Open AccessIntervertebral disc decellularisation: progress and challenges
Author(s) -
M.F. Fiordalisi,
A J Silva,
Mário A. Barbosa,
Raquel M. Gonçalves,
Joana Caldeira
Publication year - 2021
Publication title -
european cells and materials
Language(s) - English
Resource type - Journals
eISSN - 1473-2262
DOI - 10.22203/ecm.v042a15
Subject(s) - extracellular matrix , regeneration (biology) , intervertebral disc , regenerative medicine , medicine , tissue engineering , degeneration (medical) , biomedical engineering , pathology , surgery , microbiology and biotechnology , stem cell , biology
Intervertebral disc (IVD) degeneration and the consequent low-back pain (LBP) affect over 80 % of people in western societies, constituting a tremendous socio-economic burden worldwide and largely impairing patients’ life quality. Extracellular matrix (ECM)-based scaffolds, derived from decellularised tissues, are being increasingly explored in regenerative medicine for tissue repair. Decellularisation plays an essential role for host cells and antigen removal, while maintaining native microenvironmental signals, including ECM structure, composition and mechanical properties, which are essential for driving tissue regeneration. With the lack of clinical solutions for IVD repair/regeneration, implantation of decellularised IVD tissues has been explored to halt and/or revert the degenerative cascade and the associated LBP symptoms. Over the last few years, several researchers have focused on the optimisation of IVD decellularisation methods, combining physical, chemical and enzymatic treatments, in order to successfully develop a cell-free matrix. Recellularisation of IVD-based scaffolds with different cell types has been attempted and numerous methods have been explored to address proper IVD regeneration. Herein, the advances in IVD decellularisation methods, sterilisation procedures, repopulation and biocompatibility tests are reviewed. Additionally, the importance of the donor profile for therapeutic success is also addressed. Finally, the perspectives and major hurdles for clinical use of the decellularised ECM-based biomaterials for IVD are discussed. The studies reviewed support the notion that tissue-engineering-based strategies resorting to decellularised IVD may represent a major advancement in the treatment of disc degeneration and consequent LBP.