Abstract

Inflammation is the primary pathological phenomenon associated with disc degeneration; the inflammatory cytokine tumor necrosis factor (TNF-α) plays a crucial role in this pathology. The anti-inflammatory and regenerative effects of M2 macrophages on nucleus pulposus cells (NPCs) in intervertebral disc degeneration (IDD) progression remain unknown. Here, M2 conditioned medium (M2CM) was harvested and purified from human acute monocytic leukaemia cell line (THP-1) cells and mouse peritoneal macrophages, respectively; it was used for culturing human NPCs and a mouse intervertebral disc (IVD) organ culture model. NPCs and IVD organ models were divided into three groups: group 1 treated with 10% fetal bovine serum (control); group 2 treated with 10 ng/ml TNF-α; and group 3 treated with 10 ng/ml TNF-α and M2CM (coculture group). After 2-14 days, cell proliferation, extracellular matrix synthesis, apoptosis, and NPC senescence were assessed. Cell proliferation was reduced in TNF-α-treated NPCs and inhibited in the M2CM co-culture treatment. Moreover, TNF-α treatment enhanced apoptosis, senescence, and expression of inflammatory factor-related genes, including interleukin-6, MMP-13, ADAMTS-4, and ADAMTS-5, whereas M2CM coculture significantly reversed these effects. In addition, co-culture with M2CM promoted aggrecan and collagen II synthesis, but reduced collagen Iα1 levels in TNF-α treatment groups. Using our established three-dimensional murine IVD organ culture model, we show that M2CM suppressed the inhibitory effect of TNF-α-rich environment. Therefore, co-culture with M2CM promotes cell proliferation and extracellular matrix synthesis and inhibits inflammation, apoptosis, and NPC senescence. This study highlights the therapeutic potential of M2CM for IDD.

Highlights

  • Low back pain is a global issue that affects nearly 80% of individuals at some time point during their lifetime 1

  • These results indicate that M2 conditioned medium (M2CM) promotes cell proliferation and extracellular matrix synthesis and inhibits inflammation, apoptosis, and nucleus pulposus cell (NPC) senescence

  • Thereafter, the cells differentiated into M2 macrophages in the presence of IL-4 for another 24h in serum-free medium, exhibiting a homogeneous elongated spindle-like morphologywith slender tentacles (Figure 1B).The expression of M2 macrophage markers CD206 and IL-10 was significantly upregulated in M2induced macrophages compared with that in M0 macrophages

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Summary

Introduction

Low back pain is a global issue that affects nearly 80% of individuals at some time point during their lifetime 1. Intervertebral disc degeneration (IDD) is considered the pathological basis of low back pain, which reduces the quality of life and generates a massive economic burden[2]. Surgical treatment is a widely accepted, ultimate solution for IDD patients with end-stage degeneration, but is associated with the risk of surgical complications, function loss, and poor clinical effects 3, 4. For most patients with earlystage IDD, current therapies are aimed at mitigating symptoms rather than fundamentally treating the pathological condition[5]. Biological therapy to restore disc morphology and function to inhibit IDD progression is highly significant. M1 macrophages produce proinflammatory cytokines that facilitate the progression of intervertebral disc degeneration (IDD).the anti-inflammatory and regenerative effects of M2 macrophages on nucleus pulposus cells (NPCs) in IDD progression remain unknown. We aimed to determine the role of M2 macrophages in IDD progression

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