Current strategies for treatment of intervertebral disc degeneration: substitution and regeneration possibilities

Background: Intervertebral disc degeneration has an annual worldwide socioeconomic impact masked as low back pain of over 70 billion euros. This disease has a high prevalence over the working age class, which raises the socioeconomic impact over the years. Acute physical trauma or prolonged intervertebral disc mistreatment triggers a biochemical negative tendency of catabolic-anabolic balance that progress to a chronic degeneration disease. Current biomedical treatments are not only ineffective in the long-run, but can also cause degeneration to spread to adjacent intervertebral discs. Regenerative strategies are desperately needed in the clinics, such as: minimal invasive nucleus pulposus or annulus fibrosus treatments, total disc replacement, and cartilaginous endplates decalcification. Main Body: Herein, it is reviewed the state-of-the-art of intervertebral disc regeneration strategies from the perspective of cells, scaffolds, or constructs, including both popular and unique tissue engineering approaches. The premises for cell type and origin selection or even absence of cells is being explored. Choice of several raw materials and scaffold fabrication methods are evaluated. Extensive studies have been developed for fully regeneration of the annulus fibrosus and nucleus pulposus, together or separately, with a long set of different rationales already reported. Recent works show promising biomaterials and processing methods applied to intervertebral disc substitutive or regenerative strategies. Facing the abundance of studies presented in the literature aiming intervertebral disc regeneration it is interesting to observe how cartilaginous endplates have been extensively neglected, being this a major source of nutrients and water supply for the whole disc. Conclusion: Severalinnovative avenues for tackling intervertebral disc degeneration are being reported â from acellular to cellular approaches, but the cartilaginous endplates regeneration strategies remain unaddressed. Interestingly, patient-specific approaches show great promise in respecting patient anatomy and thus allow quicker translation to the clinics in the near future.The authors would like to acknowledge the support provided by the Portuguese Foundation for Science and Technology (FCT) through the project EPIDisc (UTAP-EXPL/BBBECT/0050/2014), funded in the Framework of the “International Collaboratory for Emerging Technologies, CoLab”, UT Austin|Portugal Program. The FCT distinctions attributed to J. Miguel Oliveira (IF/00423/2012 and IF/01285/ 2015) and J. Silva-Correia (IF/00115/2015) under the Investigator FCT program are also greatly acknowledged.info:eu-repo/semantics/publishedVersio

Mass loss from hot massive stars

Mass loss is a key process in the evolution of massive stars, and must be understood quantitatively to be successfully included in broader astrophysical applications. In this review, we discuss various aspects of radiation driven mass loss, both from the theoretical and the observational side. We focus on winds from OB-stars, with some excursions to the Luminous Blue Variables, Wolf- Rayet stars, A-supergiants and Central Stars of Planetary Nebulae. After reca- pitulating the 1-D, stationary standard model of line-driven wind, extensions accounting for rotation and magnetic fields are discussed. The relevance of the so-called bi-stability jump is outlined. We summarize diagnostical methods to infer wind properties from observations, and compare the results with theore- tical predictions, featuring the massloss-metallicity dependence. Subsequently, we concentrate on two urgent problems which challenge our present understanding of radiation driven winds: weak winds and wind- clumping. We discuss problems of measuring mass-loss rates from weak winds and the potential of NIR- spectroscopy. Wind-clumping has severe implications for the interpretation of observational diagnostics, as derived mass-loss rates can be overestimated by factors of 2 to 10 if clumping is ignored, and we describe ongoing attempts to allow for more uniform results. We point out that independent arguments from stellar evolution favor a moderate reduction of present- day mass-loss rates. We also consider larger scale wind structure, interpreted in terms of co-rotating interacting regions, and complete this review with a discussion of recent progress on the X-ray line emission from massive stars, highlighting as to how far the analysis of such X-ray line emission can give further clues regarding an adequate description of wind clumping. (Abridged abstract)Comment: Astronomy and Astrophysics Review (accepted