An interpenetrating network-strengthened and toughened hydrogel that supports cell-based nucleus pulposus regeneration.

Hydrogel is a suitable scaffold for the nucleus pulposus (NP) regeneration. However, its unmatched mechanical properties lead to implant failure in late-stage disc degeneration because of structural failure and implant extrusion after long-term compression. In this study, we evaluated an interpenetrating network (IPN)-strengthened and toughened hydrogel for NP regeneration, using dextran and gelatin as the primary network while poly (ethylene glycol) as the secondary network. The aim of this study was to realize the NP regeneration using the hydrogel. To achieve this, we optimized its properties by adjusting the mass ratios of the secondary/primary networks and determining the best preparation conditions for NP regeneration in a series of biomechanical, cytocompatibility, tissue engineering, and in vivo study. We found the optimal formulation of the IPN hydrogel, at a secondary/primary network ratio of 1:4, exhibited high toughness (the compressive strain reached 86%). The encapsulated NP cells showed increasing proliferation, cell clustering and matrix deposition. Furthermore, the hydrogel could support long-term cell retention and survival in the rat IVDs. It facilitated rehydration and regeneration of porcine degenerative NPs. In conclusion, this study demonstrates the tough IPN hydrogel could be a promising candidate for functional disc regeneration in future.

[1]  D. Elliott,et al.  Effects of Degeneration on the Biphasic Material Properties of Human Nucleus Pulposus in Confined Compression , 2005, Spine.

[2]  N. Blumenkrantz,et al.  An assay for hydroxyproline and proline on one sample and a simplified method for hydroxyproline. , 1975, Analytical biochemistry.

[3]  J. Matyas,et al.  The three‐dimensional architecture of the notochordal nucleus pulposus: novel observations on cell structures in the canine intervertebral disc , 2003, Journal of anatomy.

[4]  D. D’Lima,et al.  Effects of perfusion and dynamic loading on human neocartilage formation in alginate hydrogels. , 2012, Tissue engineering. Part A.

[5]  C. Perka,et al.  Cultivation of porcine cells from the nucleus pulposus in a fibrin/hyaluronic acid matrix , 2000, Acta orthopaedica Scandinavica.

[6]  G. G. Stokes "J." , 1890, The New Yale Book of Quotations.

[7]  Feng-Huei Lin,et al.  Injectable oxidized hyaluronic acid/adipic acid dihydrazide hydrogel for nucleus pulposus regeneration. , 2010, Acta biomaterialia.

[8]  W McIntosh,et al.  Transdermal photopolymerization for minimally invasive implantation. , 1999, Proceedings of the National Academy of Sciences of the United States of America.

[9]  Pengju Pan,et al.  A strong and tough interpenetrating network hydrogel with ultrahigh compression resistance. , 2014, Soft matter.

[10]  H. Horner,et al.  2001 Volvo Award Winner in Basic Science Studies: Effect of Nutrient Supply on the Viability of Cells From the Nucleus Pulposus of the Intervertebral Disc , 2001, Spine.

[11]  Zhongyang Liu,et al.  Effect of perfluorotributylamine-enriched alginate on nucleus pulposus cell: Implications for intervertebral disc regeneration. , 2016, Biomaterials.

[12]  K. Naruse,et al.  The mechanical stimulation of cells in 3D culture within a self-assembling peptide hydrogel. , 2012, Biomaterials.

[13]  A. Salgado,et al.  Angiogenic potential of gellan-gum-based hydrogels for application in nucleus pulposus regeneration: in vivo study. , 2012, Tissue engineering. Part A.

[14]  Van C. Mow,et al.  Is the Nucleus Pulposus a Solid or a Fluid? Mechanical Behaviors of the Nucleus Pulposus of the Human Intervertebral Disc , 1996, Spine.

[15]  V M Haughton,et al.  The relationship between disc degeneration and flexibility of the lumbar spine. , 2001, The spine journal : official journal of the North American Spine Society.

[16]  K. Ando,et al.  Transplantation of mesenchymal stem cells embedded in Atelocollagen gel to the intervertebral disc: a potential therapeutic model for disc degeneration. , 2003, Biomaterials.

[17]  N. E. Mckinnon,et al.  Estimating the impact of the COVID-19 pandemic on rising trends in drug overdose mortality in the United States, 2018-2021 , 2022, Annals of Epidemiology.

[18]  Myron Spector,et al.  Modulation of mesenchymal stem cell chondrogenesis in a tunable hyaluronic acid hydrogel microenvironment. , 2012, Biomaterials.

[19]  X. Mo,et al.  Hierarchically designed injectable hydrogel from oxidized dextran, amino gelatin and 4-arm poly(ethylene glycol)-acrylate for tissue engineering application , 2012 .

[20]  M. Hellström,et al.  Exposure of the porcine spine to mechanical compression: differences in injury pattern between adolescents and adults , 2000, European Spine Journal.

