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Lessons learned from intervertebral disc pathophysiology to guide rational design of sequential delivery systems for therapeutic biological factors

机译:从椎间盘病理生理学中学到的经验教训,指导治疗生物因子顺序输送系统的合理设计

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摘要

Intervertebral disc (IVD) degeneration has been associated with low back pain, which is a major musculoskeletal disorder and socio-economic problem that affects as many as 600 million patients worldwide. Here, we first review the current knowledge of IVD physiology and physiopathological processes in terms of homeostasis regulation and consecutive events that lead to tissue degeneration. Recent progress with IVD restoration by anti-catabolic or pro-anabolic approaches are then analyzed, as are the design of macro-, micro-, and nano-platforms to control the delivery of such therapeutic agents. Finally, we hypothesize that a sequential delivery strategy that i) firstly targets the inflammatory, pro-catabolic microenvironment with release of anti-inflammatory or anti-catabolic cytokines; ii) secondly increases cell density in the less hostile microenvironment by endogenous cell recruitment or exogenous cell injection, and finally iii) enhances cellular synthesis of extracellular matrix with release of pro-anabolic factors, would constitute an innovative yet challenging approach to IVD regeneration.
机译:椎间盘(IVD)变性与低腰疼有关,这是一个主要的肌肉骨骼障碍和社会经济问题,影响全球患者多达6亿患者。在这里,我们首先在稳态调节和连续事件中审查IVD生理学和物理病理过程的目前的知识,导致组织变性。然后分析了通过抗分解代谢或促​​替代方法恢复的IVD恢复的进展,以及宏观,微观和纳米平台的设计,以控制这种治疗剂的递送。最后,我们假设I)首先靶向炎症,抗炎症或抗分解代谢细胞因子的炎症,亲殖民微环境; ii)第二次源细胞募集或外源细胞注射率在较少敌对的微环境中增加细胞密度,最后III)通过释放亲具因子,增强细胞外基质的细胞合成,将构成IVD再生的创新且挑战性的方法。

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