Abstract:Activation of mitophagy was considered to be a potential therapeutic strategy for intervertebral disc degeneration (IDD). There was evidence suggesting that hyaluronic acid (HA) can protect mitochondria from oxidative stress in chondrocytes, but its protective effects and mechanism in nucleus pulposus cells (NPCs) remain unclear. This study aimed to confirm the effect of HA promoting mitophagy and protecting mitochondria function in NPCs, and explore its underlying mechanism. NPCs were treated with high molecu… Show more
“…Firstly, Alini et al demonstrated that a matrix of type I collagen and HA supplied stimulated the production of proteoglycans in both NPCs and AFCs. When HA is administered to cultured NPCs derived from human degenerating discs it stimulates mitophagy which has downstream protective effects against apoptosis and degradation of the ECM [99]. Similar ECM-protective effects of HA were demonstrated in a separate study examining the application of a HA hydrogel with fibroblast growth factor in both human and bovine NPCs [100].…”
Degenerative disc disease (DDD) is a pervasive condition that limits quality of life and burdens economies. Traditional pharmacological treatments aimed at slowing degeneration are ineffective in the long-term. Orthobiologics, regenerative agents derived from the patient’s own tissue, are a promising emerging therapy for degenerative disc disease. This review first outlines the pathophysiology of degenerative disc disease, highlighting the limitations of existing treatments and explores the orthobiologic tools for treating degenerative disc disease (platelet-rich plasma, mesenchymal stem cells). Their history in regenerative medicine is outlined, demonstrating how in vitro evidence informed preclinical animal studies on their efficacy in treating degenerative disc disease. Finally, clinical trials utilizing these treatment options are reviewed and directions for future research are outlined. Although the current clinical evidence available is limited to propagate their routine clinical usage the field holds immense potential in the management of DDD. There is room for these treatments to be optimized for effective consistent clinical outcomes in DDD.
“…Firstly, Alini et al demonstrated that a matrix of type I collagen and HA supplied stimulated the production of proteoglycans in both NPCs and AFCs. When HA is administered to cultured NPCs derived from human degenerating discs it stimulates mitophagy which has downstream protective effects against apoptosis and degradation of the ECM [99]. Similar ECM-protective effects of HA were demonstrated in a separate study examining the application of a HA hydrogel with fibroblast growth factor in both human and bovine NPCs [100].…”
Degenerative disc disease (DDD) is a pervasive condition that limits quality of life and burdens economies. Traditional pharmacological treatments aimed at slowing degeneration are ineffective in the long-term. Orthobiologics, regenerative agents derived from the patient’s own tissue, are a promising emerging therapy for degenerative disc disease. This review first outlines the pathophysiology of degenerative disc disease, highlighting the limitations of existing treatments and explores the orthobiologic tools for treating degenerative disc disease (platelet-rich plasma, mesenchymal stem cells). Their history in regenerative medicine is outlined, demonstrating how in vitro evidence informed preclinical animal studies on their efficacy in treating degenerative disc disease. Finally, clinical trials utilizing these treatment options are reviewed and directions for future research are outlined. Although the current clinical evidence available is limited to propagate their routine clinical usage the field holds immense potential in the management of DDD. There is room for these treatments to be optimized for effective consistent clinical outcomes in DDD.
“…Firstly, Alini et al [ 100 ] demonstrated that a matrix of type I collagen and supplied HA stimulated the production of proteoglycans in both NPCs and AFCs. When HA is administered to cultured NPCs derived from human degenerating discs it stimulates mitophagy which has downstream protective effects against apoptosis and degradation of the ECM [ 101 ]. Similar ECM-protective effects of HA were demonstrated in a separate study examining the application of a HA hydrogel with fibroblast growth factor in both human and bovine NPCs [ 102 ].…”
Degenerative disc disease (DDD) is a pervasive condition that limits quality of life and burdens economies worldwide. Conventional pharmacological treatments primarily aimed at slowing the progression of degeneration have demonstrated limited long-term efficacy and often do not address the underlying causes of the disease. On the other hand, orthobiologics are regenerative agents derived from the patient’s own tissue and represent a promising emerging therapy for degenerative disc disease. This review comprehensively outlines the pathophysiology of DDD, highlighting the inadequacies of existing pharmacological therapies and detailing the potential of orthobiologic approaches. It explores advanced tools such as platelet-rich plasma and mesenchymal stem cells, providing a historical overview of their development within regenerative medicine, from foundational in vitro studies to preclinical animal models. Moreover, the manuscript delves into clinical trials that assess the effectiveness of these therapies in managing DDD. While the current clinical evidence is promising, it remains insufficient for routine clinical adoption due to limitations in study designs. The review emphasizes the need for further research to optimize these therapies for consistent and effective clinical outcomes, potentially revolutionizing the management of DDD and offering renewed hope for patients.
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