纤维环退变机制及生物学治疗的研究综述
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摘要
椎间盘退变相关性疾病已成为慢性腰背痛的主要原因。椎间盘退变病因众多、机制复杂,其中纤维环在椎间盘退变中的生物学作用越来越受到重视,其退变的确切机制尚未阐明。目前,椎间盘退变所继发的各类疾患的最主要治疗措施是切除退变的椎间盘组织,而不是针对退变过程的根本治疗。因此,致力纤维环生物学治疗是一种创新性的治疗思路。随着现代分子生物学、细胞工程学、基因工程技术的发展,退变纤维环生物治疗的方法已经得到了初步的发展,但仍有许多问题仍没能得到很好的解决。本文就目前纤维环退变机制及生物学治疗进行探讨。
Intervertebral disc degeneration related diseases have become the main cause of chronic low back pain. There are many causes and complicated mechanisms of intervertebral disc degeneration, among which the biological role of annulus fibrosus in intervertebral disc degeneration has been paid more and more attention. However, the exact mechanism of degeneration has not been elucidated. At present, the most important treatment for intervertebral disc degeneration related diseases is to remove the degenerated disc tissue rather than the fundamental treatment for the degeneration process. Therefore, the biological treatment of the annulus fibrosus is an innovative treatment idea. With the development of modern molecular biology, cell engineering and genetic engineering techniques, the biotherapy of degenerative fiber loop has been initially developed, but many problems remain unresolved. In this article, the mechanism and biological treatment of fibrous ring degeneration were discussed.
Intervertebral disc degeneration related diseases have become the main cause of chronic low back pain. There are many causes and complicated mechanisms of intervertebral disc degeneration, among which the biological role of annulus fibrosus in intervertebral disc degeneration has been paid more and more attention. However, the exact mechanism of degeneration has not been elucidated. At present, the most important treatment for intervertebral disc degeneration related diseases is to remove the degenerated disc tissue rather than the fundamental treatment for the degeneration process. Therefore, the biological treatment of the annulus fibrosus is an innovative treatment idea. With the development of modern molecular biology, cell engineering and genetic engineering techniques, the biotherapy of degenerative fiber loop has been initially developed, but many problems remain unresolved. In this article, the mechanism and biological treatment of fibrous ring degeneration were discussed.
引文
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[15]Liu C,Guo Q,Li J,et al.Identification of rabbit annulus fibrosusderived stem cells.PLoS One,2014,9(9):e108239.
[16]Marfia G,Campanella R,Navone SE,et al.Potential use of human adipose mesenchymal stromal cells for intervertebral disc regeneration:a preliminary study on biglycan-deficient murine model of chronic disc degeneration.Arthritis Res Ther,2014,16(5):457.
[17]Centeno C,Markle J,Dodson E,et al.Treatment of lumbar degenerative disc disease-associated radicular pain with cultureexpanded autologous mesenchymal stem cells:a pilot study on safety and efficacy.J Transl Med,2017,15(1):197.
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[19]Tsai TL,Nelson BC,Anderson PA,et al.Intervertebral disc and stem cells cocultured in biomimetic extracellular matrix stimulated by cyclic compression in perfusion bioreactor.Spine J,2014,14(9):2127-40.
[20]Hansson A,Wenger A,Henriksson HB,et al.The direction of human mesenchymal stem cells into the chondrogenic lineage is influenced by the features of hydrogel carriers.Tissue Cell,2017,49(1):35-44.
[21]Nerurk Kennedy KM,Bhaw-Luximon A,Jhurry D.Cell-matrix mechanical interaction in electrospun polymeric scaffolds for tissue engineering:Implications for scaffold design and performance.Acta Biomater,2017,50:41-55.
[22]Park SH,Gil ES,Mandal BB,et al.Annulus fibrosus tissue engineering using lamellar silk scaffolds.J Tissue Eng Regen Med,2012,6 Suppl3:s24-33.
[23]Xu B,Xu H,Wu Y,et al.Intervertebral disc tissue engineering with natural extracellular matrix-derived biphasic composite scaffolds.PLoS One,2015,10(4):e0124774.
[24]Guillaume O,Naqvi SM,Lennon K,et al.Enhancing cell migration in shape-memory alginate-collagen composite scaffolds:In vitro and ex vivo assessment for intervertebral disc repair.J Biomater Appl,2015,29(9):1230-1246.
[2]Kadow T,Sowa G,Vo N,et al.Molecular basis of intervertebral disc degeneration and herniations:what are the important translational questions?Clin Orthop Relat Res,2015,473(6):1903-1912.
