Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio.
Department of Orthopedics, The Ohio State University Wexner Medical Center, Columbus, Ohio.
J Orthop Res. 2019 Nov;37(11):2389-2400. doi: 10.1002/jor.24408. Epub 2019 Jul 29.
Intervertebral disc (IVD) degeneration is a major contributor to chronic low back pain and is characterized by decreases in cellularity and proteoglycan synthesis, upregulation of matrix degradation, and increases in pro-inflammatory factors with neurovascular invasion. Current treatments fail to target the underlying pathology or promote tissue repair and approaches such as viral transfection raise safety concerns due to mutagenesis and unwarranted immune responses. To avoid such concerns, nonviral transfection is a viable method of gene delivery into the host cell while bypassing the caveats of viral delivery. Brachyury is expressed in the developing notochord and is associated with an immature healthy nucleus pulposus (NP). We hypothesize that Brachyury can reprogram degenerate NP cells to a healthy pro-anabolic phenotype with increased proteoglycan content and decreased expression of catabolic, inflammatory, and neurovascular markers. NP cells obtained from human autopsy and surgical tissues were transfected with plasmids encoding for Brachyury or an empty vector control via bulk electroporation. Post transfection, cells were seeded in three-dimensional agarose constructs cultured over 4 weeks and analyzed for viability, gene expression, and proteoglycan. Results demonstrated successful transfection of both autopsy and surgical NP cells. We observed long-term Brachyury expression, significant increased expression of NP phenotypic markers FOXF1, KRT19, and chondrogenic marker SOX9 with decreases in inflammatory cytokines IL1-β/IL6, NGF, and MMPs and significant increases in glycosaminoglycan accumulation. These results highlight nonviral transfection with developmental transcription factors, such as Brachyury, as a promising method to reprogram degenerate human disc cells toward a healthy NP phenotype. Clinical significance: This project proposes a novel translational approach for the treatment of intervertebral disc degeneration via direct reprogramming of diseased human patient-derived IVD cells to a healthy phenotype. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2389-2400, 2019.
椎间盘(IVD)退变是慢性腰痛的主要原因,其特征是细胞减少和蛋白聚糖合成减少,基质降解增加,以及前炎症因子增加和神经血管入侵。目前的治疗方法未能针对潜在的病理变化,也未能促进组织修复,而病毒转染等方法由于基因突变和不必要的免疫反应而引起安全问题。为了避免这些问题,非病毒转染是将基因递送入宿主细胞的可行方法,同时避免了病毒递送的缺点。Brachyury 在发育中的脊索中表达,并与未成熟的健康髓核(NP)相关。我们假设 Brachyury 可以将退变的 NP 细胞重新编程为具有更高蛋白聚糖含量和降低的代谢物、炎症和神经血管标志物表达的健康前合成表型。通过 bulk 电穿孔将编码 Brachyury 或空载体对照的质粒转染到从人体尸检和手术组织中获得的 NP 细胞中。转染后,将细胞接种在三维琼脂糖构建体中,培养 4 周,然后分析细胞活力、基因表达和蛋白聚糖。结果表明,尸检和手术 NP 细胞的转染均成功。我们观察到 Brachyury 的长期表达,NP 表型标志物 FOXF1、KRT19 和软骨形成标志物 SOX9 的表达显著增加,同时炎症细胞因子 IL1-β/IL6、NGF 和 MMPs 减少,糖胺聚糖积累显著增加。这些结果突出了非病毒转染与发育转录因子(如 Brachyury)相结合,是一种有前途的方法,可以将退变的人类椎间盘细胞重新编程为健康的 NP 表型。临床意义:本项目提出了一种通过直接将患病的人类患者源性 IVD 细胞重编程为健康表型来治疗椎间盘退变的新的转化方法。
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