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对抗椎间盘退变的创新策略:病理机制与生物材料进展

Innovative strategies in combating intervertebral disc degeneration: pathological mechanisms and biomaterial advancements.

作者信息

Ma Long, Pan Jizhou, Zhang Jiankang, Liu Fashun

机构信息

Department of Pain Medicine, Sanya Central Hospital (The Third People's Hospital of Hainan Province), Sanya, China.

Department of Emergency Surgery, Guizhou Provincial People's Hospital, Guiyang, China.

出版信息

Front Bioeng Biotechnol. 2025 Aug 14;13:1643222. doi: 10.3389/fbioe.2025.1643222. eCollection 2025.

Abstract

Intervertebral disc degeneration (IVDD) is a leading cause of chronic low back pain, significantly impacting the quality of life for millions of individuals worldwide. The onset of IVDD is associated with various factors such as age, lifestyle, and genetics, and its pathological mechanisms involve multidimensional interactions, including oxidative stress, inflammation, and extracellular matrix (ECM) metabolic disorders. During degeneration, there is a reduction in the number of nucleus pulposus cells (NPCs), resulting in an imbalance between the synthesis and degradation of the ECM, leading to changes in the disc's morphology and biomechanical function, ultimately causing pain and mobility issues. As the global population ages, the incidence of IVDD continues to rise, necessitating the development of effective treatment strategies. Recent research into biomaterials, particularly hydrogels and stem cell technologies, has shown promise for disc regeneration, providing scaffolds to enhance cellular repair and facilitate drug delivery. This review comprehensively examines recent advancements in IVDD research, focusing on the pathological mechanisms and the potential application of biomaterials in treatment. Additionally, the integration of emerging technologies such as 3D printing and stem cell therapy represents a transformative approach in IVDD management. These findings open new avenues for targeted intervention strategies that address the underlying causes of IVDD, paving the way for improved clinical outcomes.

摘要

椎间盘退变(IVDD)是慢性下腰痛的主要原因,严重影响全球数百万人的生活质量。IVDD的发病与年龄、生活方式和遗传等多种因素有关,其病理机制涉及多维度相互作用,包括氧化应激、炎症和细胞外基质(ECM)代谢紊乱。在退变过程中,髓核细胞(NPCs)数量减少,导致ECM合成与降解失衡,进而引起椎间盘形态和生物力学功能改变,最终导致疼痛和活动问题。随着全球人口老龄化,IVDD的发病率持续上升,因此需要开发有效的治疗策略。最近对生物材料,特别是水凝胶和干细胞技术的研究,显示出椎间盘再生的潜力,为增强细胞修复和促进药物递送提供支架。本综述全面考察了IVDD研究的最新进展,重点关注病理机制以及生物材料在治疗中的潜在应用。此外,3D打印和干细胞治疗等新兴技术的整合代表了IVDD管理中的一种变革性方法。这些发现为针对IVDD根本原因的靶向干预策略开辟了新途径,为改善临床结果铺平了道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6220/12391112/1ddb5d6f2f96/fbioe-13-1643222-g001.jpg

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