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A Biodegradable Polymeric Matrix for the Repair of Annulus Fibrosus Defects in Intervertebral Discs

Tissue Engineering and Regenerative Medicine (2022)Cite this article

Abstract

Background:

Tissue defects in the annulus fibrosus (AF) due to intervertebral disc (IVD) degeneration or after nucleodiscectomy have little self-healing capacity. To prevent progressive degeneration of the IVD, the AF must be repaired. Biological closure has not yet been achieved and is a challenge for the research community. In this study, a scaffold made of absorbable poly (glycolic acid) (PGA) and hyaluronan (HA) that exhibit excellent biocompatibility and cell colonization properties was used to repair AF defects in an ovine model.

Methods:

A partial resection was performed in AF in L3/4 or L4/5 of 10 sheep and PGA-HA scaffolds were implanted on the defects (n = 5), while defects in the control group were left untreated (n = 5). Three months post-operation, the lumbar discs were sectioned and stained with hematoxylin and eosin and safranin-O/fast-green. Histological features including proteoglycan content, annular structure, cellular morphology, blood vessel ingrowth and tear/cleft formation were scored using a modified scoring scheme by 3 investigators and evaluated by a pathologist independently.

Results:

The treated AF exhibited significantly enhanced repair tissue structure with signs of proteoglycan formation compared to the untreated group. The median scores were 4.3 for the treated and 9.8 for the untreated group. Cystic degeneration, perivascular infiltration, inflammation and necrosis were only present in the untreated group. Blood vessel ingrowth and tear/cleft formation were increased, though not significant, in the untreated group while cell morphology was comparable in both groups.

Conclusion:

PGA-HA scaffolds used for AF closure support repair tissue formation in an ovine lumbar disc defect model.

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Acknowledgements

The authors thank Dr. Katja Reiter, Dr. Pia Ostach and Prof. Dr. Christian Große-Siestrup for animal surgery. We also like to thank the Research facilities for experimental medicine (FEM) and the animal holding unit of the Charité-Universitaetsmedizin Berlin for animal care. Grateful thanks to Samuel Vetterlein and Anja Wachtel for technical support of sample preparation and histochemical staining. The research leading to these results received funding from Federal Ministry of Education and Research (BMBF) grant no. 13N13435 and 13N13437.

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Authors and Affiliations

  1. TransTissue Technologies GmbH, Charitéplatz 1/Virchowweg 11, 10117, Berlin, Germany

    Mohammad R. Saghari Fard, Jan Philipp Krueger, Phil Berger & Michaela Endres

  2. Tissue Engineering Laboratory, BIH Center for Regenerative Therapies and Department for Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Stefan Stich & Michael Sittinger

  3. Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, iPATH.Berlin, Berlin, Germany

    Anja A. Kühl

  4. Department of Back and Spinal Surgery, Vivantes Clinic Spandau, Berlin, Germany

    Tony Hartwig

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  1. Mohammad R. Saghari Fard
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Correspondence to Michaela Endres.

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Conflict of interest

MRSF, JPK, PB and ME are employees of the research company TransTissue Technologies GmbH and receive salaries from the company. All other declare no conflict of interest.

Ethical statement

All procedures performed in this study involving animals were approved by the State Office for Health and Social Affairs in Berlin, Germany (LaGeSo No. G 0093/16). The study was performed under German Animal Welfare Act (§ 8.1 and § 7.2).

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Saghari Fard, M.R., Krueger, J.P., Stich, S. et al. A Biodegradable Polymeric Matrix for the Repair of Annulus Fibrosus Defects in Intervertebral Discs. Tissue Eng Regen Med (2022). https://doi.org/10.1007/s13770-022-00466-0

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  • DOI: https://doi.org/10.1007/s13770-022-00466-0

Keywords

  • Annulus fibrosus
  • PGA-HA
  • Ovine
  • Intervertebral discs