Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Cells. 2021 Aug 29;10(9):2241. doi: 10.3390/cells10092241.
Intervertebral disc degeneration (IVDD) occurs as a result of an imbalance of the anabolic and catabolic processes in the intervertebral disc, leading to an alteration in the composition of the extracellular matrix (ECM), loss of nucleus pulposus (NP) cells, excessive oxidative stress and inflammation. Degeneration of the IVD occurs naturally with age, but mechanical trauma, lifestyle factors and certain genetic abnormalities can increase the likelihood of symptomatic disease progression. IVDD, often referred to as degenerative disc disease (DDD), poses an increasingly substantial financial burden due to the aging population and increasing incidence of obesity in the United States. Current treatments for IVDD include pharmacological and surgical interventions, but these lack the ability to stop the progression of disease and restore the functionality of the IVD. Biological therapies have been evaluated but show varying degrees of efficacy in reversing disc degeneration long-term. Stem cell-based therapies have shown promising results in the regeneration of the IVD, but face both biological and ethical limitations. Exosomes play an important role in intercellular communication, and stem cell-derived exosomes have been shown to maintain the therapeutic benefit of their origin cells without the associated risks. This review highlights the current state of research on the use of stem-cell derived exosomes in the treatment of IVDD.
椎间盘退行性变（IVDD）是由于椎间盘内合成代谢和分解代谢过程失衡引起的，导致细胞外基质（ECM）组成改变、髓核（NP）细胞丢失、过度氧化应激和炎症。IVDD 随着年龄的增长而自然发生，但机械创伤、生活方式因素和某些遗传异常会增加出现症状性疾病进展的可能性。由于美国人口老龄化和肥胖症发病率的增加，IVDD 造成的经济负担越来越大。目前 IVDD 的治疗方法包括药物和手术干预，但这些方法缺乏阻止疾病进展和恢复椎间盘功能的能力。生物疗法已经得到了评估，但在长期逆转椎间盘退变方面显示出不同程度的疗效。基于干细胞的疗法在椎间盘再生方面显示出了有希望的结果，但面临着生物学和伦理方面的限制。外泌体在细胞间通讯中起着重要作用，干细胞衍生的外泌体在没有相关风险的情况下保持其来源细胞的治疗益处。这篇综述强调了目前关于使用干细胞衍生的外泌体治疗 IVDD 的研究现状。
