Mehrkens Arne, Karim M Zia, Kim Sarah, Hilario Raychel, Fehlings Michael G, Erwin William Mark
Toronto Western Research Institute, University of Toronto, Toronto, Canada ; Department of Orthopaedic Surgery, Spine Unit, Basel University Hospital, Basel, Switzerland.
Toronto Western Research Institute, University of Toronto, Toronto, Canada.
Evid Based Spine Care J. 2013 Oct;4(2):154-6. doi: 10.1055/s-0033-1357363.
Introduction Effective therapies that may stop or even reverse disc degeneration remain elusive. A minimally invasive method through which nucleus pulposus (NP) cell viability could be achieved would revolutionize the treatment of degenerative disc disease (DDD). With the presented work, we have investigated if nonchondrodystrophic (NCD) canine intervertebral disc (IVD)-derived notochordal cell conditioned medium (NCCM) and chondrodystrophic (CD) canine IVD-derived conditioned medium (CDCM) are able to protect murine and human NP cells from apoptosis. Materials and Methods We developed NCCM and CDCM from hypoxic culture of freshly isolated NPs from NCD and CD canines, respectively. We obtained murine NP cells from nine different C57BL/6 mice and human NP cells from four patients who underwent surgery for discectomy. The cells were cultured with ADMEM/F-12 (control media), NCCM, or CDCM under hypoxic conditions (3.5% O2) and treated with IL-1β + FasL or Etoposide. All media were supplemented with 2% fetal bovine serum. We then determined the expression of specific apoptotic pathways in the murine and human NP cells by recording activated caspase-8, caspase-9, and caspase-3/7 activity. Results In the murine NP cells, NCCM inhibits IL-1β + FasL- and Etoposide-mediated apoptosis via suppression of activated caspase-9 and caspase-3/7, CDCM demonstrated an inhibitory effect on IL-1β + FasL-mediated apoptosis via caspase-3/7 (Fig. 1A). In the human NP cells, NCCM inhibits Etoposide- mediated apoptosis via suppression of activated caspase-8, caspase-9, and mainly caspase-3/7. CDCM demonstrated an inhibitory effect on Etoposide-mediated apoptosis via suppression of activated caspase-8, caspase-9, and mainly caspase-3/7, though not as effective as NCCM (Fig. 1B). Conclusion IL-1β + FasL are known key molecules in the progression of DDD. Here, we demonstrate that soluble factors secreted by the NCD IVD NP strongly protect murine NP cells not only from IL-1β + FasL but also from Etoposide-induced apoptosis via suppression of activated caspase-9 and caspase-3/7. In the human samples, addition of IL-1β + FasL did not increase cell death. Because the human cell samples were obtained from herniated discs that are probably already undergoing a degenerative process, it is likely that there was already some degree of activation by the endogenously secreted prodegenerative factors such as IL-1β + FasL. It may be that the NP cells, once they have reached a pivotal point of the degenerative cascade, no longer respond to exogenously applied IL-1β + FasL in contrast to the otherwise "healthy" discs obtained from the mice. Interestingly, the rescue effect of NCCM in the etoposide-treated cells (murine and human) suggests that NCCM is capable of influencing the signaling pathways known to be relevant to etoposide-induced cell death. A better understanding and harnessing of the restorative powers of the notochordal cell could lead to novel cellular and molecular strategies for the treatment of DDD.
引言 能够阻止甚至逆转椎间盘退变的有效疗法仍然难以捉摸。一种能够实现髓核(NP)细胞存活的微创方法将彻底改变退行性椎间盘疾病(DDD)的治疗方式。通过本研究,我们探讨了非软骨发育不良(NCD)犬椎间盘(IVD)来源的脊索细胞条件培养基(NCCM)和软骨发育不良(CD)犬IVD来源的条件培养基(CDCM)是否能够保护小鼠和人类NP细胞免于凋亡。
材料与方法 我们分别通过对从NCD和CD犬新鲜分离的NP进行低氧培养来制备NCCM和CDCM。我们从9只不同的C57BL/6小鼠中获取小鼠NP细胞,并从4例接受椎间盘切除术的患者中获取人类NP细胞。将细胞在低氧条件(3.5% O₂)下用ADMEM/F-12(对照培养基)、NCCM或CDCM培养,并用IL-1β + FasL或依托泊苷处理。所有培养基均添加2%胎牛血清。然后通过记录活化的半胱天冬酶-8、半胱天冬酶-9和半胱天冬酶-3/7的活性来测定小鼠和人类NP细胞中特定凋亡途径的表达。
结果 在小鼠NP细胞中,NCCM通过抑制活化的半胱天冬酶-9和半胱天冬酶-3/7来抑制IL-1β + FasL和依托泊苷介导的凋亡,CDCM通过半胱天冬酶-3/7对IL-1β + FasL介导的凋亡表现出抑制作用(图1A)。在人类NP细胞中,NCCM通过抑制活化的半胱天冬酶-8、半胱天冬酶-9以及主要是半胱天冬酶-3/7来抑制依托泊苷介导的凋亡。CDCM通过抑制活化的半胱天冬酶-8、半胱天冬酶-9以及主要是半胱天冬酶-3/7对依托泊苷介导的凋亡表现出抑制作用,尽管不如NCCM有效(图1B)。
结论 IL-1β + FasL是已知的DDD进展中的关键分子。在此,我们证明NCD IVD NP分泌的可溶性因子不仅通过抑制活化的半胱天冬酶-9和半胱天冬酶-3/7来强烈保护小鼠NP细胞免受IL-1β + FasL的影响,还能使其免受依托泊苷诱导的凋亡。在人类样本中,添加IL-1β + FasL并未增加细胞死亡。由于人类细胞样本取自可能已经处于退变过程的椎间盘突出症患者,很可能内源性分泌的促退变因子如IL-1β + FasL已经有一定程度的激活。与从小鼠获得的“健康”椎间盘不同,NP细胞一旦达到退变级联反应的关键点,可能不再对外源性施加的IL-1β + FasL产生反应。有趣的是,NCCM对依托泊苷处理的细胞(小鼠和人类)的挽救作用表明,NCCM能够影响已知与依托泊苷诱导的细胞死亡相关的信号通路。更好地理解和利用脊索细胞的修复能力可能会为DDD的治疗带来新的细胞和分子策略。