Intervertebral disc tissue engineering: A brief review

Abstract

Intervertebral disc (IVD) degeneration (IDD) is associated with low back pain and significantly affects the patient’s quality of life. Degeneration of the IVD alters disk height and the mechanics of the spine, leading to chronic segmental spinal instability. The pathophysiology of IVD disease is still not well understood. Current therapies for IDD include conservative and invasive approaches, but none of those treatments are able to restore the disc structure and function. Recently, tissue engineering techniques emerged as a possible approach to treat IDD, by replacing a damaged IVD with scaffolds and appropriate cells. Advances in manufacturing techniques, material processing and development, surface functionalization, drug delivery systems and cell incorporation furthered the development of tissue engineering therapies. In this review, biomaterial scaffolds and cell-based therapies for IVD regeneration are briefly discussed.

Multiscale Regulation of the Intervertebral Disc: Achievements in Experimental, In Silico, and Regenerative Research

“…Biomaterials serve a fundamental role in tissue engineering (TE) by acting as scaffolds for in situ tissue replenishment as well as being carriers for cells and biological molecules. A number of review articles provide summaries of the numerous and varied biomaterials suitable for the IVD [ 358 , 359 , 360 ]. Often, the biomechanics of the native tissue is replicated as closely as possible with the design of the biomaterial, along with the ability to encourage adherence, growth, and/or differentiation of cells.…”

“…Low immunoreactivity, injectable due to liquid–solid transition when warmed to body temperature, support high-density cell cultures [ 360 ].…”

“…Thermo-reversible gel properties, acid and heat resistant, non-cytotoxic, gelation without the need of harsh reagents, supports chondrocyte ECM deposition [ 360 , 385 ].…”

Quantitative Single-Cell Transcript Assessment of Biomarkers Supports Cellular Heterogeneity in the Bovine IVD

“…In this field of regenerative medicine, strategies are pursued to refurbish ailing IVDs with autologous or allogenic cells, derived either from the disc itself or other sources, with special interest in mesenchymal stem cells (MSC) derived from bone marrow, articular cartilage or adipose tissue. Alternatively, strategies to stimulate intrinsic disc cells through the injection of growth factors or the use of gene therapy to replace degenerating extracellular matrix (ECM) molecules are envisioned as ways to “rejuvenate” IVD function as a shock absorber in the spinal joints [2,3,4,5,6]. On first glance the IVD might appear as an anatomically simple structure, comprised of concentric rings in the annulus fibrosus (AF) and gradually transitioning towards a central nucleus pulposus (NP) [1,7,8].…”

The Role of Hyaluronic Acid in Intervertebral Disc Regeneration

“…These treatments are not deemed curative, nor do they reverse the underlying pathology but rather aim to achieve symptomatic relief. Therefore, tissue-engineering approaches through developing biomaterial-based platforms to deliver active therapeutic products such as mesenchymal cells, inhibitory molecules and growth factors (GF) are being investigated to repair the degenerated IVD and revert it to a healthy state [34]. In the last few decades, hyaluronic acid (HA) was broadly used in treating osteoarthritis, popularised due to its anti-inflammatory, analgesic and extracellular matrix enhancing properties [35][36][37].…”