Ex vivo intervertebral disc cultures: degeneration-induction methods and their implications for clinical translation
1 Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
2 AO Research Institute, Davos, CH-7270, Switzerland
3 Tissue Engineering for Orthopaedics and Mechanobiology, Bone and Joint Program, Department for BioMedical Research (DBMR), Medical Faculty, University of Bern, Bern, CH-3008, Switzerland
4 Department for Orthopaedic Surgery and Traumatology, Insel University Hospital, Medical Faculty, University of Bern, Bern, CH-3010, Switzerland
5 Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm (ZTF Ulm), Ulm University, Ulm, Germany
6 Department of Oncology and Metabolism, Medical School, University of Sheffield, Sheffield, United Kingdom
7 Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
Abstract
Because low back pain is frequently a result of intervertebral disc degeneration (IVDD), strategies to regenerate or repair the IVD are currently being investigated. Often, ex vivo disc cultures of non-human IVD organs or tissue explants are used that usually do not exhibit natural IVDD. Therefore, degenerative changes mimicking those reported in human IVDD need to be induced. To support researchers in selecting ex vivo disc cultures, a systematic search was performed for them and their potential use for studying human IVDD reviewed. Five degeneration induction categories (proinflammatory cytokines, injury/damage, degenerative loading, enzyme, and other) were identified in 129 studies across 7 species. Methods to induce degeneration are diverse and can induce mild to severe degenerative changes that progress over time, as described for human IVDD. The induced degenerative changes are model-specific and there is no “one-fits-all” IVDD induction method. Nevertheless, specific aspects of human IVDD can be well mimicked. Currently, spontaneously degenerated disc cultures from large animals capture human IVDD in most aspects. Combinatorial approaches of several induction methods using discs derived from large animals are promising to recapitulate pathological changes on several levels, such as cellular behaviour, extracellular matrix composition, and biomechanical function, and therefore better mimic human IVDD. Future disc culture setups might increase in complexity, and mimic human IVDD even better. As ex vivo disc cultures have the potential to reduce and even replace animal trials, especially during preclinical development, advancement of such models is highly relevant for more efficient and cost-effective clinical translation from bench-to-bedside.
Graphical Abstract

Keywords
- Disc culture
- organ culture
- explant culture
- 3R
- low back pain
Cite
Share
Top
