Abstract

Objective Low back pain (LBP) is one of the top three causes of disability in developed countries, and intervertebral disc degeneration (IDD) is a major contributor to LBP. In the process of IDD, there is a gradual decrease in nucleus pulposus cells (NPCs) and extracellular matrix (ECM). Exosomes are important exocrine mediators of stem cells that can act directly on cells for tissue repair and regeneration. In this study, we determined the antisenescence, cell proliferation promotion, and ECM modulation effects of human urine-derived stem cell (USC) exosomes (USC-exos) on degenerated intervertebral discs and explored the underlying mechanism. Methods and Materials USCs were identified by multipotent differentiation and flow cytometry for mesenchymal stem cell- (MSC-) specific surface protein markers. USC-exos were isolated from the conditioned medium of USCs by ultracentrifugation and then analyzed by transmission electron microscopy (TEM), particle size analysis, and western blotting (WB) for exosome marker proteins. The effects of USC-exos on NPC proliferation and ECM synthesis were assessed by Cell Counting Kit-8 (CCK-8), WB, and immunofluorescence (IF) analyses. The protein differences between normal and degenerative intervertebral discs were mined, and the temporal and spatial variations in matrilin-3 (MATN3) content were determined by WB and IF in the intervertebral disc tissues. The candidate molecules that mediated the function of USC-exos were screened out and confirmed by multiple assays. Meanwhile, the mechanism underlying the candidate protein in USC-exos-induced cell proliferation and regulation of ECM synthesis promoting the activities of NPCs was explored. In addition, the effects of USC-exos on ameliorating intervertebral disc degeneration (IVD) in mice were examined by assessing computed tomography (CT), magnetic resonance imaging (MRI), and histological analyses. Results The flow cytometry results showed that USCs were positive for CD29, CD44, and CD73, which are USC surface-specific markers, but negative for CD34 and CD45. In addition, USCs showed osteogenic, adipogenic, and chondrogenic differentiation potential. USC-exos exhibited a cup-shaped morphology, with a mean diameter of 49.7 ± 7.3 nm, and were positive for CD63 and TSG101 and negative for calnexin. USC-exos could promote NPC proliferation and ECM synthesis. The protein content of the matrilin family was significantly reduced in degenerative intervertebral discs, and the decrease in MATN3 was the most significant. USC-exos were found to be rich in MATN3 protein, and exosomal MATN3 was required for USC-exos-induced promotion of NPC proliferation and ECM synthesis, as well as alleviation of intervertebral disc degeneration in IVD rats. In addition, the effects of MATN3 in USC-exos were demonstrated to be achieved by activating TGF-β, which elevated the phosphorylation level of SMAD and AKT. Conclusions Our study suggests that reduced MATN3 can be considered a characteristic of intervertebral disc degeneration. USC-exos may represent a potentially effective agent for alleviating intervertebral disc degeneration by promoting NPC proliferation and ECM synthesis by transferring the MATN3 protein.

Highlights

  • Low back pain (LBP) is a very common problem experienced by most people at a certain time in their life, and it is among the top three causes of disability in developed countries [1,2,3]

  • The results showed that IL-1β, iNOS, COX-2, IL-6, MMP3, MMP13, and other inflammatory cytokines and extracellular matrix-degrading enzymes were significantly reduced after the addition of stem cell-derived exosomes

  • Lu et al [45] used mesenchymal stem cells (MSCs)-derived exosomes to intervene in NPCs, and the results showed that exosomes could stimulate the phenotypes of degenerated NPCs to restore undegenerated NPCs to increase the synthesis of extracellular matrix and achieve self-repair

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Summary

Introduction

Low back pain (LBP) is a very common problem experienced by most people at a certain time in their life, and it is among the top three causes of disability in developed countries [1,2,3]. The main pathological change is a gradual reduction in the total NPCs and extracellular matrix (ECM). Collagen type II (COL2) and proteoglycan (predominantly aggrecan (ACAN)) are crucial ECMs for discs to maintain proper function, for the nucleus pulposus [8, 9]. ACAN is a biological macromolecule formed by one or more glycosaminoglycan (GAG) chains covalently connected to a core protein. It is the main noncollagen component of the intervertebral disc. One of the reasons for the damage and degeneration of the intervertebral disc is the degradation and loss of ACAN. COL2 is one of the most important collagen components in intervertebral discs. Determining the methods of rebalancing disordered COL2 and ACAN expression and increasing their synthesis is considered a key factor for slowing down or even reversing IVD damage

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