title: 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.
authors.affiliation: Network of Excellence for Functional Biomaterials, National University of Ireland, Galway, Ireland.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Fontana
authors.affiliation: Network of Excellence for Functional Biomaterials, National University of Ireland, Galway, Ireland.
authors.forename: Eugene
authors.initials: E
authors.lastname: See
authors.affiliation: Network of Excellence for Functional Biomaterials, National University of Ireland, Galway, Ireland. Electronic address: abhay.pandit@nuigalway.ie.
authors.forename: Abhay
authors.initials: A
authors.lastname: Pandit
mesh_terms: D001672:Biocompatible Materials / Q000008:administration & dosage; D001688:Biological Products / Q000008:administration & dosage*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods / Q000639:trends*; D015316:Genetic Therapy / Q000379:methods* / Q000639:trends; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000378:metabolism / Q000628:therapy*; D012038:Regeneration / Q000502:physiology
chemical_list: D001672:Biocompatible Materials; D001688:Biological Products
keywords: Annulus fibrosus; Biomaterials; Cell therapy; Gene therapy; Growth factors; Inflammation; Intervertebral disc; Nucleus pulposus