Department of Spinal Surgery, The First Hospital of Jilin University, Changchun, China.
Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China.
Orthop Surg. 2022 Jul;14(7):1271-1280. doi: 10.1111/os.13254. Epub 2022 Apr 29.
Intervertebral disc degeneration (IDD) causes a variety of signs and symptoms, such as low back pain (LBP), intervertebral disc herniation, and spinal stenosis, which contribute to high social and economic costs. IDD results from many factors, including genetic factors, aging, mechanical injury, malnutrition, and so on. The pathological changes of IDD are mainly composed of the senescence and apoptosis of nucleus pulposus cells (NPCs), the progressive degeneration of extracellular matrix (ECM), the fibrosis of annulus fibrosus (AF), and the inflammatory response. At present, IDD can be treated by conservative treatment and surgical treatment based on patients' symptoms. However, all of these can only release the pain but cannot reverse IDD and reconstruct the mechanical function of the spine. The latest research is moving towards the field of biotherapy. Mesenchymal stem cells (MSCs) are regard as the potential therapy of IDD because of their ability to self-renew and differentiate into a variety of tissues. Moreover, the non-coding RNAs (ncRNAs) are found to regulate many vital processes in IDD. There have been many successes in the in vitro and animal studies of using biotherapy to treat IDD, but how to transform the experimental data to real therapy which can apply to humans is still a challenge. This article mainly reviews the treatment strategies and research progress of IDD and indicates that there are many problems that need to be solved if the new biotherapy is to be applied to clinical treatment of IDD. This will provide reference and guidance for clinical treatment and research direction of IDD.
椎间盘退变（IDD）引起多种症状和体征，如腰痛（LBP）、椎间盘突出和椎管狭窄，这导致了高昂的社会和经济成本。IDD 由多种因素引起，包括遗传因素、衰老、机械损伤、营养不良等。IDD 的病理变化主要由髓核细胞（NPC）的衰老和凋亡、细胞外基质（ECM）的渐进性退变、纤维环（AF）的纤维化和炎症反应组成。目前，可根据患者的症状，通过保守治疗和手术治疗来治疗 IDD。然而，所有这些都只能缓解疼痛，但不能逆转 IDD 并重建脊柱的机械功能。最新的研究正朝着生物治疗领域发展。间充质干细胞（MSCs）因其自我更新和分化为多种组织的能力，被认为是 IDD 的潜在治疗方法。此外，非编码 RNA（ncRNAs）被发现调节 IDD 中的许多重要过程。在使用生物疗法治疗 IDD 的体外和动物研究中已经取得了许多成功，但如何将实验数据转化为真正适用于人类的治疗方法仍然是一个挑战。本文主要综述了 IDD 的治疗策略和研究进展，并指出如果将新的生物疗法应用于 IDD 的临床治疗，仍有许多问题需要解决。这将为 IDD 的临床治疗和研究方向提供参考和指导。
