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Xu Y, Zheng S, Tian Q, Kou Z, Li W, Xie X, Wu X. Deep Learning Model for Grading and Localization of Lumbar Disc Herniation on Magnetic Resonance Imaging. J Magn Reson Imaging 2024. [PMID: 38676436 DOI: 10.1002/jmri.29403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Methods for grading and localization of lumbar disc herniation (LDH) on MRI are complex, time-consuming, and subjective. Utilizing deep learning (DL) models as assistance would mitigate such complexities. PURPOSE To develop an interpretable DL model capable of grading and localizing LDH. STUDY TYPE Retrospective. SUBJECTS 1496 patients (M/F: 783/713) were evaluated, and randomly divided into training (70%), validation (10%), and test (20%) sets. FIELD STRENGTH/SEQUENCE 1.5T MRI for axial T2-weighted sequences (spin echo). ASSESSMENT The training set was annotated by three spinal surgeons using the Michigan State University classification to train the DL model. The test set was annotated by a spinal surgery expert (as ground truth labels), and two spinal surgeons (comparison with the trained model). An external test set was employed to evaluate the generalizability of the DL model. STATISTICAL TESTS Calculated intersection over union (IoU) for detection consistency, utilized Gwet's AC1 to assess interobserver agreement, and evaluated model performance based on sensitivity and specificity, with statistical significance set at P < 0.05. RESULTS The DL model achieved high detection consistency in both the internal test dataset (grading: mean IoU 0.84, recall 99.6%; localization: IoU 0.82, recall 99.5%) and external test dataset (grading: 0.72, 98.0%; localization: 0.71, 97.6%). For internal testing, the DL model (grading: 0.81; localization: 0.76), Rater 1 (0.88; 0.82), and Rater 2 (0.86; 0.83) demonstrated results highly consistent with the ground truth labels. The overall sensitivity of the DL model was 87.0% for grading and 84.0% for localization, while the specificity was 95.5% and 94.4%. For external testing, the DL model showed an appreciable decrease in consistency (grading: 0.69; localization: 0.66), sensitivity (77.2%; 76.7%), and specificity (92.3%; 91.8%). DATA CONCLUSION The classification capabilities of the DL model closely resemble those of spinal surgeons. For future improvement, enriching the diversity of cases could enhance the model's generalization. LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY Stage 2.
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Affiliation(s)
- Yefu Xu
- Department of Spine Surgery, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shijie Zheng
- Department of Spine Surgery, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Qingyi Tian
- Department of Spine Surgery, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhuoyan Kou
- Department of Spine Surgery, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Wenqing Li
- Department of Spine Surgery, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xinhui Xie
- Department of Spine Surgery, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xiaotao Wu
- Department of Spine Surgery, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
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Notarangelo MP, Penolazzi L, Lambertini E, Falzoni S, De Bonis P, Capanni C, Di Virgilio F, Piva R. The NFATc1/P2X7 receptor relationship in human intervertebral disc cells. Front Cell Dev Biol 2024; 12:1368318. [PMID: 38638530 PMCID: PMC11024252 DOI: 10.3389/fcell.2024.1368318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/13/2024] [Indexed: 04/20/2024] Open
Abstract
A comprehensive understanding of the molecules that play key roles in the physiological and pathological homeostasis of the human intervertebral disc (IVD) remains challenging, as does the development of new therapeutic treatments. We recently found a positive correlation between IVD degeneration (IDD) and P2X7 receptor (P2X7R) expression increases both in the cytoplasm and in the nucleus. Using immunocytochemistry, reverse transcription PCR (RT-PCR), overexpression, and chromatin immunoprecipitation, we found that NFATc1 and hypoxia-inducible factor-1α (HIF-1α) are critical regulators of P2X7R. Both transcription factors are recruited at the promoter of the P2RX7 gene and involved in its positive and negative regulation, respectively. Furthermore, using the proximity ligation assay, we revealed that P2X7R and NFATc1 form a molecular complex and that P2X7R is closely associated with lamin A/C, a major component of the nuclear lamina. Collectively, our study identifies, for the first time, P2X7R and NFATc1 as markers of IVD degeneration and demonstrates that both NFATc1 and lamin A/C are interaction partners of P2X7R.
