McDonnell Emily E, Ní Néill Tara, Wilson Niamh, Darwish Stacey L, Butler Joseph S, Buckley Conor T
Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin The University of Dublin Dublin Ireland.
Discipline of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin The University of Dublin Dublin Ireland.
JOR Spine. 2024 Jul 31;7(3):e1352. doi: 10.1002/jsp2.1352. eCollection 2024 Sep.
While growth factors have the potential to halt degeneration and decrease inflammation in animal models, the literature investigating the effect of dosage on human cells is lacking. Moreover, despite the completion of clinical trials using growth differentiation factor-5 (GDF-5), no results have been publicly released.
The overall objective was to quantitatively assess the effect of three clinically relevant concentrations of GDF-5 (0.25, 1, and 2 mg) as a therapeutic for disc regeneration.
Firstly, this work experimentally determined the effects of GDF-5 concentration on the metabolic and matrix synthesis rates of human nucleus pulposus (NP) cells. Secondly, in silico modeling was employed to predict the subsequent regenerative effect of different GDF-5 treatments (± cells).
This study suggests a trend of increased matrix synthesis with 0.25 and 1 mg of GDF-5. However, 2 mg of GDF-5 significantly upregulates oxygen consumption. Despite this, in silico models highlight the potential of growth factors in promoting matrix synthesis compared to cell-only treatments, without significantly perturbing the nutrient microenvironment.
This work elucidates the potential of GDF-5 on human NP cells. Although the results did not reveal statistical differences across all doses, the variability and response among donors is an interesting finding. It highlights the complexity of human response to biological treatments and reinforces the need for further human research and personalized approaches. Furthermore, this study raises a crucial question about whether these potential biologics are more regenerative in nature or better suited as prophylactic therapies for younger patient groups.
Biological agents exhibit unique characteristics and features, demanding tailored development strategies and individualized assessments rather than a one-size-fits-all approach. Therefore, the journey to realizing the full potential of biological therapies is long and costly. Nonetheless, it holds the promise of revolutionizing spinal healthcare and improving the quality of life for patients suffering from discogenic back pain.
虽然生长因子在动物模型中具有阻止退变和减轻炎症的潜力,但研究剂量对人类细胞影响的文献却很匮乏。此外,尽管使用生长分化因子5(GDF-5)的临床试验已经完成,但尚未公开任何结果。
总体目标是定量评估三种临床相关浓度的GDF-5(0.25、1和2毫克)作为椎间盘再生治疗药物的效果。
首先,本研究通过实验确定了GDF-5浓度对人髓核(NP)细胞代谢和基质合成速率的影响。其次,采用计算机模拟来预测不同GDF-5处理(±细胞)的后续再生效果。
本研究表明,0.25毫克和1毫克的GDF-5有使基质合成增加的趋势。然而,2毫克的GDF-5显著上调了氧消耗。尽管如此,计算机模拟模型显示,与仅进行细胞处理相比,生长因子在促进基质合成方面具有潜力,且不会显著扰乱营养微环境。
本研究阐明了GDF-5对人NP细胞的潜在作用。尽管结果未显示所有剂量之间存在统计学差异,但供体之间的变异性和反应是一个有趣的发现。它突出了人类对生物治疗反应的复杂性,并强调了进一步开展人体研究和采用个性化方法的必要性。此外,本研究还提出了一个关键问题,即这些潜在的生物制剂本质上是否更具再生性,或者是否更适合作为年轻患者群体的预防性治疗方法。
生物制剂具有独特的特性,需要量身定制的开发策略和个性化评估,而不是一刀切的方法。因此,要充分发挥生物治疗的潜力,道路漫长且成本高昂。尽管如此,它有望彻底改变脊柱医疗保健,并改善椎间盘源性背痛患者的生活质量。