Can Manganese Dioxide Microspheres be Used as Intermediaries to Alleviate Intervertebral Disc Degeneration With Strengthening Drugs?

Abstract

Degenerative disc disease (DDD) is a pathological condition associated with intervertebral discs (IVDs) that causes chronic back pain. IVD degeneration has become a significant issue in contemporary society. To date, numerous biological therapies have been applied to alleviate the progression of DDD, among which therapeutic protein injection is the most direct and convenient. However, there are some limitations to applying direct protein injection therapy, the most significant being that the efficacy of this method has a short duration, which is a major factor in its effectiveness and the resulting patient satisfaction. How do we solve this problem? Or how can the effectiveness of the treatment be enhanced? It has been proved that manganese dioxide (MnO2) microspheres, widely used in environmental science, not only regulate the expression of cell genes and cytokines in the microenvironment, but also have the ability to release drugs slowly. We propose that direct injection of protein encapsulated in hollow MnO2 (h-MnO2) microspheres could solve the problem of rapid drug release. In addition, the use of a MnO2 and protein injection in the treatment of DDD may have a synergistic effect, which would be highly significant for the degradation of pro-inflammatory factors in the DDD microenvironment. Therefore, the combination of MnO2 and protein may provide a new therapeutic approach to alleviate the progression of DDD.

Why clinical trials in disc regeneration strive to achieve completion: Insights from publication status and funding sources

“…Varied regional, local, and institutional policies contribute to the potential absence of numerous clinical trials that have received approval from alternative regulatory bodies, such as the European Union Drug Regulating Authorities Clinical Trials Database, national boards, or local institutional review boards. Indeed, recent systematic reviews investigating the available clinical evidence on disc regeneration have included a significantly higher number of published studies in addition to the trials found in our search 4,65 . Therefore, although representative, the conclusions of this study may be partial and not completely faultless.…”

Biomaterials delivery strategies to repair degenerated intervertebral discs by regulating the inflammatory microenvironment

“…IL-1β is the most widely studied inflammatory factor in IVDD and is associated with inflammatory radiculopathy ( 13 ). IL-1β accelerates IVDD mainly by inducing the expression of MMPs in the ECM ( 35 , 97 ). This process primarily depends on wingless-related integration site (Wnt)/β-catenin signaling ( 98 ).…”