4.5 Article

Regenerative Capability of Human Nucleus Pulposus Cells in Degenerated Disc Under Hydrostatic Pressure Mimicking Physiologically Relevant Intradiscal Pressure In Vitro

Journal

SPINE
Volume 48, Issue 10, Pages 728-736

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BRS.0000000000004530

Keywords

cervical spine; extracellular matrix; human; hydrostatic pressure; intervertebral disc degeneration; lumbar spine; nucleus pulposus cell; osmolality; Pfirrmann degeneration grade; regenerative therapy

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Isolated human nucleus pulposus (hNP) cells from degenerated IVD were treated under high osmolality and evaluated for regenerative potential. The study found that mild to moderate degenerated cells can promote extracellular matrix production and maintain cell viability under physiological spinal loading. This study explored the potential of degenerated cells in a physiological environment, which may lead to strategies for IVD regeneration.
Study Design.Isolated human nucleus pulposus (hNP) cells from the degenerated intervertebral disc (IVD) were incubated under hydrostatic pressure (HP) and evaluated for regenerative potential. Objectives.To characterize metabolic turnover in hNP cells isolated from degenerated IVDs classified by Pfirrmann grade under physiologically relevant HP at high osmolality in vitro. Summary of Background Data.We demonstrated that bovine caudal nucleus pulposus cells isolated from healthy cows produced more extracellular matrix under cyclic HP followed by constant pressure (mimicking physiological intradiscal pressure in humans) than under no pressure in vitro. We assessed the effects of pressure on human degenerated cells isolated under the same regimen of pressure used for bovine cells. Materials and Methods.hNP cells isolated from discarded tissue classified as Pfirrmann grade 2 to 3 (n = 13: age, 46.7 +/- 14.0) and grade 4 (n = 13: age, 53.0 +/- 11.5) were incubated under cyclic HP at 0.2 to 0.7 MPa, 0.5 Hz for 2 days followed by constant pressure at 0.3 MPa for 1 day, repeated twice over 6 days. The gene expression and immunohistology of matrix molecules and catabolic and anticatabolic proteins were evaluated. Results.Aggrecan and collagen type II expression were significantly more upregulated under HP in grades 2 to 3 than in grade 4 tissues (both, P < 0.01). Linear regression analysis showed a positive correlation between matrix metalloproteinase 13 and tissue inhibitor for metalloproteinase 2 expression in grades 2 to 3, whereas a negative correlation was found in grade 4 (P < 0.05). Immunohistological staining revealed the activation of a mechanoreceptor, transient receptor potential vanilloid 4, under HP. Conclusions.Resident cells in mild-moderate degenerated discs classified as Pfirrmann grade 2 to 3 have the potential to promote extracellular matrix production and maintain adequate cell viability under physiological spinal loading. Relevance.This study explored the potential of degenerated remnant nucleus pulposus cells under a physiological environment, possibly leading to establishing strategies for IVD regeneration.

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