New ideas for the treatment of intervertebral discs: injection of hydrogel microspheres = regulation of inflammation + promotion of nucleus pulposus repair

Low back pain caused by degeneration of the intervertebral disc is a common disease in modern people. In the existing treatment methods, only by completely removing the inflammatory storm of the degenerated intervertebral disc, can the potential harm be eliminated and the repair and repair of the degenerated nucleus pulposus can be achieved. regeneration.

Low back pain is one of the common causes of the inconvenience of lower limbs, which brings a huge economic burden to society. However, there are many reasons for low back pain, and a large proportion of them are related to intervertebral disc degeneration. At present, the most common treatment methods for spinal problems related to intervertebral disc degeneration include conservative treatment methods (ie, physical therapy and drug therapy) and surgical treatment.

Although, research on the etiology and treatment of degenerative intervertebral discs has achieved good results in animal models, such as: application of inflammatory factor antagonists, supplementation of growth factors, or transplantation of seed cells. However, the harsh microenvironment in the intervertebral disc still restricts the further development of these biological treatments.

In the degenerative intervertebral disc, the supply and demand balance of nutrients is broken, and the removal of the breakdown products of the extracellular matrix (ECM) is hindered, which leads to changes in the biological characteristics of the nucleus pulposus cells and abnormal expression of TNF-α, IL-1β and IL- 6 and other inflammatory factors, forming a local inflammatory factor storm.

If these inflammatory factors are not suppressed in time or are not completely removed, they may be transformed into potentially harmful substances to further aggravate the damage to the intervertebral disc. Therefore, how to achieve the repair and regeneration of the degenerated nucleus pulposus while regulating the excessive inflammation in the degenerated intervertebral disc is the bottleneck that needs to be broken through.

In view of this, the Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine/Shanghai Institute of Traumatology and Orthopedics-Professor Cui Wenguo team and the team of Director Chen Liang of the First Affiliated Hospital of Soochow University used microfluidic technology and freeze-drying technology to prepare uniform injectable porous water The gel microspheres are grafted with the polypeptide APETx-2 through covalent cross-linking, and at the same time load the nucleus pulposus cells to construct an immunoregulatory "polypeptide-cell-hydrogel" that has the potential to regulate local inflammation and promote the regeneration of intervertebral disc tissue.

Reference

Modulation of Local Overactive Inflammation via Injectable Hydrogel Microspheres

https://pubs.acs.org/doi/10.1021/acs.nanolett.0c04713