期刊
ADVANCED DRUG DELIVERY REVIEWS
卷 149, 期 -, 页码 49-71出版社
ELSEVIER
DOI: 10.1016/j.addr.2019.08.007
关键词
Drug delivery systems; Degenerative disc disease; Anti-catabolic factors; Pro-anabolic factors; Cell supplementation; Endogenous repair
资金
- Inserm
- Region Pays de la Loire (Paris Scientifique) [B102, 2015-10762]
- Agence Nationale pour la Recherche [ANR-14-CE16-0017, ANR-16-CE18-0008]
- Fondation de I'Avenir pour la Recherche Medicale Appliquee [AP-RMA-2015-018, BO-RMA-15-001]
- Ministere de l'Enseignement superieur et de la Recherche (France)
- Agence Nationale de la Recherche (ANR) [ANR-14-CE16-0017, ANR-16-CE18-0008] Funding Source: Agence Nationale de la Recherche (ANR)
Intervertebral disc (IVD) degeneration has been associated with low back pain, which is a major musculoskeletal disorder and socio-economic problem that affects as many as 600 million patients worldwide. Here, we first review the current knowledge of IVD physiology and physiopathological processes in terms of homeostasis regulation and consecutive events that lead to tissue degeneration. Recent progress with IVD restoration by anti-catabolic or pro-anabolic approaches are then analyzed, as are the design of macro-, micro-, and nanoplatforms to control the delivery of such therapeutic agents. Finally, we hypothesize that a sequential delivery strategy that i) firstly targets the inflammatory, pro-catabolic microenvironment with release of anti inflammatory or anti-catabolic cytokines; ii) secondly increases cell density in the less hostile microenvironment by endogenous cell recruitment or exogenous cell injection, and finally iii) enhances cellular synthesis of extracellular matrix with release of pro-anabolic factors, would constitute an innovative yet challenging approach to IVD regeneration. (C) 2019 Elsevier B.V. All rights reserved.
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