Mai Yingjie, Wu Siying, Zhang Penghui, Chen Ningning, Wu Jun, Wei Fuxin
Department of Orthopaedics, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong Province, 518107, China.
Bioscience and Biomedical Engineering Thrust, The Hong Kong University of Science & Technology (Guangzhou), Nansha, Guangzhou, Guangdong Province, 511400, China.
Bioact Mater. 2024 Nov 9;45:19-40. doi: 10.1016/j.bioactmat.2024.10.012. eCollection 2025 Mar.
Intervertebral disc degeneration (IVDD) is a prevalent chronic spinal condition characterized by the deterioration of the intervertebral discs (IVD), leading to structural damage and associated pain. This degenerative process is closely linked to oxidative stress injury, which plays a pivotal role in its onset and progression. Oxidative stress in IVDD results from the excessive production of reactive oxygen species (ROS) and impaired ROS clearance mechanisms, disrupting the redox balance within the intervertebral disc. Consequently, oxidative stress contributes to the degradation of the extracellular matrix (ECM), promotes cell apoptosis, and exacerbates disc tissue damage. Current treatment options for IVDD face significant challenges in effectively alleviating the oxidative stress-induced damage and facilitating disc tissue repair. However, recent advancements in biomaterials have opened new avenues of hope for IVDD treatment by addressing oxidative stress. In this review, we first provide an overview of the pathophysiological process of IVDD and explore the mechanisms and pathways associated with oxidative stress injury. Then, we delve into the current research on antioxidant biomaterials employed in the treatment of IVDD, and outline the advantages and limitations of hydrogel, nanomaterials, polyphenol and inorganic materials. Finally, we propose the future research direction of antioxidant biomaterials in IVDD treatment. The main idea of this review is shown in Scheme 1.
椎间盘退变(IVDD)是一种常见的慢性脊柱疾病,其特征是椎间盘(IVD)退变,导致结构损伤并伴有疼痛。这种退变过程与氧化应激损伤密切相关,氧化应激损伤在其发病和进展中起关键作用。IVDD中的氧化应激源于活性氧(ROS)的过量产生以及ROS清除机制受损,从而破坏了椎间盘内的氧化还原平衡。因此,氧化应激会导致细胞外基质(ECM)降解,促进细胞凋亡,并加剧椎间盘组织损伤。目前IVDD的治疗方案在有效减轻氧化应激诱导的损伤和促进椎间盘组织修复方面面临重大挑战。然而,生物材料的最新进展通过解决氧化应激问题为IVDD治疗开辟了新的希望途径。在本综述中,我们首先概述IVDD的病理生理过程,并探讨与氧化应激损伤相关的机制和途径。然后,我们深入研究用于IVDD治疗的抗氧化生物材料的当前研究,并概述水凝胶、纳米材料、多酚和无机材料的优点和局限性。最后,我们提出抗氧化生物材料在IVDD治疗中的未来研究方向。本综述的主要内容见图1。