Current trends in biologics delivery to restore intervertebral disc anabolism.

Abstract:

:Low back pain is generally attributed to intervertebral disc (IVD) degeneration. This is a multifactorial disease induced by genetic and environmental factors and that progresses with aging. Disc degeneration is characterized by a limited ability of IVD cells to produce functional matrix while producing abnormal amounts of matrix-degrading enzymes. The prolonged imbalance between anabolism and catabolism in degenerative discs alters their composition and hydration. In turn, this results in increased angiogenesis and the loss of the disc's ability to maintain its aneural condition. Inflammation in the IVD, in particular the presence of pro-inflammatory cytokines, was found to favor innervation and also sensitization of the nociceptive pathways, thereby exacerbating degenerative symptoms. In this review, we discuss anti-inflammatory approaches to encounter disc catabolism, potential treatments to lower discogenic pain and pro-anabolic approaches in the form of protein delivery, gene therapy and cell delivery, to trigger regeneration in the IVD.

journal_name

Adv Drug Deliv Rev

authors

Fontana G,See E,Pandit A

doi

10.1016/j.addr.2014.08.008

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

146-58

eissn

0169-409X

issn

1872-8294

pii

S0169-409X(14)00182-3

journal_volume

84

pub_type

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