[21]  Rui L Reis,et al.  Development of gellan gum-based microparticles/hydrogel matrices for application in the intervertebral disc regeneration. , 2011, Tissue engineering. Part C, Methods.

[22]  Christopher J Hunter,et al.  The Functional Significance of Cell Clusters in the Notochordal Nucleus Pulposus: Survival and Signaling in the Canine Intervertebral Disc , 2004, Spine.

[23]  Kai-Chiang Yang,et al.  Thermosensitive chitosan-gelatin-glycerol phosphate hydrogels as a cell carrier for nucleus pulposus regeneration: an in vitro study. , 2010, Tissue engineering. Part A.

[24]  L. Claes,et al.  New in vivo measurements of pressures in the intervertebral disc in daily life. , 1999, Spine.

[25]  V. Parsegian,et al.  Osmotic stress for the direct measurement of intermolecular forces. , 1986, Methods in enzymology.

[26]  C. Pfirrmann,et al.  Magnetic Resonance Classification of Lumbar Intervertebral Disc Degeneration , 2001, Spine.

[27]  Michael S Detamore,et al.  Hierarchically designed agarose and poly(ethylene glycol) interpenetrating network hydrogels for cartilage tissue engineering. , 2010, Tissue engineering. Part C, Methods.

[28]  T. Kurokawa,et al.  Double‐Network Hydrogels with Extremely High Mechanical Strength , 2003 .

[29]  J. Kragstrup,et al.  Compressive strength, ash weight, and volume of vertebral trabecular bone in experimental fluorosis in pigs , 1987, Calcified Tissue International.

[30]  Brenton D Hoffman,et al.  The role of extracellular matrix elasticity and composition in regulating the nucleus pulposus cell phenotype in the intervertebral disc: a narrative review. , 2014, Journal of biomechanical engineering.

[31]  Sally Roberts,et al.  Histology and pathology of the human intervertebral disc. , 2006, The Journal of bone and joint surgery. American volume.

[32]  Rui L Reis,et al.  Tissue engineering strategies applied in the regeneration of the human intervertebral disk. , 2013, Biotechnology advances.

[33]  Michelle S. Gupta,et al.  Role of biomechanics in intervertebral disc degeneration and regenerative therapies: what needs repairing in the disc and what are promising biomaterials for its repair? , 2013, The spine journal : official journal of the North American Spine Society.

[34]  Lei Song,et al.  A novel axial-stress bioreactor system combined with a substance exchanger for tissue engineering of 3D constructs. , 2014, Tissue engineering. Part C, Methods.

[35]  D. Kaplan,et al.  Silk-fibrin/hyaluronic acid composite gels for nucleus pulposus tissue regeneration. , 2011, Tissue engineering. Part A.

[36]  Vincenzo Denaro,et al.  Mesenchymal stem cells injection in degenerated intervertebral disc: cell leakage may induce osteophyte formation , 2012, Journal of tissue engineering and regenerative medicine.

[37]  T. Le,et al.  The epidemiology, economic burden, and pharmacological treatment of chronic low back pain in France, Germany, Italy, Spain and the UK: a literature-based review , 2009, Expert opinion on pharmacotherapy.

[38]  C. Gilchrist,et al.  Extracellular Matrix Ligand and Stiffness Modulate Immature Nucleus Pulposus Cell-Cell Interactions , 2011, PloS one.

[39]  H. Brisby Pathology and possible mechanisms of nervous system response to disc degeneration. , 2006, The Journal of bone and joint surgery. American volume.

[40]  R. Soames,et al.  Human intervertebral disc: Structure and function , 1988, The Anatomical record.

[41]  Allan S Hoffman,et al.  Hydrogels for biomedical applications. , 2002, Advanced drug delivery reviews.

[42]  S. Nicoll,et al.  Lower crosslinking density enhances functional nucleus pulposus-like matrix elaboration by human mesenchymal stem cells in carboxymethylcellulose hydrogels. , 2016, Journal of biomedical materials research. Part A.

[43]  B. Reid,et al.  PEG hydrogel degradation and the role of the surrounding tissue environment , 2015, Journal of tissue engineering and regenerative medicine.

[44]  R. Reis,et al.  Rheological and mechanical properties of acellular and cell-laden methacrylated gellan gum hydrogels. , 2013, Journal of biomedical materials research. Part A.

[45]  C. Moser,et al.  A photopolymerized composite hydrogel and surgical implanting tool for a nucleus pulposus replacement. , 2016, Biomaterials.

[46]  J. Urban,et al.  Swelling Pressure of the Lumbar Intervertebral Discs: Influence of Age, Spinal Level, Composition, and Degeneration , 1988, Spine.

[47]  Lutz Claes,et al.  Biomechanical evaluation of conventional anulus fibrosus closure methods required for nucleus replacement. Laboratory investigation. , 2008, Journal of neurosurgery. Spine.

