Ding Yifan, Li Fan, Wang Yunyun, Pan Weizhen, Fu Xiangning, Tan Songwei
Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Department of Cardiology, the Fifth Hospital of Wuhan, Jianghan University, Wuhan 430030, China.
Pharmaceutics. 2025 Feb 28;17(3):313. doi: 10.3390/pharmaceutics17030313.
Intervertebral disc degeneration (IDD) is a leading cause of low back pain (LBP) and neurological dysfunction, contributing significantly to disability-adjusted life years globally. The progression of IDD is driven by excessive oxidative stress, inflammation, apoptosis, and fibrosis, which disrupt the balance between anabolic and catabolic processes, leading to extracellular matrix (ECM) degradation and IDD. Current treatment options, such as conservative therapy and surgical intervention, are limited in halting the disease progression and often exacerbate degeneration in adjacent discs. This review highlights the challenges in treating IDD, particularly due to the limited drug delivery efficiency to the intervertebral disc (IVD). It explores the potential of nanobiomedicine and various nanomaterial-based delivery systems, including nanoparticles, microspheres, gene-nanocomplexes, fullerene, exosomes, and nanomaterial-composite hydrogels. These advanced delivery systems can enhance targeted drug delivery, improve local drug concentration, and sustain drug retention within the IVD, offering promising therapeutic strategies to address IDD. The review also examines the therapeutic effects of these nanomaterials on IDD, focusing on their impact on metabolism, inflammation, apoptosis, fibrosis, and stem cell migration and differentiation, aiming to provide innovative strategies for intervertebral disc regeneration.
椎间盘退变（IDD）是下腰痛（LBP）和神经功能障碍的主要原因，在全球范围内对伤残调整生命年有重大影响。IDD的进展是由过度的氧化应激、炎症、细胞凋亡和纤维化驱动的，这些因素破坏了合成代谢和分解代谢过程之间的平衡，导致细胞外基质（ECM）降解和IDD。目前的治疗选择，如保守治疗和手术干预，在阻止疾病进展方面有限，并且常常加剧相邻椎间盘的退变。这篇综述强调了治疗IDD的挑战，特别是由于向椎间盘（IVD）的药物递送效率有限。它探讨了纳米生物医学和各种基于纳米材料的递送系统的潜力，包括纳米颗粒、微球、基因纳米复合物、富勒烯、外泌体和纳米材料复合水凝胶。这些先进的递送系统可以增强靶向药物递送，提高局部药物浓度，并在IVD内维持药物滞留，为解决IDD提供了有前景的治疗策略。该综述还研究了这些纳米材料对IDD的治疗效果，重点关注它们对代谢、炎症、细胞凋亡、纤维化以及干细胞迁移和分化的影响，旨在为椎间盘再生提供创新策略。
