Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th.), Thessaloniki, Greece.
cGMP Regenerative Medicine Facility, Department of Physiology and Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (A.U.Th), Thessaloniki, Greece.
Tissue Eng Part B Rev. 2022 Aug;28(4):848-860. doi: 10.1089/ten.TEB.2021.0090. Epub 2022 Jan 10.
Intervertebral disc (IVD) represents a structure of crucial structural and functional importance for human spine. Pathology of IVD institutes a frequently encountered condition in current clinical practice. Degenerative disc disease (DDD), the principal clinical representative of IVD pathology, constitutes an increasingly diagnosed spinal disorder associated with substantial morbidity and mortality in recent years. Despite the considerable incidence and socioeconomic burden of DDD, existing treatment modalities including conservative and surgical methods have been demonstrated to provide a limited therapeutic effect, being not capable of interrupting or reversing natural progress of underlying disease. These limitations underline the requirement for development of novel, innovative, and more effective therapeutic strategies for DDD management. Within this literature framework, compromised IVD replacement with a viable IVD construct manufactured with tissue-engineering (TE) methods has been recommended as a promising therapeutic strategy for DDD. Existing preliminary preclinical data demonstrate that proper combination of cells from various sources, different scaffold materials, and appropriate signaling molecules renders manufacturing of whole-IVD tissue-engineered constructs a technically feasible process. The aim of this narrative review was to critically summarize current published evidence regarding particular aspects of IVD-TE, primarily emphasizing in providing researchers in this field with practicable knowledge to enhance clinical translatability of their research and informing clinical practitioners about the features and capabilities of innovative TE science in the field of IVD-TE. Impact Statement Human intervertebral disc (IVD) pathology represents an extremely frequent condition in current clinical practice. Given the considerable limitations of available treatment options, deployment of novel and groundbreaking therapeutic modalities constitutes a rather urgent need. Tissue engineering of entire human IVD, a technically feasible process within laboratory framework, is theoretically capable of overcoming limitations that characterize currently applied therapeutic measures. Optimization of laboratory manufacturing techniques in conjunction with more diligent evaluation of tissue-engineered constructs are expected to lay the foundations for clinical trials initiation.
椎间盘（IVD）是人体脊柱结构和功能的重要组成部分。IVD 病理学是当前临床实践中常见的疾病。退行性椎间盘疾病（DDD）是 IVD 病理学的主要临床表现，是近年来与发病率和死亡率显著相关的日益诊断出的脊柱疾病。尽管 DDD 的发病率和社会经济负担相当大，但现有的治疗方法，包括保守和手术方法，已被证明疗效有限，无法中断或逆转潜在疾病的自然进程。这些局限性强调了需要开发新的、创新的、更有效的 DDD 治疗策略。在这一文献框架内，使用组织工程（TE）方法制造具有活力的 IVD 替代物来替代受损的 IVD，已被推荐为 DDD 的一种有前途的治疗策略。现有的初步临床前数据表明，适当组合来自不同来源的细胞、不同的支架材料和适当的信号分子，使得制造整个 IVD 组织工程构建体成为一种技术上可行的过程。本综述的目的是批判性地总结当前关于 IVD-TE 各个方面的已发表证据，主要强调为该领域的研究人员提供实用知识，以增强其研究的临床转化，并向临床医生介绍创新 TE 科学在 IVD-TE 领域的特点和能力。
人类椎间盘（IVD）病理学是当前临床实践中极为常见的疾病。
鉴于现有治疗选择的局限性相当大，部署新的开创性治疗模式是相当迫切的需要。
整个人类 IVD 的组织工程，在实验室框架内是一种技术上可行的过程，理论上能够克服目前应用的治疗措施所具有的局限性。
优化实验室制造技术并结合更认真地评估组织工程构建体，有望为临床试验的启动奠定基础。
