Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, MOE Key Laboratory of Geriatric Diseases and Immunology, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu 215000, China.
Department of Spinal Surgery, Ma'anshan People's Hospital, Ma'anshan, Anhui, 243000, China.
Acta Biomater. 2024 Sep 1;185:336-349. doi: 10.1016/j.actbio.2024.06.048. Epub 2024 Jul 4.
Presently, the clinical treatment of intervertebral disc degeneration (IVDD) remains challenging, but the strategy of simultaneously overcoming the overactive inflammation and restoring the anabolic/catabolic balance of the extracellular matrix (ECM) in the nucleus pulposus (NP) has become an effective way to alleviate IVDD. IL-1ra, a natural antagonist against IL-1β, can mitigate inflammation and promote regeneration in IVDD. Chondroitin sulfate (CS), an important component of the NP, can promote ECM synthesis and delay IVDD. Thus, these were chosen and integrated into functionalized microspheres to achieve their synergistic effects. First, CS-functionalized microspheres (GelMA-CS) with porous microstructure, good monodispersion, and about 200 µm diameter were efficiently and productively fabricated using microfluidic technology. After lyophilization, the microspheres with good local injection and tissue retention served as the loading platform for IL-1ra and achieved sustained release. In in vitro experiments, the IL-1ra-loaded microspheres exhibited good cytocompatibility and efficacy in inhibiting the inflammatory response of NP cells induced by lipopolysaccharide (LPS) and promoting the secretion of ECM. In in vivo experiments, the microspheres showed good histocompatibility, and local, minimally invasive injection of the IL-1ra-loaded microspheres could reduce inflammation, maintain the height of the intervertebral disc (IVD) and the water content of NP close to about 70 % in the sham group, and retain the integrated IVD structure. In summary, the GelMA-CS microspheres served as an effective loading platform for IL-1ra, eliminated inflammation through the controlled release of IL-1ra, and promoted ECM synthesis via CS to delay IVDD, thereby providing a promising intervention strategy for IVDD. STATEMENT OF SIGNIFICANCE: The strategy of simultaneously overcoming the overactive inflammation and restoring the anabolic/catabolic balance of the extracellular matrix (ECM) in nucleus pulposus (NP) has shown great potential prospects for alleviating intervertebral disc degeneration (IVDD). From the perspective of clinical translation, this study developed chondroitin sulfate functionalized microspheres to act as the effective delivery platform of IL-1ra, a natural antagonist of interleukin-1β. The IL-1ra loading microspheres (GelMA-CS-IL-1ra) showed good biocompatibility, good injection with tissue retention, and synergistic effects of inhibiting the inflammatory response induced by lipopolysaccharide and promoting the secretion of ECM in NPCs. In vivo, they also showed the beneficial effect of reducing the inflammatory response, maintaining the height of the intervertebral disc and the water content of the NP, and preserving the integrity of the intervertebral disc structure after only one injection. All demonstrated that the GelMA-CS-IL-1ra microspheres would have great promise for the minimally invasive treatment of IVDD.
目前,椎间盘退行性病变(IVDD)的临床治疗仍然具有挑战性,但同时克服过度炎症反应和恢复髓核(NP)细胞外基质(ECM)合成/分解代谢平衡的策略已成为缓解 IVDD 的有效方法。白细胞介素 1 受体拮抗剂(IL-1ra)是白细胞介素 1β 的天然拮抗剂,可减轻炎症并促进 IVDD 再生。硫酸软骨素(CS)是 NP 的重要组成部分,可促进 ECM 合成并延缓 IVDD。因此,选择并整合到功能化微球中以实现协同作用。首先,使用微流控技术高效且大量地制备了具有多孔微结构、良好的单分散性和约 200µm 直径的 CS 功能化微球(GelMA-CS)。经冻干后,微球具有良好的局部注射和组织保留能力,可作为 IL-1ra 的载药平台,并实现持续释放。在体外实验中,负载 IL-1ra 的微球表现出良好的细胞相容性,并能有效抑制脂多糖(LPS)诱导的 NP 细胞的炎症反应,促进 ECM 的分泌。在体内实验中,微球表现出良好的组织相容性,局部、微创注射负载 IL-1ra 的微球可降低炎症反应,使椎间盘高度(IVD)和 NP 含水量接近 sham 组的约 70%,并保持完整的 IVDD 结构。总之,GelMA-CS 微球作为 IL-1ra 的有效载药平台,通过控制释放 IL-1ra 消除炎症,并通过 CS 促进 ECM 合成来延缓 IVDD,为 IVDD 提供了一种有前途的干预策略。