Enhancing intervertebral disc repair and regeneration through biology: platelet-rich plasma as an alternative strategy

Shan-Zheng Wang, Yun-Feng Rui, Qi Tan, Chen Wang, Shan-Zheng Wang, Yun-Feng Rui, Qi Tan, Chen Wang

Abstract

Intervertebral disc degeneration (IDD) is a common orthopedic disease associated with mechanical changes that may result in significant pain. Current treatments for IDD mainly depend on conservative therapies and spinal surgeries that are only able to relieve the symptoms but do not address the cause of the degeneration and even accelerate the degeneration of adjacent segments. This has prompted research to improve our understanding of the biology of intervertebral disc healing and into methods to enhance the regenerative process. Recently, biological therapies, including active substances, gene therapy and tissue engineering based on certain cells, have been attracting more attention in the field of intervertebral disc repair and regeneration. Early selection of suitable biological treatment is an ideal way to prevent or even reverse the progressive trend of IDD. Growth factors have been enjoying more popularity in the field of regeneration of IDD and many have been proved to be effective in reversing the degenerative trend of the intervertebral disc. Identification of these growth factors has led to strategies to deliver platelet-derived factors to the intervertebral disc for regeneration. Platelet-rich plasma (PRP) is the latest technique to be evaluated for promoting intervertebral disc healing. Activation of the PRP leads to the release of growth factors from the α-granules in the platelet cytoplasm. These growth factors have been associated with the initiation of a healing cascade that leads to cellular chemotaxis, angiogenesis, synthesis of collagen matrix, and cell proliferation. This review describes the current understanding of IDD and related biological therapeutic strategies, especially the promising prospects of PRP treatment. Future limitations and perspectives of PRP therapy for IDD are also discussed.

References

    1. Frymoyer JW, Cats-Baril WL. An overview of the incidence and costs of low back pain. Orthop Clin North Am. 1991;15:263–271.
    1. Shvartzman L, Weingarten E, Sherry H, Levin S, Persaud A. Cost-effectiveness analysis of extended conservative therapy versus surgical intervention in the management of herniated lumbar intervertebral disc. Spine. 1992;15:176–182.
    1. An HS, Thonar EJ, Masuda K. Biological repair of intervertebral disc. Spine. 2003;15:S86–S92.
    1. Evans C. Potential biologic therapies for the intervertebral disc. J Bone Joint Surg Am. 2006;15:95–98.
    1. Pietrzak WS, Eppley BL. Platelet rich plasma: biology and new technology. J Craniofac Surg. 2005;15:1043–1054.
    1. Freemont AJ. The cellular pathobiology of the degenerate intervertebral disc and discogenic back pain. Rheumatology. 2009;15:5–10.
    1. Choi YS. Pathophysiology of degenerative disc disease. Asian Spine J. 2009;15:39–44.
    1. Schoenfeld AJ, Nelson JH, Burks R, Belmont PJ Jr. Incidence and risk factors for lumbar degenerative disc disease in the United States military 1999-2008. Mil Med. 2011;15:1320–1324.
    1. Singh K, Masuda K, An HS. Animal models for human disc degeneration. Spine J. 2005;15:267S–279S.
    1. Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it? Spine. 2006;15:2151–2161.
    1. Karppinen J, Shen FH, Luk KD, Andersson GB, Cheung KM, Samartzis D. Management of degenerative disk disease and chronic low back pain. Orthop Clin North Am. 2011;15:513–528.
    1. Sakai D. Future perspectives of cell-based therapy for intervertebral disc disease. Eur Spine J. 2008;15:452–458.
    1. Yoon ST, Patel NM. Molecular therapy of the intervertebral disc. Eur Spine J. 2006;15:S379–S388.
    1. Masuda K, An HS. Prevention of disc degeneration with growth factors. Eur Spine J. 2006;15:S422–S432.
    1. Crevensten G, Walsh AJ, Ananthakrishnan D, Page P, Wahba GM, Lotz JC, Berven S. Intervertebral disc cell therapy for regeneration: mesenchymal stem cell implantation in rat intervertebral discs. Ann Biomed Eng. 2004;15:430–434.
    1. Hiyama A, Mochida J, Iwashina T, Omi H, Watanabe T, Serigano K, Tamura F, Sakai D. Transplantation of mesenchymal stem cells in a canine disc degeneration model. J Orthop Res. 2008;15:589–600.