[3]Iu J,Santerre JP,Kandel RA.Towards engineering distinct multi-lamellated outer and inner annulus fibrosus tissues.JOrthop Res,2018,36(5):1346-1355.
[4]Yang B,O'Connell GD.Effect of collagen fibre orientation on intervertebral disc torsion mechanics.Biomech Model Mechanobiol,2017,16(6):2005-2015.
[5]Steele J,Bruce-Low S,Smith D,et al.Can specific loading through exercise impart healing or regeneration of the intervertebral disc?Spine J,2015,15(10):2117-2121.
[6]Zhang F,Zhao X,Shen H,et al.Molecular mechanisms of cell death in intervertebral disc degeneration.Int J Mol Med,2016,37(6):1439-1448.
[7]Martins DE,Medeiros VP,Wajchenberg M,et al.Changes in human intervertebral disc biochemical composition and bony end plates between middle and old age.PLoS One,2018,13(9):e0203932.
[8]Wang WJ,Yu XH,Wang C,et al.MMPs and ADAMTSs in intervertebral disc degeneration.Clin Chim Acta,2015,448:238-246.
[9]Ni BB,Li B,Yang YH,et al.The effect of transforming growth factorβ1 on the crosstalk between autophagy and apoptosis in the annulus fibrosus cells under serum deprivation.Cytokine,2014,70(2):87-96.
[10]Court C,Chin JR,Liebenberg E,et al.Biological and mechanical consequences of transient intervertebral disc bending.Eur Spine J,2007,16(11):1899-1906.
[11]Kobielarz M,Szotek S,G硂wacki M,et al.Qualitative and quantitative assessment of collagen and elastin in annulus fibrosus of the physiologic and scoliotic intervertebral discs.JMech Behav Biomed Mater,2016,62:45-56.
[12]Sampara P,Banala RR,Vemuri SK,et al.Understanding the molecular biology of intervertebral disc degeneration and potential gene therapy strategies for regeneration:a review.Gene Ther,2018,25(2):67-82.
[13]Wang SZ,Chang Q,Lu J,et al.Growth factors and plateletrich plasma:promising biological strategies for early intervertebral disc degeneration.Int Orthop,2015,39(5):927-934.
[14]Tuakli-Wosornu YA,Terry A,Boachie-Adjei K,et al.Lumbar intradiskal platelet-rich plasma(PRP)injections:a prospective,double-blind,randomized controlled study.PM R,2016,8(1):1-10.
[15]Liu C,Guo Q,Li J,et al.Identification of rabbit annulus fibrosusderived stem cells.PLoS One,2014,9(9):e108239.
[16]Marfia G,Campanella R,Navone SE,et al.Potential use of human adipose mesenchymal stromal cells for intervertebral disc regeneration:a preliminary study on biglycan-deficient murine model of chronic disc degeneration.Arthritis Res Ther,2014,16(5):457.
[17]Centeno C,Markle J,Dodson E,et al.Treatment of lumbar degenerative disc disease-associated radicular pain with cultureexpanded autologous mesenchymal stem cells:a pilot study on safety and efficacy.J Transl Med,2017,15(1):197.
[18]Noriega DC,Ardura F,Hernández-Ramajo R,et al.Intervertebral disc repair by allogeneic mesenchymal bone marrow cells:a randomized controlled trial.Transplantation,2017,101(8):1945-1951.
[19]Tsai TL,Nelson BC,Anderson PA,et al.Intervertebral disc and stem cells cocultured in biomimetic extracellular matrix stimulated by cyclic compression in perfusion bioreactor.Spine J,2014,14(9):2127-40.
[20]Hansson A,Wenger A,Henriksson HB,et al.The direction of human mesenchymal stem cells into the chondrogenic lineage is influenced by the features of hydrogel carriers.Tissue Cell,2017,49(1):35-44.
[21]Nerurk Kennedy KM,Bhaw-Luximon A,Jhurry D.Cell-matrix mechanical interaction in electrospun polymeric scaffolds for tissue engineering:Implications for scaffold design and performance.Acta Biomater,2017,50:41-55.
[22]Park SH,Gil ES,Mandal BB,et al.Annulus fibrosus tissue engineering using lamellar silk scaffolds.J Tissue Eng Regen Med,2012,6 Suppl3:s24-33.
[23]Xu B,Xu H,Wu Y,et al.Intervertebral disc tissue engineering with natural extracellular matrix-derived biphasic composite scaffolds.PLoS One,2015,10(4):e0124774.
[24]Guillaume O,Naqvi SM,Lennon K,et al.Enhancing cell migration in shape-memory alginate-collagen composite scaffolds:In vitro and ex vivo assessment for intervertebral disc repair.J Biomater Appl,2015,29(9):1230-1246.