Intervertebral disc (IVD) degeneration (IDD) is a multifactorial pathological process associated with low back pain (LBP). The pathogenesis is complicated, and the main pathological changes are IVD cell apoptosis and extracellular matrix (ECM) degradation. Apoptotic cell loss leads to ECM degradation, which plays an essential role in IDD pathogenesis. Apoptosis regulation may be a potential attractive therapeutic strategy for IDD. Previous studies have shown that IVD cell apoptosis is mainly induced by the death receptor pathway, mitochondrial pathway, and endoplasmic reticulum stress (ERS) pathway. This article mainly summarizes the factors that induce IDD and apoptosis, the relationship between the three apoptotic pathways and IDD, and potential therapeutic strategies. Preliminary animal and cell experiments show that targeting apoptotic pathway genes or drug inhibition can effectively inhibit IVD cell apoptosis and slow IDD progression. Targeted apoptotic pathway inhibition may be an effective strategy to alleviate IDD at the gene level. This manuscript provides new insights and ideas for IDD therapy.
Intervertebral disc (IVD) degeneration (IVDD) has been considered the dominant factor in low back pain (LBP), and its etiological mechanisms are complex and not yet fully elucidated. To date, the treatment of IVDD has mainly focused on relieving clinical symptoms and cannot fundamentally solve the problem. Recently, a novel microsphere-based therapeutic strategy has held promise for IVD regeneration and has yielded encouraging results with in vitro experiments and animal models. With excellent injectability, biocompatibility, and biodegradability, this microsphere carrier allows for targeted delivery and controlled release of drugs, gene regulatory sequences, and other bioactive substances and supports cell implantation and directed differentiation, aiming to improve the disease state of IVD at the source. This review discusses the possible mechanisms of IVDD and the limitations of current therapies, focusing on the application of microsphere delivery systems in IVDD, including targeted delivery of active substances and drugs, cellular therapy, and gene therapy, and attempts to provide a new understanding for the treatment of IVDD.
Background: Primary mesenchymal chondrosarcoma (PMC) is a relatively rare malignancy that can occur in bone or soft tissue, but rarely in the lumbar spine; there is currently no unified treatment. We report a case of mesenchymal chondrosarcoma originating from the L1 vertebra.Case Description: A 47-year-old female patient was admitted to the hospital with intermittent low back pain for 20 years, accompanied by intermittent headache and radiating pain in both lower limbs. After admission, magnetic resonance imaging (MRI) showed bone destruction of the L1 vertebral body and accessories and a surrounding soft tissue mass. Enhanced MRI revealed significant enhancement of the L1 vertebral body and soft tissue mass. Technetium 99 m-methylene diphosphonate (99 m Tc-MDP) bone scan showed abnormally high metabolism in the L1 vertebral body, which is highly suspicious of malignancy, and vertebral biopsy revealed a soft tissue malignancy originating from the mesenchymal tissue. Total vertebrectomy combined with postoperative adjuvant radiotherapy was planned, but the patient refused radiotherapy for financial reasons. Intraoperative frozen sections indicated mesenchymal chondrosarcoma, as confirmed by postoperative pathological examination. After 1 year of outpatient follow-up, the patient had no related symptoms, and normal motor and sensory function, and her condition had improved.Conclusions: Total tumor resection is an effective treatment for PMC, and increased attention to this disease in the clinic is essential.
Stimulus responsive composite hydrogels combines with ready-to-use particles to form multi-scale delivery system. After solidification in vivo, the biological agents slowly released induce stem cells to differentiate into IVD tissue.
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