Xiang Honglin, Zhao Weikang, Jiang Ke, He Jiangtao, Chen Lu, Cui Wenguo, Li Yuling
Department of Orthopaedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, PR China.
Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Orthopedic Laboratory of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, PR China.
Bioact Mater. 2023 Dec 8;33:506-531. doi: 10.1016/j.bioactmat.2023.11.021. eCollection 2024 Mar.
Intervertebral disc degeneration (IVDD) is rising worldwide and leading to significant health issues and financial strain for patients. Traditional treatments for IVDD can alleviate pain but do not reverse disease progression, and surgical removal of the damaged disc may be required for advanced disease. The inflammatory microenvironment is a key driver in the development of disc degeneration. Suitable anti-inflammatory substances are critical for controlling inflammation in IVDD. Several treatment options, including glucocorticoids, non-steroidal anti-inflammatory drugs, and biotherapy, are being studied for their potential to reduce inflammation. However, anti-inflammatories often have a short half-life when applied directly and are quickly excreted, thus limiting their therapeutic effects. Biomaterial-based platforms are being explored as anti-inflammation therapeutic strategies for IVDD treatment. This review introduces the pathophysiology of IVDD and discusses anti-inflammatory therapeutics and the components of these unique biomaterial platforms as comprehensive treatment systems. We discuss the strengths, shortcomings, and development prospects for various biomaterials platforms used to modulate the inflammatory microenvironment, thus providing guidance for future breakthroughs in IVDD treatment.
椎间盘退变(IVDD)在全球范围内呈上升趋势,给患者带来了严重的健康问题和经济负担。IVDD的传统治疗方法可以缓解疼痛,但不能逆转疾病进展,对于晚期疾病可能需要手术切除受损椎间盘。炎症微环境是椎间盘退变发展的关键驱动因素。合适的抗炎物质对于控制IVDD中的炎症至关重要。包括糖皮质激素、非甾体抗炎药和生物疗法在内的几种治疗方案正在研究其减轻炎症的潜力。然而,抗炎药直接应用时往往半衰期较短,会很快被排出体外,从而限制了它们的治疗效果。基于生物材料的平台正在被探索作为IVDD治疗的抗炎治疗策略。本综述介绍了IVDD的病理生理学,并讨论了抗炎治疗方法以及这些独特生物材料平台作为综合治疗系统的组成部分。我们讨论了用于调节炎症微环境的各种生物材料平台的优点、缺点和发展前景,从而为IVDD治疗的未来突破提供指导。