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Affiliation(s)
| | - Letizia Penolazzi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Elisabetta Lambertini
- Department of Chemical, Pharmaceutical and Agricultural Sciences of the University of Ferrara, Ferrara, Italy
| | - Simonetta Falzoni
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pasquale De Bonis
- Neurosurgery Department, Sant’Anna University Hospital, Ferrara, Italy
| | - Cristina Capanni
- CNR Institute of Molecular Genetics “Luigi Luca Cavalli-Sforza”, Unit of Bologna, Bologna, Italy
- IRCCS Rizzoli Orthopedic Institute, Bologna, Italy
| | | | - Roberta Piva
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Yu C, Zhao J, Cheng F, Chen J, Chen J, Xu H, Shi K, Xia K, Ding S, Wang K, Wang R, Chen Y, Li Y, Li H, Chen Q, Yu X, Shao F, Liang C, Li F. Silencing circATXN1 in Aging Nucleus Pulposus Cell Alleviates Intervertebral Disc Degeneration via Correcting Progerin Mislocalization. RESEARCH (WASHINGTON, D.C.) 2024; 7:0336. [PMID: 38533181 PMCID: PMC10964222 DOI: 10.34133/research.0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/17/2024] [Indexed: 03/28/2024]
Abstract
Circular RNAs (circRNAs) play a critical regulatory role in degenerative diseases; however, their functions and therapeutic applications in intervertebral disc degeneration (IVDD) have not been explored. Here, we identified that a novel circATXN1 highly accumulates in aging nucleus pulposus cells (NPCs) accountable for IVDD. CircATXN1 accelerates cellular senescence, disrupts extracellular matrix organization, and inhibits mitochondrial respiration. Mechanistically, circATXN1, regulated by heterogeneous nuclear ribonucleoprotein A2B1-mediated splicing circularization, promotes progerin translocation from the cell nucleus to the cytoplasm and inhibits the expression of insulin-like growth factor 1 receptor (IGF-1R). To demonstrate the therapeutic potential of circATXN1, siRNA targeting the backsplice junction of circATNX1 was screened and delivered by tetrahedral framework nucleic acids (tFNAs) due to their unique compositional and tetrahedral structural features. Our siRNA delivery system demonstrates superior abilities to transfect aging cells, clear intracellular ROS, and enhanced biological safety. Using siRNA-tFNAs to silence circATXN1, aging NPCs exhibit reduced mislocalization of progerin in the cytoplasm and up-regulation of IGF-1R, thereby demonstrating a rejuvenated cellular phenotype and improved mitochondrial function. In vivo, administering an aging cell-adapted siRNA nucleic acid framework delivery system to progerin pathologically expressed premature aging mice (zmpste24-/-) can ameliorate the cellular matrix in the nucleus pulposus tissue, effectively delaying IVDD. This study not only identified circATXN1 functioning as a cell senescence promoter in IVDD for the first time, but also successfully demonstrated its therapeutic potential via a tFNA-based siRNA delivery strategy.
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Affiliation(s)
- Chao Yu
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Jing Zhao
- Department of Chemistry,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
| | - Feng Cheng
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Jiangjie Chen
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Jinyang Chen
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Haibin Xu
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Kesi Shi
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Kaishun Xia
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Siwen Ding
- Westlake Street Community Health Service Center, Hangzhou 310009, Zhejiang, PR China
| | - Kanbin Wang
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Ronghao Wang
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Yazhou Chen
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Yi Li
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Hao Li
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Qixin Chen
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Xiaohua Yu
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Fangwei Shao
- Zhejiang University-University of Illinois at Urbana-Champaign Institute,
Zhejiang University, Haining 314400, Zhejiang, PR China
- Biomedical and Health Translational Research Centre,
Zhejiang University, Haining 314400, Zhejiang, PR China
| | - Chengzhen Liang
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
| | - Fangcai Li
- Department of Orthopedics, 2nd Affiliated Hospital, School of Medicine,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Orthopedics Research Institute of Zhejiang University,
Zhejiang University, Hangzhou 310009, Zhejiang, PR China
- Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
- Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou 310009, Zhejiang, PR China
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Li C, Zhang Y, Deng Y, Chen Y, Wu C, Zhao X, Chen X, Wang X, Zhou Y, Zhang X, Tian N. Fisetin suppresses ferroptosis through Nrf2 and attenuates intervertebral disc degeneration in rats. Eur J Pharmacol 2024; 964:176298. [PMID: 38145645 DOI: 10.1016/j.ejphar.2023.176298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
Low back pain, primarily caused by intervertebral disc degeneration (IVDD), lacks effective pharmacological treatments. Oxidative stress has been identified as a significant contributor to IVDD. This study aims to establish an in vitro model of IVDD induced by oxidative stress and identify potential therapeutic agents and their underlying mechanisms. By screening the natural product library, fisetin emerged as the most promising compound in suppressing cell death induced by oxidative stress in nucleus pulposus cells (NPCs). Furthermore, our investigation revealed that the cell death induced by oxidative stress was predominantly associated with ferroptosis, and fisetin demonstrated the ability to inhibit ferroptosis in NPCs. Mechanistic exploration suggested that the impact of fisetin on ferroptosis may be mediated through the Nrf2/HO-1 (Nuclear factor erythroid 2-related factor 2/heme oxygenase-1) axis. Notably, the in vivo study demonstrated that fisetin could alleviate IVDD in rats. These findings highlight fisetin as a potential therapeutic option for IVDD and implicate the involvement of the Nrf2/HO-1 pathway in its mechanism of action.
