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Review
. 2021 Jul 20:9:592118.
doi: 10.3389/fbioe.2021.592118. eCollection 2021.

Intervertebral Disk Degeneration: The Microenvironment and Tissue Engineering Strategies

Yiming Dou  1 , Xun Sun  1 , Xinlong Ma  1 , Xin Zhao  2 , Qiang Yang  1
Affiliations
Review

Intervertebral Disk Degeneration: The Microenvironment and Tissue Engineering Strategies

Yiming Dou et al. Front Bioeng Biotechnol. .

Abstract

Intervertebral disk degeneration (IVDD) is a leading cause of disability. The degeneration is inevitable, and the mechanisms are complex. Current therapeutic strategies mainly focus on the relief of symptoms, not the intrinsic regeneration of the intervertebral disk (IVD). Tissue engineering is a promising strategy for IVDD due to its ability to restore a healthy microenvironment and promote IVD regeneration. This review briefly summarizes the IVD anatomy and composition and then sets out elements of the microenvironment and the interactions. We rationalized different scaffolds based on tissue engineering strategies used recently. To fulfill the complete restoration of a healthy IVD microenvironment, we propose that various tissue engineering strategies should be combined and customized to create personalized therapeutic strategies for each individual.

Keywords: disk herniation; intervertebral disk degeneration; low back pain; microenvironment; regeneration; scaffold; tissue engineering.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Physiological microenvironment of intervertebral disk (IVD). AF, annulus fibrosus; NP, nucleus pulposus; CEP, cartilage endplate; ECM, extracellular matrix; HIF, hypoxia-inducible factor; MMPs, metalloproteinases; ADAMTs, metalloproteinase with thrombospondin motifs; TIMPs, tissue inhibitors of metalloproteinases; CTGF, connective tissue growth factor; Shh, sonic hedgehog; BMPs, bone morphogenetic protein; VEGF, vascular endothelial growth factor.
FIGURE 2
FIGURE 2
Pathological microenvironment of intervertebral disk (IVD). AF, annulus fibrosus; NP, nucleus pulposus; CEP, cartilage endplate. ECM, extracellular matrix; MMPs, metalloproteinases; ADAMTs, metalloproteinase with thrombospondin motifs; TIMPs, tissue inhibitors of metalloproteinases; VEGF, vascular endothelial growth factor; NGF, nerve growth factor; IL-1,4,6,8,10, interleukin-1,4,6,8,10; TNF-a, tumor necrosis factor; PGE2, prostaglandin E2.
See this image and copyright information in PMC

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