The intervertebral disc (IVD) is an integral load-bearing tissue that derives its function from its composite structure and extracellular matrix composition. IVD herniations involve the failure of the annulus fibrosus (AF) and the extrusion of the nucleus pulposus beyond the disc boundary. Disc herniations can impinge the neural elements and cause debilitating pain and loss of function, posing a significant burden on individual patients and society as a whole. Patients with persistent symptoms may require surgery; however, surgical intervention fails to repair the ruptured AF and is associated with the risk for reherniation and further disc degeneration. Given the limitations of AF endogenous repair, many attempts have been made toward the development of effective repair approaches that reestablish IVD function. These methods, however, fail to recapitulate the composition and organization of the native AF, ultimately resulting in inferior tissue mechanics and function over time and high rates of reherniation. Harnessing the cellular function of cells (endogenous or exogenous) at the repair site through the provision of cell-instructive cues could enhance AF tissue regeneration and, ultimately, improve healing outcomes. In this study, we review the diverse approaches that have been developed for AF repair and emphasize the potential for mobilizing the appropriate cellular players at the site of injury to improve AF healing.

中文翻译：

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各部分到位：动员细胞参与者改善纤维环修复


椎间盘（IVD）是一个完整的承重组织，其功能源自其复合结构和细胞外基质组成。 IVD 突出涉及纤维环 (AF) 的衰竭和髓核挤出椎间盘边界之外。椎间盘突出会影响神经元件，导致衰弱性疼痛和功能丧失，给患者个体和整个社会带来沉重负担。症状持续的患者可能需要手术；然而，手术干预无法修复破裂的 AF，并且存在再突出和进一步椎间盘退变的风险。鉴于 AF 内源性修复的局限性，人们做出了许多尝试来开发重建 IVD 功能的有效修复方法。然而，这些方法无法概括天然 AF 的组成和组织，最终导致组织力学和功能随着时间的推移而下降，并导致高复发率。通过提供细胞指导信号来利用修复部位细胞（内源性或外源性）的细胞功能可以增强房颤组织再生，并最终改善愈合结果。在这项研究中，我们回顾了为房颤修复开发的多种方法，并强调了在损伤部位调动适当的细胞参与者来改善房颤愈合的潜力。