    1. Zhang YG, Guo X, Xu P, Kang LL, Li J. Bone mesenchymal stem cells transplanted into rabbit intervertebral discs can increase proteoglycans. Clin Orthop Relat Res. 2005;15:219–226.
    1. Lyons G, Eisenstein SM, Sweet MB. Biochemical changes in intervertebral disc degeneration. Biochim Biophys Acta. 1981;15:443–453.
    1. Urban JP, Roberts S. Degeneration of the intervertebral disc. Arthritis Res Ther. 2003;15:120–130.
    1. Freemont AJ. The cellular pathobiology of the degenerate intervertebral disc and discogenic back pain. Rheumatology. 2009;15:5–10.
    1. Yang SH, Lin CC, Hu MH, Shih TT, Sun YH, Lin FH. Influence of age-related degeneration on regenerative potential of human nucleus pulposus cells. J Orthop Res. 2010;15:379–383.
    1. Masuda K. Biological repair of the degenerated intervertebral disc by the injection of growth factors. Eur Spine J. 2008;15:441–451.
    1. Le Maitre CL, Freemont AJ, Hoyland JA. A preliminary in vitro study into the use of IL-1Ra gene therapy for the inhibition of intervertebral disc degeneration. Int J Exp Pathol. 2006;15:17–28.
    1. Wallach CJ, Sobajima S, Watanabe Y, Kim JS, Georgescu HI, Robbins P, Gilbertson LG, Kang JD. Gene transfer of the catabolic inhibitor TIMP-1 increases measured proteoglycans in cells from degenerated human intervertebral discs. Spine. 2003;15:2331–2337.
    1. Sakai D, Mochida J, Iwashina T, Watanabe T, Nakai T, Ando K, Hotta T. Differentiation of mesenchymal stem cells transplanted to a rabbit degenerative disc model: potential and limitations for stem cell therapy in disc regeneration. Spine. 2005;15:2379–2387.
    1. Zhang Y, Drapeau S, Howard SA, Thonar EJ, Anderson DG. Transplantation of goat bone marrow stromal cells to the degenerating intervertebral disc in a goat disc injury model. Spine. 2011;15:372–377.
    1. Masuda K, Oegema TR Jr, An HS. Growth factors and treatment of intervertebral disc degeneration. Spine. 2004;15:2757–2769.
    1. Nishida K, Kang JD, Gilbertson LG, Moon SH, Suh JK, Vogt MT, Robbins PD, Evans CH. Modulation of the biologic activity of the rabbit intervertebral disc by gene therapy: an in vivo study of adenovirus-mediated transfer of the human transforming growth factor beta 1 encoding gene. Spine. 1999;15:2419–2425.
    1. Osada R, Ohshima H, Ishihara H, Yudoh K, Sakai K, Matsui H, Tsuji H. Autocrine/paracrine mechanism of insulin-like growth factor-1 secretion, and the effect of insulin-like growth factor-1 on proteoglycan synthesis in bovine intervertebral discs. J Orthop Res. 1996;15:690–699.
    1. Gruber HE, Fisher EC Jr, Desai B, Stasky AA, Hoelscher G, Hanley EN Jr. Human intervertebral disc cells from the annulus: three-dimensional culture in agarose or alginate and responsiveness to TGF-beta1. Exp Cell Res. 1997;15:13–21.
    1. Lee KI, Moon SH, Kim H, Kwon UH, Kim HJ, Park SN, Suh H, Lee HM, Kim HS, Chun HJ, Kwon IK, Jang JW. Tissue engineering of the intervertebral disc with cultured nucleus pulposus cells using atelocollagen scaffold and growth factors. Spine. 2012;15:452–458.
    1. Thompson JP, Oegema TR Jr, Bradford DS. Stimulation of mature canine intervertebral disc by growth factors. Spine. 1991;15:253–260.
    1. Hayes AJ, Ralphs JR. The response of foetal annulus fibrosus cells to growth factors: modulation of matrix synthesis by TGF-β1 and IGF-1. Histochem Cell Biol. 2011;15:163–175.
    1. Gruber HE, Norton HJ, Hanley EN Jr. Anti-apoptotic effects of IGF-1 and PDGF on human intervertebral disc cells in vitro. Spine. 2000;15:2153–2157.
