Advanced Science, 2023 · DOI: 10.1002/advs.202304722 · Published: October 23, 2023
Chronic lower back pain is often caused by the degradation of intervertebral discs (IVD). This study explores a novel approach using small extracellular vesicles (sEVs) derived from mesenchymal stem cells (MSCs) that have been preconditioned in a low-oxygen (hypoxic) environment to promote IVD regeneration. These hypoxic preconditional engineering sEVs (HP-sEVs) were found to reduce inflammation, enhance the proliferation of cells in the nucleus pulposus (NP), and boost the synthesis of proteoglycans and collagen, which are essential components of the IVD. The therapeutic effect of HP-sEVs involves delivering a specific microRNA (miR-7-5p), which suppresses the production of p65 and inhibits Cxcl2 production, leading to improved IVD regeneration and alleviation of chronic lower back pain.
HP-sEVs offer a novel therapeutic strategy for treating IVD degradation and associated chronic lower back pain.
The study enhances understanding of the mechanism-of-action of HP-sEVs in IVD regeneration, particularly through the miR-7-5p/NF-κB/Cxcl2 axis.
HP-sEV-based therapy may serve as a promising treatment pending further pharmacokinetic analysis, dosimetry optimization, and large-scale production protocols.