular, the hydrogel offers the clinically important advantage of visibility in CT and T2-weighted magnetic resonance imaging. Based on the results of the current study, the SF/AU composite hydrogel may offer several advantages for future application in nucleus pulposus replacement.
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Affiliation(s)
- Jingen Hu
- Department of Orthopedics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Guo H, Ulbricht M. Preparation of thermo-responsive polypropylene membranes via surface entrapment of poly(N-isopropylacrylamide)-containing macromolecules. J Memb Sci 2011. [DOI: 10.1016/j.memsci.2011.02.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hsieh AH, Yoon ST. Update on the pathophysiology of degenerative disc disease and new developments in treatment strategies. Open Access J Sports Med 2010; 1:191-9. [PMID: 24198557 PMCID: PMC3781869 DOI: 10.2147/oajsm.s9057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Degenerative disc disease (DDD) continues to be a prevalent condition that afflicts populations on a global scale. The economic impact and decreased quality of life primarily stem from back pain and neurological deficits associated with intervertebral disc degeneration. Although much effort has been invested into understanding the etiology of DDD and its relationship to the onset of back pain, this endeavor is a work in progress. The purpose of this review is to provide focused discussion on several areas in which recent advances have been made. Specifically, we have categorized these advances into early, middle, and late phases of age-related or degenerative changes in the disc and into promising minimally invasive treatments, which aim to restore mechanical and biological functions to the disc.
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Affiliation(s)
- Adam H Hsieh
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA
- Department of Orthopedics, University of Maryland, Baltimore, MD, USA
| | - S Tim Yoon
- Department of Orthopedic Surgery, Emory University, Chief of Orthopedic Surgery, Veterans Affairs Medical Center, Atlanta, GA, USA
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