    1. Pratsinis H, Kletsas D. PDGF, bFGF and IGF-I stimulate the proliferation of intervertebral disc cells in vitro via the activation of the ERK and Akt signaling pathways. Eur Spine J. 2007;15:1858–1866.
    1. Fujita N, Imai J, Suzuki T, Yamada M, Ninomiya K, Miyamoto K. Vascular endothelial growth factor-A is a survival factor for nucleus pulposus cells in the intervertebral disc. Biochem Biophys Res Commun. 2008;15:367–372.
    1. Liu Y, Kong J, Chen BH, Hu YG. Combined expression of CTGF and tissue inhibitor of metalloprotease-1 promotes synthesis of proteoglycan and collagen type II in rhesus monkey lumbar intervertebral disc cells in vitro. Chin Med J (Engl) 2010;15:2082–2087.
    1. Walsh AJ, Bradford DS, Lotz JC. In vivo growth factor treatment of degenerated intervertebral discs. Spine. 2004;15:156–163.
    1. Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent. 2001;15:225–228.
    1. Sánchez-González DJ, Méndez-Bolaina E, Trejo-Bahena NI. Platelet-rich plasma peptides: key for regeneration. Int J Pept. 2012;15:532519.
    1. Brass L. Understanding and evaluating platelet function. Hematology Am Soc Hematol Educ Program. 2010;15:387–396.
    1. Knighton DR, Hunt TK, Thakral KK, Goodson WH 3rd. Role of platelets and fibrin in the healing sequence: an in vivo study of angiogenesis and collagen synthesis. Ann Surg. 1982;15:379–388.
    1. Fréchette JP, Martineau I, Gagnon G. Platelet-rich plasmas: growth factor content and roles in wound healing. J Dent Res. 2005;15:434–439.
    1. Leslie M. Cell biology. Beyond clotting: the powers of platelets. Science. 2010;15:562–564.
    1. Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;15:489–496.
    1. Gullung GB, Woodall JW, Tucci MA, James J, Black DA, McGuire RA. Platelet-rich plasma effects on degenerative disc disease: analysis of histology and imaging in an animal model. Evid Based Spine Care J. 2011;15:13–18.
    1. Obata S, Akeda K, Morimoto R, Asanuma Y, Kasai Y, Masuda K, Uchida A, Sudo A. Intradiscal injection of autologous platelet-rich plasma-serum induces the restoration of disc height in the rabbit anular needle puncture model: 12 [abstract] Spine Aff Soc Meeting Abstracts. 2010;15
    1. Obata S, Akeda K, Imanishi T, Masuda K, Bae W, Morimoto R, Asanuma Y, Kasai Y, Uchida A, Sudo A. Effect of autologous platelet-rich plasma-releasate on intervertebral disc degeneration in the rabbit anular puncture model: a preclinical study. Arthritis Res Ther. 2012;15:R241.
    1. Hu X, Wang C. An experimental study on the effect of autologous platelet-rich plasma on treatment of early intervertebral disc degeneration. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;15:977–983.
    1. Chen WH, Lo WC, Lee JJ, Su CH, Lin CT, Liu HY, Lin TW, Lin WC, Huang TY, Deng WP. Tissue-engineered intervertebral disc and chondrogenesis using human nucleus pulposus regulated through TGF-beta1 in platelet-rich plasma. J Cell Physiol. 2006;15:744–754.
    1. Chen WH, Liu HY, Lo WC, Wu SC, Chi CH, Chang HY, Hsiao SH, Wu CH, Chiu WT, Chen BJ, Deng WP. Intervertebral disc regeneration in an ex vivo culture system using mesenchymal stem cells and platelet-rich plasma. Biomaterials. 2009;15:5523–5533.
    1. Akeda K, An HS, Pichika R, Attawia M, Thonar EJ, Lenz ME, Uchida A, Masuda K. Platelet-rich plasma (PRP) stimulates the extracellular matrix metabolism of porcine nucleus pulposus and anulus fibrosus cells cultured in alginate beads. Spine. 2006;15:959–966.
    1. Nagae M, Ikeda T, Mikami Y, Hase H, Ozawa H, Matsuda K, Sakamoto H, Tabata Y, Kawata M, Kubo T. Intervertebral disc regeneration using platelet-rich plasma and biodegradable gelatin hydrogel microspheres. Tissue Eng. 2007;15:147–158.
