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van Uden S, Silva-Correia J, Oliveira JM, et al. Current strategies for treatment of intervertebral disc degeneration: substitution and regeneration possibilities. Biomater Res. 2017;21:22doi: 10.1186/s40824-017-0106-6.
van Uden, S., Silva-Correia, J., Oliveira, J. M., & Reis, R. L. (2017). Current strategies for treatment of intervertebral disc degeneration: substitution and regeneration possibilities. Biomaterials research, 2122. https://doi.org/10.1186/s40824-017-0106-6
van Uden, Sebastião, et al. "Current strategies for treatment of intervertebral disc degeneration: substitution and regeneration possibilities." Biomaterials research vol. 21 (2017): 22. doi: https://doi.org/10.1186/s40824-017-0106-6
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 Oct 23;21:22. doi: 10.1186/s40824-017-0106-6. eCollection 2017. PMID: 29085662; PMCID: PMC5651638.
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Biomater Res. 2017 Oct 23;21:22. doi: 10.1186/s40824-017-0106-6. eCollection 2017.

Current strategies for treatment of intervertebral disc degeneration: substitution and regeneration possibilities.

Biomaterials research

Sebastião van Uden, Joana Silva-Correia, Joaquim Miguel Oliveira, Rui Luís Reis

Affiliations

  1. 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.
  2. ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga Portugal.
  3. Present Address: Bioengineering Laboratories Srl, Viale Brianza 8, Meda, Italy.
  4. Present Address: Politecnico di Milano, Piazza Leonardo da Vinci, 32 Milan, Italy.
  5. The Discoveries Centre for Regenerative and Precision Medicine, Headquarters at University of Minho, Avepark, 4805-017 Barco Guimarães, Portugal.

PMID: 29085662 PMCID: PMC5651638 DOI: 10.1186/s40824-017-0106-6

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.

Keywords: Intervertebral disc; Regenerative strategies; Tissue engineering

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