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Integrating cells; scaffolds; and molecular regulation: a mechanobiological and translational review of bioengineering therapies for intervertebral disc degeneration
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DOI：10.3389/fbioe.2026.1803183.png)
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Abstract
En 中文
Intervertebral disc degeneration (IDD) is a primary cause of chronic low back pain; severely impacting patients' quality of life. Conventional treatments focus on symptom relief but fail to restore disc structure and function. Recent bioengineering advances offer regenerative solutions; integrating cell therapy; tissue-engineered scaffolds; gene therapy; and mechanobiology. Cell therapy leverages mesenchymal stem cells (MSCs) from bone marrow; adipose tissue; or umbilical cord blood; with biomaterial carriers enhancing survival in the harsh disc microenvironment. Scaffolds—natural (collagen; chitosan) or synthetic (PLGA; PCL)—mimic native extracellular matrix (ECM) and provide mechanical support; often combined with growth factors for controlled release. Gene therapy targets ECM synthesis; inflammation; and degradation pathways via viral or non-viral vectors; while mechanobiology reveals how mechanical forces regulate disc cell behavior; guiding scaffold design. Animal models validate these therapies; and early clinical trials show promise in pain reduction and disc height restoration. However; challenges remain; including low cell survival; scaffold mechanical adaptation; and gene delivery safety. Multidisciplinary collaboration is key to translating preclinical progress into effective clinical interventions; addressing the unmet medical need for IDD treatment.
Keywords:
gene therapy
mechanobiology
cell therapy
biomaterials
tissue engineering
intervertebral disc degeneration
bioengineering
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