    1. Sawamura K, Ikeda T, Nagae M, Okamoto S, Mikami Y, Hase H, Ikoma K, Yamada T, Sakamoto H, Matsuda K, Tabata Y, Kawata M, Kubo T. Characterization of in vivo effects of platelet-rich plasma and biodegradable gelatin hydrogel microspheres on degenerated intervertebral discs. Tissue Eng. 2009;15:3719–3727.
    1. Brass L. Understanding and evaluating platelet function. Hematology. Am Soc Hematol Educ Program. 2010;15:387–396.
    1. McNicol A, Israels SJ. Beyond hemostasis: the role of platelets in inflammation, malignancy and infection. Cardiovasc Hematol Disord Drug Targets. 2008;15:99–117.
    1. Rozman P, Bolta Z. Use of platelet growth factors in treating wounds and soft-tissue injuries. Acta Dermatovenerol Alp Panonica Adriat. 2007;15:156–165.
    1. Johnstone B, Bayliss MT. The large proteoglycans of the human intervertebral disc. Changes in their biosynthesis and structure with age, topography, and pathology. Spine. 1995;15:674–684.
    1. Urban JP, Maroudas A, Bayliss MT, Dillon J. Swelling pressures of proteoglycans at the concentrations found in cartilaginous tissues. Biorheology. 1979;15:447–464.
    1. Urban JP, Smith S, Fairbank JC. Nutrition of the intervertebral disc. Spine. 2004;15:2700–2709.
    1. Moore RJ. The vertebral endplate: disc degeneration, disc regeneration. Eur Spine. 2006;15:S333–S337.
    1. Brown MF, Hukkanen MVJ, McCarthy ID, Redfern DRM, Batten JJ, Crock HV, Hughes SPF, Polak JM. Sensory and sympathetic innervation of the vertebral endplate in patients with degenerative disc disease. J Bone Joint Surg. 1997;15:147–153.
    1. Fagan A, Moore R, Vernon Roberts B, Blumbergs P, Fraser R. The innervation of the intervertebral disc: a quantitative analysis. Spine. 2003;15:2570–2576.
    1. Gurtner GC, Werner S, Barrandon Y, Longaker MT. Wound repair and regeneration. Nature. 2008;15:314–321.
    1. Folkman J. Fundamental concepts of the angiogenic process. Curr Mol Med. 2003;15:643–651.
    1. Peng BG. Pathophysiology, diagnosis, and treatment of discogenic low back pain. World J Orthop. 2013;15:42–52.
    1. David G, Ciurea AV, Iencean SM, Mohan A. Angiogenesis in the degeneration of the lumbar intervertebral disc. J Med Life. 2010;15:154–161.
    1. Liu LT, Huang B, Li CQ, Zhuang Y, Wang J, Zhou Y. Characteristics of stem cells derived from the degenerated human intervertebral disc cartilage endplate. PLoS One. 2011;15:e26285.
    1. Henriksson H, Thornemo M, Karlsson C, Hägg O, Junevik K, Lindahl A, Brisby H. Identification of cell proliferation zones, progenitor cells and a potential stem cell niche in the intervertebral disc region: a study in four species. Spine. 2009;15:2278–2287.
    1. Blanco JF, Graciani IF, Sanchez-Guijo FM, Muntión S, Hernandez-Campo P, Santamaria C, Carrancio S, Barbado MV, Cruz G, Gutierrez-Cosío S, Herrero C, San Miguel JF, Briñon JG, del Cañizo MC. Isolation and characterization of mesenchymal stromal cells from human degenerated nucleus pulposus: comparison with bone marrow mesenchymal stromal cells from the same subjects. Spine. 2010;15:2259–2265.
    1. Risbud MV, Guttapalli A, Tsai TT, Lee JY, Danielson KG, Vaccaro AR, Albert TJ, Gazit Z, Gazit D, Shapiro IM. Evidence for skeletal progenitor cells in the degenerate human intervertebral disc. Spine. 2007;15:2537–2544.
    1. Mishra A, Tummala P, King A, Lee B, Kraus M, Tse V, Jacobs CR. Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation. Tissue Eng. 2009;15:431–435.
    1. Zhang J, Wang JH. Platelet-rich plasma releasate promotes differentiation of tendon stem cells into active tenocytes. Am J Sports Med. 2010;15:2477–2486.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する