Vadalà Gianluca, Russo Fabrizio, Di Martino Alberto, Denaro Vincenzo
Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Italy.
J Tissue Eng Regen Med. 2015 Jun;9(6):679-90. doi: 10.1002/term.1719. Epub 2013 Mar 20.
Low back pain is one of the major health problems in industrialized countries, as a leading source of disability in the working population. Intervertebral disc degeneration has been identified as its main cause, being a progressive process mainly characterized by alteration of extracellular matrix composition and water content. Many factors are involved in the degenerative cascade, such as anabolism/catabolism imbalance, reduction of nutrition supply and progressive cell loss. Currently available treatments are symptomatic, and surgical procedures consisting of disc removal are often necessary. Recent advances in our understanding of intervertebral disc biology led to an increased interest in the development of novel biological treatments aimed at disc regeneration. Growth factors, gene therapy, stem cell transplantation and biomaterials-based tissue engineering might support intervertebral disc regeneration by overcoming the limitation of the self-renewal mechanism. The aim of this paper is to overview the literature discussing the current status of our knowledge from the degenerative cascade of the intervertebral disc to the latest molecular, cell-based therapies and tissue-engineering strategies for disc regeneration.
腰痛是工业化国家的主要健康问题之一，是劳动人口致残的主要原因。椎间盘退变已被确定为其主要原因，这是一个渐进的过程，主要特征是细胞外基质组成和含水量的改变。许多因素参与了退变级联反应，如合成代谢/分解代谢失衡、营养供应减少和细胞逐渐丢失。目前可用的治疗方法是对症治疗，通常需要进行椎间盘切除术等外科手术。我们对椎间盘生物学认识的最新进展引发了人们对开发旨在促进椎间盘再生的新型生物治疗方法的兴趣增加。生长因子、基因治疗、干细胞移植和基于生物材料的组织工程可能通过克服自我更新机制的局限性来支持椎间盘再生。本文的目的是综述相关文献，讨论从椎间盘退变级联反应到最新的分子、基于细胞的治疗方法以及用于椎间盘再生的组织工程策略等方面的知识现状。