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Affiliation(s)
- Chenchao Li
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Yekai Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Yuxin Deng
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Yu Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Chenyu Wu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Xiaoying Zhao
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Ximiao Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China
| | - Xiangyang Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China; Chinese Orthopaedic Regenerative Medicine Society, Hangzhou, 310000, Zhejiang Province, China
| | - Yifei Zhou
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China; Chinese Orthopaedic Regenerative Medicine Society, Hangzhou, 310000, Zhejiang Province, China
| | - Xiaolei Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China; Chinese Orthopaedic Regenerative Medicine Society, Hangzhou, 310000, Zhejiang Province, China.
| | - Naifeng Tian
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China; Zhejiang Provincial Key Laboratory of Orthopaedics, Wenzhou, 325035, Zhejiang Province, China; Chinese Orthopaedic Regenerative Medicine Society, Hangzhou, 310000, Zhejiang Province, China.
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Leão Monteiro R. Future of low back pain: unravelling IVD components and MSCs' potential. CELL REGENERATION (LONDON, ENGLAND) 2024; 13:1. [PMID: 38227139 DOI: 10.1186/s13619-023-00184-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/27/2023] [Indexed: 01/17/2024]
Abstract
Low back pain (LBP) mainly emerges from intervertebral disc (IVD) degeneration. However, the failing mechanism of IVD ́s components, like the annulus fibrosus (AF) and nucleus pulposus (NP), leading to IVD degeneration/herniation is still poorly understood. Moreover, the specific role of cellular populations and molecular pathways involved in the inflammatory process associated with IVD herniation remains to be highlighted. The limited knowledge of inflammation associated with the initial steps of herniation and the lack of suitable models to mimic human IVD ́s complexity are some of the reasons for that. It has become essential to enhance the knowledge of cellular and molecular key players for AF and NP cells during inflammatory-driven degeneration. Due to unique properties of immunomodulation and pluripotency, mesenchymal stem cells (MSCs) have attained diverse recognition in this field of bone and cartilage regeneration. MSCs therapy has been particularly valuable in facilitating repair of damaged tissues and may benefit in mitigating inflammation' degenerative events. Therefore, this review article conducts comprehensive research to further understand the intertwine between the mechanisms of action of IVD components and therapeutic potential of MSCs, exploring their characteristics, how to optimize their use and establish them safely in distinct settings for LPB treatment.
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Liu Y, Zhao Z, Guo C, Huang Z, Zhang W, Ma F, Wang Z, Kong Q, Wang Y. Application and development of hydrogel biomaterials for the treatment of intervertebral disc degeneration: a literature review. Front Cell Dev Biol 2023; 11:1286223. [PMID: 38130952 PMCID: PMC10733535 DOI: 10.3389/fcell.2023.1286223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023] Open
Abstract
Low back pain caused by disc herniation and spinal stenosis imposes an enormous medical burden on society due to its high prevalence and refractory nature. This is mainly due to the long-term inflammation and degradation of the extracellular matrix in the process of intervertebral disc degeneration (IVDD), which manifests as loss of water in the nucleus pulposus (NP) and the formation of fibrous disc fissures. Biomaterial repair strategies involving hydrogels play an important role in the treatment of intervertebral disc degeneration. Excellent biocompatibility, tunable mechanical properties, easy modification, injectability, and the ability to encapsulate drugs, cells, genes, etc. make hydrogels good candidates as scaffolds and cell/drug carriers for treating NP degeneration and other aspects of IVDD. This review first briefly describes the anatomy, pathology, and current treatments of IVDD, and then introduces different types of hydrogels and addresses "smart hydrogels". Finally, we discuss the feasibility and prospects of using hydrogels to treat IVDD.
