Liu Yang, Liu Hao, Meng Yang, Zhang Liang
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
Department of Orthopedics, Northern Jiangsu People's Hospital, Yangzhou Jiangsu, 225000, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 May 15;35(5):636-641. doi: 10.7507/1002-1892.202012070.
To review the research progress of endogenous repair strategy (ERS) in intervertebral disc (IVD).
The domestic and foreign literature related to ERS in IVD in recent years was reviewed, and its characteristics, status, and prospect in the future were summarized.
The key of ERS in IVD is to improve the vitality of stem/progenitor cells in IVD or promote its migration from stem cell Niche to the tissue that need to repair. These stem/progenitor cells in IVD are derived from nucleus pulposus, annulus fibrosus, and cartilaginous endplate, showing similar biological characteristics to mesenchymal stem cells including the expression of the specific stem/progenitor cell surface markers and gene, and also the capacity of multiple differentiations potential. However, the development, senescence, and degeneration of IVD have consumed these stem/progenitor cells, and the harsh internal microenvironment further impair their biological characteristics, which leads to the failure of endogenous repair in IVD. At present, relevant research mainly focuses on improving the biological characteristics of endogenous stem/progenitor cells, directly supplementing endogenous stem/progenitor cells, biomaterials and small molecule compounds to stimulate the endogenous repair in IVD, so as to improve the effect of endogenous repair.
At present, ERS has gotten some achievements in the treatment of IVD degeneration, but its related studies are still in the pre-clinical stage. So further studies regarding ERS should be carried out in the future, especially experiments and clinical transformation.
综述椎间盘内源性修复策略(ERS)的研究进展。
回顾近年来国内外有关椎间盘ERS的文献,并总结其特点、现状及未来前景。
椎间盘ERS的关键在于提高椎间盘内干细胞/祖细胞的活力,或促进其从干细胞龛迁移至需要修复的组织。椎间盘内的这些干细胞/祖细胞来源于髓核、纤维环和软骨终板,表现出与间充质干细胞相似的生物学特性,包括特定干细胞/祖细胞表面标志物和基因的表达,以及多向分化潜能。然而,椎间盘的发育、衰老和退变消耗了这些干细胞/祖细胞,恶劣的内部微环境进一步损害了它们的生物学特性,导致椎间盘内源性修复失败。目前,相关研究主要集中在改善内源性干细胞/祖细胞的生物学特性、直接补充内源性干细胞/祖细胞、生物材料和小分子化合物以刺激椎间盘内源性修复,从而提高内源性修复效果。
目前,ERS在椎间盘退变治疗方面已取得一些成果,但其相关研究仍处于临床前阶段。因此,未来应进一步开展关于ERS的研究,尤其是实验研究和临床转化。