Critical aspects and challenges for intervertebral disc repair and regeneration—Harnessing advances in tissue engineering

Buckley, Conor T.; Hoyland, Judith A.; Fujii, Kengo; Pandit, Abhay; Iatridis, James C.; Grad, Sibylle

doi:10.1002/jsp2.1029

Cited by 91 publications

(99 citation statements)

References 124 publications

(216 reference statements)

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“…AF is a type of tissue that comprises distinguishable and intricately designed layers, which gradually change from the inner to outer AF . High technological skills, sophisticated biomaterials, and tissue engineering methods are likely necessary to form AF tissue constituents . Moreover, AF tissue maintenance and repair depends on lower cell numbers than other cartilage tissues.…”

Section: Discussionmentioning

confidence: 99%

“…For these reasons, a multitude of studies has explored different approaches to establish AF repair . One approach that is showing potential for IVD repair, is cell transplantation, with initial clinical trials aimed at repairing the IVD via the nucleus pulposus (NP) showing promising safety and efficacy outcomes .…”

Section: Introductionmentioning

confidence: 99%

“…A variety of studies have reported on AF cell transplantation by applying adhering scaffolds, however realization of cell engraftment remained limited. Moreover, the AF is a layered tissue structure that gradually changes morphology and composition from the inner to outer the layers, thus likely requiring specialized tissue engineering approaches for successful long‐term repair …”

Section: Introductionmentioning

confidence: 99%

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Annulus fibrosus cell sheets limit disc degeneration in a rat annulus fibrosus injury model

et al. 2019

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In recent years, studies have explored novel approaches for cell transplantation to enable annulus fibrosus (AF) regeneration of the intervertebral disc in particular for lumbar disc herniation. Nevertheless, successful engraftment of cells is structurally challenging, and no definitive method has yet been established. This study investigated the potential of cell sheet technology to facilitate cell engraftment for AF repair. AF injury was induced by a 1 × 1 mm defect in rat tails after which AF cell sheets were transplanted. Its regenerative effects were compared to a nondegenerated and degeneration only conditions. Degenerative changes of the entire intervertebral disc were examined by disc height measurements, histology, and immunohistochemistry for 4‐, 8‐, and 12‐weeks post‐transplantation. Cell engraftment was confirmed by tracing PKH26 fluorescent dyed AF cells. In the transplant group, disc degeneration was significantly suppressed after 4, 8, and 12 weeks when compared with the degenerative group, as indicated by histological scoring and DHI observations. At 2 and 4 weeks after transplant, PKH26 positive cells could be detected in defect region and surrounding AF. The results suggest cell engraftment into AF tissue could be established by the cell sheet technology without additional scaffolding or adhesives. In short, AF cell sheets appear to be an effective and accessible tool for AF repair and to support intervertebral disc regeneration.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Annulus fibrosus cell sheets limit disc degeneration in a rat annulus fibrosus injury model

et al. 2019

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“…Buckley et al 9 reviewed and discussed the current approaches in tissue engineering and regeneration to treat intervertebral disc disorders. This review also highlights the role of disc microenvironment and mechanical properties that may influence the success of the disc repair and regenerative strategies with description of some of the harsh microenvironment factors known to be factors in disc degeneration and aging that may affect the disc repair and regeneration strategies.…”

Section: Collaborative Review Articles On Scientific Topics Of the Mementioning

confidence: 99%

New horizons in spine research: Disc biology, tissue engineering, biomechanics, translational, and clinical research

2018

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“…Many authors in the field of intervertebral disc degeneration have also acknowledged the need for improved nondestructive imaging techniques for the assessment of animal and preclinical models of disc degeneration …”

Section: Introductionmentioning

confidence: 99%

A novel magnetic resonance imaging postprocessing technique for the assessment of intervertebral disc degeneration—Correlation with histological grading in a rabbit disc degeneration model

et al. 2019

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Introduction Estimation of intervertebral disc degeneration on magnetic resonance imaging (MRI) is challenging. Qualitative schemes used in clinical practice correlate poorly with pain and quantitative techniques have not entered widespread clinical use. Methods As part of a prior study, 25 New Zealand white rabbits underwent annular puncture to induce disc degeneration in 50 noncontiguous lumbar discs. At 16 weeks, the animals underwent multi‐echo T2 MRI scanning and were euthanized. The discs were stained and examined histologically. Quantitative T2 relaxation maps were prepared using the nonlinear least squares method. Decay Variance maps were created using a novel technique of aggregating the deviation in the intensity of each echo signal from the expected intensity based on the previous rate of decay. Results Decay Variance maps showed a clear and well demarcated nucleus pulposus with a consistent rate of decay (low Decay Variance) in healthy discs that showed progressively more variable decay (higher Decay Variance) with increasing degeneration. Decay Variance maps required significantly less time to generate (1.0 ± 0.0 second) compared with traditional T2 relaxometry maps (5 (±0.9) to 1788.9 (±116) seconds). Histology scores correlated strongly with Decay Variance scores (r = 0.82, P < .01) and weakly with T2 signal intensity (r = 0.32, P < .01) and quantitative T2 relaxometry (r = 0.39, P < .01). Decay Variance had superior sensitivity and specificity for the detection of degenerate discs when compared to T2 signal intensity or Quantitative T2 mapping. Conclusion Our results show that using a multi‐echo T2 MRI sequence, Decay Variance can quantitatively assess disc degeneration more accurately and with less image‐processing time than quantitative T2 relaxometry in a rabbit disc puncture model. The technique is a viable candidate for quantitative assessment of disc degeneration on MRI scans. Further validation on human subjects is needed.

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Critical aspects and challenges for intervertebral disc repair and regeneration—Harnessing advances in tissue engineering

Cited by 91 publications

References 124 publications

Annulus fibrosus cell sheets limit disc degeneration in a rat annulus fibrosus injury model

Annulus fibrosus cell sheets limit disc degeneration in a rat annulus fibrosus injury model

New horizons in spine research: Disc biology, tissue engineering, biomechanics, translational, and clinical research

A novel magnetic resonance imaging postprocessing technique for the assessment of intervertebral disc degeneration—Correlation with histological grading in a rabbit disc degeneration model

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