A biological approach to treating disc degeneration: not for today, but maybe for tomorrow
A biological approach to treating disc degeneration: not for today, but maybe for tomorrow
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DOI：
10.1007/s00586-002-0485-8
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发表时间：
2002-10-01
影响因子：
2.8
通讯作者：
Aebi, M
中科院分区：
文献类型：
--
作者：
Alini, M;Roughley, PJ;Aebi, M
椎间盘将脊椎中的椎骨结合在一起，提供弯曲和扭转所需的灵活性，并在直立姿势时抵抗重力造成的压缩。椎间盘具有复杂的结构，外部纤维环具有组织化的胶原纤维层，而内部髓核具有更随机的胶原组织和丰富的聚集蛋白聚糖。这种复合性质赋予椎间盘韧带的抗张力特性和关节软骨的抗压缩特性。不幸的是，椎间盘结构和功能在整个生命过程中并不保持最佳状态，而是经历进行性退化，从年轻人开始，在髓核中尤其明显。随着时间的推移，椎间盘退变可能导致临床症状，如腰痛，并需要医疗干预。这种治疗可能涉及通过手术切除病变椎间盘，而不是修复，后者是首选的行动方案。在不久的将来，目前的生物工程技术可能会提供修复受损的椎间盘的可能性，如果一个工程组织与适当的功能特性可以产生，以增加患病的椎间盘。在这份报告中，我们总结了我们最近的结果，其中椎间盘细胞被植入到胶原蛋白和透明质酸的支架，或陷入壳聚糖凝胶，生长因子被用来调节基质合成，试图产生一个组织与天然髓核组织的分子组成相似。
The intervertebral disc unites the vertebrae in the spine, providing the flexibility required for bending and twisting and resisting the compression inflicted by gravity when in an upright posture. The discs have a complex structure, with the outer annulus fibrosus having lamellae of organized collagen fibrils and the inner nucleus pulposus having a more random collagen organization and an abundance of aggregating proteoglycans. This composite nature endows the disc with both the tension-resisting properties of a ligament and the compression-resisting properties of articular cartilage. Unfortunately, disc structure and function does not remain optimal throughout life, but undergoes progressive degeneration, commencing in the young adult, and is particularly evident in the nucleus pulposus. With time, disc degeneration may result in clinical symptoms, such as low back pain, and require medical intervention. Such treatment may involve removal of the offending disc by surgery rather than its repair, which would be the preferred course of action. In the near future, current bioengineering techniques may offer the possibility of repairing the damaged disc, if an engineered tissue with the appropriate functional properties can be generated to augment the ailing disc. In this report, we summarized our recent results, in which disc cells were implanted into a scaffold of collagen and hyaluronan, or entrapped into a chitosan gel, and growth factors were used to modulate matrix synthesis in an attempt to produce a tissue with a similar molecular composition to native nucleus pulposus tissue.