Abstract

The purpose of the present pilot study was to evaluate the effect of a hydrogel composed of hyaluronic acid (HA) and platelet-rich plasma (PRP) as a carrier for human mesenchymal stem cells (hMSCs) for intervertebral disc (IVD) regeneration using a disc organ culture model. HA was mixed with batroxobin (BTX) and PRP to form a hydrogel encapsulating 1 × 106 or 2 × 106 hMSCs. Bovine IVDs were nucleotomized and filled with hMSCs suspended in ~200 μL of the PRP/HA/BTX hydrogel. IVDs collected at day 0 and nucleotomized IVDs with no hMSCs and/or hydrogel alone were used as controls. hMSCs encapsulated in the hydrogel were also cultured in well plates to evaluate the effect of the IVD environment on hMSCs. After 1 week, tissue structure, scaffold integration, hMSC viability and gene expression of matrix and nucleus pulposus (NP) cell markers were assessed. Histological analysis showed a better preservation of the viability of the IVD tissue adjacent to the gel in the presence of hMSCs (~70%) compared to the hydrogel without hMSCs. Furthermore, disc morphology was maintained, and the hydrogel showed signs of integration with the surrounding tissues. At the gene expression level, the hydrogel loaded with hMSCs preserved the normal metabolism of the tissue. The IVD environment promoted hMSC differentiation towards a NP cell phenotype by increasing cytokeratin-19 (KRT19) gene expression. This study demonstrated that the hydrogel composed of HA/PRP/BTX represents a valid carrier for hMSCs being able to maintain a good cell viability while stimulating cell activity and NP marker expression.

Highlights

  • We have previously shown that a hydrogel composed of hyaluronic acid (HA) and platelet-rich plasma (PRP) blended with batroxobin (BTX) as a gelling agent is an efficacious mesenchymal stem cells (MSCs) carrier for nucleus pulposus (NP) regeneration in vitro

  • We evaluated the effect of a HA/PRP/BTX hydrogel [22] as a carrier for human mesenchymal stem cells (hMSCs) within the intervertebral disc (IVD) environment using an ex vivo whole disc culture model [23]

  • We demonstrated the stimulating effect of the hMSCs on IVD cell viability, while gene expression did not greatly differ between IVDs injected with 1 or 2 million hMSCs, which may be a consequence of the close concentrations of hMSCs used

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Summary

Introduction

Low back pain (LBP) is mainly caused by intervertebral disc degeneration (IDD). Current treatment strategies include both conservative and surgical approaches. None of these can hamper or arrest IDD [1]. There is an ongoing effort to develop novel therapeutic tools which target the biological cascades involved in the degenerative process in order to prevent the invasiveness of spine surgery. Intradiscal stem cell application has been introduced as a promising regenerative approach, both in vitro and in vivo [2]. Bone marrow mesenchymal stem cells (MSCs) hold the capacity to differentiate towards nucleus pulposus (NP)-like cells [3] and secrete a range of cytokines which induce an anabolic response in resident NP cells following intradiscal application [4]

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