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关于使用生长因子治疗椎间盘退变的当前见解。

Current insights on use of growth factors as therapy for Intervertebral Disc Degeneration.

作者信息

Kennon Justin C, Awad Mohamed E, Chutkan Norman, DeVine John, Fulzele Sadanand

机构信息

Department of Orthopaedic Surgery, Augusta University, Augusta, GA, USA.

Department of Oral Biology, Augusta University, Augusta, GA, USA.

出版信息

Biomol Concepts. 2018 May 19;9(1):43-52. doi: 10.1515/bmc-2018-0003.

Abstract

Chronic low back pain is a critical health problem and a leading cause of disability in aging populations. A major cause of low back pain is considered to be the degeneration of the intervertebral disc (IVD). Recent advances in therapeutics, particularly cell and tissue engineering, offer potential methods for inhibiting or reversing IVD degeneration, which have previously been impossible. The use of growth factors is under serious consideration as a potential therapy to enhance IVD tissue regeneration. We reviewed the role of chosen prototypical growth factors and growth factor combinations that have the capacity to improve IVD restoration. A number of growth factors have demonstrated potential to modulate the anabolic and anticatabolic effects in both in vitro and animal studies of IVD tissue engineering. Members of the transforming growth factor-β superfamily, IGF-1, GDF-5, BMP-2, BMP-7, and platelet-derived growth factor have all been investigated as possible therapeutic options for IVD regeneration. The role of growth factors in IVD tissue engineering appears promising; however, further extensive research is needed at both basic science and clinical levels before its application is appropriate for clinical use.

摘要

慢性下腰痛是一个严重的健康问题,也是老年人群致残的主要原因。下腰痛的一个主要原因被认为是椎间盘退变。治疗方法的最新进展,特别是细胞和组织工程,提供了抑制或逆转椎间盘退变的潜在方法,而这在以前是不可能的。使用生长因子作为增强椎间盘组织再生的潜在疗法正在受到认真考虑。我们综述了所选的具有改善椎间盘修复能力的典型生长因子及其组合的作用。在椎间盘组织工程的体外和动物研究中,许多生长因子已显示出调节合成代谢和抗分解代谢作用的潜力。转化生长因子-β超家族成员、胰岛素样生长因子-1、生长分化因子-5、骨形态发生蛋白-2、骨形态发生蛋白-7和血小板衍生生长因子都已作为椎间盘再生的可能治疗选择进行了研究。生长因子在椎间盘组织工程中的作用似乎很有前景;然而,在其适用于临床应用之前,基础科学和临床层面都需要进一步进行广泛研究。

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