[48]  Fan Yang,et al.  Mesenchymal stem cells arrest intervertebral disc degeneration through chondrocytic differentiation and stimulation of endogenous cells. , 2009, Molecular therapy : the journal of the American Society of Gene Therapy.

[49]  Dawn M Elliott,et al.  The Effect of Relative Needle Diameter in Puncture and Sham Injection Animal Models of Degeneration , 2008, Spine.

[50]  Dino Di Carlo,et al.  Accelerated wound healing by injectable microporous gel scaffolds assembled from annealed building blocks. , 2015, Nature materials.

[51]  Deli Wang,et al.  Biological evaluation of human degenerated nucleus pulposus cells in functionalized self-assembling peptide nanofiber hydrogel scaffold. , 2014, Tissue engineering. Part A.

[52]  Linyong Zhu,et al.  Tissue‐Integratable and Biocompatible Photogelation by the Imine Crosslinking Reaction , 2016, Advanced materials.

[53]  Makarand V Risbud,et al.  Chitosan: a versatile biopolymer for orthopaedic tissue-engineering. , 2005, Biomaterials.

[54]  Dawn M. Elliott,et al.  Material properties in unconfined compression of human nucleus pulposus, injectable hyaluronic acid-based hydrogels and tissue engineering scaffolds , 2007, European Spine Journal.

[55]  Alexander R. Vaccaro,et al.  Nucleus Pulposus Replacement: Basic Science and Indications for Clinical Use , 2005, Spine.

[56]  C. Werner,et al.  Modulating Biofunctional starPEG Heparin Hydrogels by Varying Size and Ratio of the Constituents , 2011 .

[57]  Samantha C W Chan,et al.  Intervertebral disc regeneration or repair with biomaterials and stem cell therapy--feasible or fiction? , 2012, Swiss medical weekly.

[58]  S. Blumenthal,et al.  Prospective, Multicenter, Randomized, Controlled Study of Anular Repair in Lumbar Discectomy: Two-Year Follow-up , 2013, Spine.

[59]  Y. Ikada,et al.  Soft tissue adhesive composed of modified gelatin and polysaccharides , 2000, Journal of biomaterials science. Polymer edition.

[60]  P. Brinckmann,et al.  Do human lumbar discs reconstitute after chemonucleolysis? A 7-year follow-up study. , 1999, Spine.

[61]  A. Van de Voorde,et al.  In vitro and in vivo biocompatibility of dextran dialdehyde cross-linked gelatin hydrogel films. , 1998, Biomaterials.

[62]  S. Nicoll,et al.  Photo-crosslinked alginate hydrogels support enhanced matrix accumulation by nucleus pulposus cells in vivo. , 2009, Osteoarthritis and cartilage.

[63]  L. Bonassar,et al.  Biomechanical and biochemical characterization of composite tissue-engineered intervertebral discs. , 2006, Biomaterials.

[64]  Farshid Guilak,et al.  Injectable laminin-functionalized hydrogel for nucleus pulposus regeneration. , 2013, Biomaterials.

[65]  Christophe Moser,et al.  Miniature probe for the delivery and monitoring of a photopolymerizable material , 2015, Journal of biomedical optics.

[66]  H. Wilke,et al.  A New Porcine In Vivo Animal Model of Disc Degeneration: Response of Anulus Fibrosus Cells, Chondrocyte-Like Nucleus Pulposus Cells, and Notochordal Nucleus Pulposus Cells to Partial Nucleotomy , 2009, Spine.

[67]  Pierre Weiss,et al.  An injectable vehicle for nucleus pulposus cell-based therapy. , 2011, Biomaterials.

[68]  M. Oyen,et al.  Mechanical characterisation of hydrogel materials , 2014 .

[69]  A. Gefen,et al.  In situ forming hydrogels composed of oxidized high molecular weight hyaluronic acid and gelatin for nucleus pulposus regeneration. , 2013, Acta biomaterialia.

[70]  Jaw-Lin Wang,et al.  The Leakage Pathway and Effect of Needle Gauge on Degree of Disc Injury Post Anular Puncture: A Comparative Study Using Aged Human and Adolescent Porcine Discs , 2007, Spine.

[71]  V C Mow,et al.  The viscoelastic behavior of the non-degenerate human lumbar nucleus pulposus in shear. , 1997, Journal of biomechanics.

[72]  Lutz Claes,et al.  Biomechanical evaluation of conventional annulus closure methods required for nucleus replacement , 2006 .

[73]  J. Urban,et al.  Injectable hydrogels with high fixed charge density and swelling pressure for nucleus pulposus repair: biomimetic glycosaminoglycan analogues. , 2014, Acta biomaterialia.

[74]  P. Roughley,et al.  The potential of chitosan-based gels containing intervertebral disc cells for nucleus pulposus supplementation. , 2006, Biomaterials.

[75]  M. Ferrer,et al.  Prevalence of low back pain and its effect on health-related quality of life in adolescents. , 2009, Archives of pediatrics & adolescent medicine.