PDF(Pubmed)
Abstract：
Intervertebral disc (IVD) degeneration (IDD), a highly prevalent pathological condition worldwide, is widely associated with back pain. Treatments available compensate for the impaired function of the degenerated IVD but typically have incomplete resolutions because of their adverse complications. Therefore, fundamental regenerative treatments need exploration. Mesenchymal stem cell (MSC) therapy has been recognized as a mainstream research objective by the World Health Organization and was consequently studied by various research groups. Implanted MSCs exert anti-inflammatory, anti-apoptotic, and anti-pyroptotic effects and promote extracellular component production, as well as differentiation into IVD cells themselves. Hence, the ultimate goal of MSC therapy is to recover IVD cells and consequently regenerate the extracellular matrix of degenerated IVDs. Notably, in addition to MSC implantation, healthy nucleus pulposus (NP) cells (NPCs) have been implanted to regenerate NP, which is currently undergoing clinical trials. NPC-derived exosomes have been investigated for their ability to differentiate MSCs from NPC-like phenotypes. A stable and economical source of IVD cells may include allogeneic MSCs from the cell bank for differentiation into IVD cells. Therefore, multiple alternative therapeutic options should be considered if a refined protocol for the differentiation of MSCs into IVD cells is established. In this study, we comprehensively reviewed the molecules, scaffolds, and environmental factors that facilitate the differentiation of MSCs into IVD cells for regenerative therapies for IDD.
摘要：
椎间盘(IVD)退变(IDD),全球范围内非常普遍的病理状况，与背痛广泛相关。可用的治疗可补偿退化的IVD的功能受损，但由于其不良并发症，通常具有不完全的解决方法。因此,基础再生治疗需要探索。间充质干细胞（MSC）疗法已被世界卫生组织视为主流研究目标，因此被各种研究小组研究。植入的MSCs发挥抗炎作用，抗凋亡，和抗热解作用，并促进细胞外成分的产生，以及分化为IVD细胞本身。因此，MSC治疗的最终目标是恢复IVD细胞，从而再生变性IVD的细胞外基质。值得注意的是,除了MSC植入，健康的髓核（NP）细胞（NPC）已被植入再生NP，目前正在进行临床试验。已经研究了NPC衍生的外泌体将MSC从NPC样表型分化的能力。IVD细胞的稳定和经济来源可以包括来自细胞库的用于分化成IVD细胞的同种异体MSC。因此,如果建立了将MSCs分化为IVD细胞的精细方案,则应考虑多种替代治疗方案.在这项研究中,我们全面回顾了分子，脚手架,以及促进MSCs分化为IVD细胞用于IDD再生治疗的环境因素。