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Affiliation(s)
| | | | | | | | | | | | | | - Qingquan Kong
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Wang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Alfaya FF, Reddy RS, Alshahrani MS, Gautam AP, Mukherjee D, Al Salim ZA, Alqhtani RS, Ghulam HSH, Alyami AM, Al Adal S, Jabour AA. Exploring the Interplay of Muscular Endurance, Functional Balance, and Limits of Stability: A Comparative Study in Individuals with Lumbar Spondylosis Using a Computerized Stabilometric Force Platform. Life (Basel) 2023; 13:2104. [PMID: 37895485 PMCID: PMC10608059 DOI: 10.3390/life13102104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 10/29/2023] Open
Abstract
Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving the management and well-being of affected individuals. This study aimed to assess lumbar extensor endurance, functional balance, and limits of stability in individuals with lumbar spondylosis compared to age-matched healthy individuals and explore the correlations among these parameters within the lumbar spondylosis group. The lumbar spondylosis group consisted of 60 individuals initially screened by an orthopedician and referred to physical therapy. Age-matched healthy controls (n = 60) were recruited. Inclusion criteria encompassed adults aged 45-70 years for both groups. Lumbar extensor endurance was assessed using the Sorensen test, functional balance with the Berg Balance Scale, and limits of stability using a computerized stabilometric force platform. Lumbar extensor endurance was significantly lower in individuals with lumbar spondylosis compared to healthy controls (23.06 s vs. 52.45 s, p < 0.001). Functional balance, as assessed by the Berg Balance Scale, demonstrated a significant decrement in the lumbar spondylosis group (48.36 vs. 53.34, p < 0.001). Additionally, limits of stability variables, under both eyes-open and eyes-closed conditions, exhibited marked impairments in the lumbar spondylosis group (p < 0.001 for all variables). Within the lumbar spondylosis group, lumbar extensor endurance exhibited significant positive correlations with functional balance (0.46, p < 0.001) and negative correlations with limits of stability variables (r ranging from -0.38 to -0.49, p < 0.01 for all variables). This study underscores the significance of addressing lumbar extensor endurance, functional balance, and stability impairments in the comprehensive management of lumbar spondylosis.
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Affiliation(s)
- Fareed F Alfaya
- Department of Orthopedic Surgery, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Ajay Prashad Gautam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Debjani Mukherjee
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Zuhair A Al Salim
- Department of Sport Science and Physical Activity, College of Science, University of Hafr Al Batin, Hafr Al Batin 39524, Saudi Arabia
| | - Raee S Alqhtani
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
| | - Hussain Saleh H Ghulam
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
| | - Abdullah Mohammed Alyami
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
| | - Saeed Al Adal
- Physical Therapy Department, Medical Applied Sciences College, Najran University, Najran 66462, Saudi Arabia
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Yi J, Zhou Q, Huang J, Niu S, Ji G, Zheng T. Lipid metabolism disorder promotes the development of intervertebral disc degeneration. Biomed Pharmacother 2023; 166:115401. [PMID: 37651799 DOI: 10.1016/j.biopha.2023.115401] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/22/2023] [Accepted: 08/27/2023] [Indexed: 09/02/2023] Open
Abstract
Lipid metabolism is a complex process that maintains the normal physiological function of the human body. The disorder of lipid metabolism has been implicated in various human diseases, such as cardiovascular diseases and bone diseases. Intervertebral disc degeneration (IDD), an age-related degenerative disease in the musculoskeletal system, is characterized by high morbidity, high treatment cost, and chronic recurrence. Lipid metabolism disorder may promote the pathogenesis of IDD, and the potential mechanisms are complex. Leptin, resistin, nicotinamide phosphoribosyltransferase (NAMPT), fatty acids, and cholesterol may promote the pathogenesis of IDD, while lipocalin, adiponectin, and progranulin (PGRN) exhibit protective activity against IDD development. Lipid metabolism disorder contributes to extracellular matrix (ECM) degradation, cell apoptosis, and cartilage calcification in the intervertebral discs (IVDs) by activating inflammatory responses, endoplasmic reticulum (ER) stress, and oxidative stress and inhibiting autophagy. Several lines of agents have been developed to target lipid metabolism disorder. Inhibition of lipid metabolism disorder may be an effective strategy for the therapeutic management of IDD. However, an in-depth understanding of the molecular mechanism of lipid metabolism disorder in promoting IDD development is still needed.
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Affiliation(s)
- Jun Yi
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Qingluo Zhou
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Jishang Huang
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Shuo Niu
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Guanglin Ji
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Tiansheng Zheng
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China.
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