Abstract
Spine degenerative conditions are becoming increasingly prevalent, affecting about 5.7% of the population in Europe, resulting in a significant reduction of life’s quality. Up to now, many materials have been used in manufacturing cage implants, used as graft substitutes, to achieve immediate and long-term spinal fixation. Particularly, titanium and its alloys are emerging as valuable candidates to develop new types of cages. The aim of this in vitro study was to evaluate the adhesion, proliferation and osteogenic differentiation of adipose derived mesenchymal stem cells (ASCs) seeded on trabecular titanium cages. ASCs adhered, proliferated and produced an abundant extracellular matrix during the 3 weeks of culture. In the presence of osteogenic medium, ASCs differentiated into osteoblast-like cells: the expression of typical bone genes, as well as the alkaline phosphatase activity, was statistically higher than in controls. Furthermore, the dispersive spectrometry microanalysis showed a marked increase of calcium level in cells grown in osteogenic medium. Plus, our preliminary data about osteoinduction suggest that this titanium implant has the potential to induce the ASCs to produce a secretome able to trigger a shift in the ASCs phenotype, possibly towards the osteogenic differentiation, as illustrated by the qRT-PCR and ALP biochemical assay results. The trabecular porous organization of these cages is rather similar to the cancellous bone structure, thus allowing the bone matrix to colonize it efficiently; for these reasons we can conclude that the architecture of this cage may play a role in modulating the osteoinductive capabilities of the implant, thus encouraging its engagement in in vivo studies for the treatment of spinal deformities and diseases.
Highlights
Degenerative conditions of the cervical and lumbar spine are becoming increasingly prevalent, resulting in significant reduction of quality of life caused by p ain[1]
We evaluated the differentiation of human subcutaneous tissue (hASCs) by analyzing some known indicators of the osteoblast phenotype: alkaline phosphatase activity (ALP), reverse transcriptase RT-PCR of alkaline phosphatase, runx-2 and ibsp
The hASCs were positive for the mesenchymal stem cell markers CD73, CD90, and CD105 and negative for the hematopoietic cell markers CD34 and CD45 according to the analysis performed by flow cytometer (Navios Beckman Coulter)
Summary
Degenerative conditions of the cervical and lumbar spine are becoming increasingly prevalent, resulting in significant reduction of quality of life caused by p ain[1]. Spinal fusion procedures were initially employed to treat these pathologies by the use of structural autografts and allografts, but they were associated with intra- and post-operative complications and vertebral non-union. In the 1950s the fusion was obtained by the use of a bone graft. It was collected from the iliac crest or via allograft bone bank, it was pre-cutted and inserted through distraction and force[3]. This technique was associated with a high level of morbidity as pain, wound drainage, infection, haematomas, nerve injury and iliac crest fractures or d eformity[4]. For the first time Bagby attempted to use these structures in horses, Scientific Reports | (2020) 10:18284
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