Intervertebral disc (IVD) degeneration (IVDD) that greatly affected by regional biomechanical environment is a major cause of low back pain. Injectable hydrogels have been commonly studied for treatment of IVDD due to their capability of mimicking extracellular matrix structure to support cellular behavior and clinical prospects in minimally invasive treatment. However, most hydrogels suffer from complicated chemistry, potential uncertainty and toxicity from in-situ gelation, and mismatch with IVD mechanical environment that limit their therapeutic effects or clinical translation in IVDD or intervertebral disc defect repair. For IVD lesion repair, the study aims to develop a novel hydrogel with shear-thinning enabled injectability, high bio-safety, and mechanical properties adaptable to the IVD environment, using a simple chemistry and method. And therapeutic efficacy of the novel hydrogel in the treatment of IVDD or intervertebral disc defect will be revealed. A glycerol cross-linked PVA gel (GPG) was synthesized based on multiple H-bonds formation between glycerol molecules and PVA chains. The rheological and mechanical properties were tested. The swelling ratio was measured. The micro-architecture was observed through scanning and transmission electron microscopes. Nucleus pulposus (NP) cells were cultured in GPG-coated plates or silicone chambers treated under hydrostatic or dynamic loading in vitro, and examined for proliferation, vitality, apoptosis, expression of catabolic and anabolic markers. GPG was injected in needle puncture (IDD) or NP discectomy (NPD) models in vivo, and examined through magnetic resonance imaging, micro-computed tomography scanning and histological staining. GPG had a highly porous structure consisting of interconnected pores. Meanwhile, the GPG had NP-like viscoelastic property, and was able to withstand the cyclic deformation while exhibiting a prominent energy-dissipating capability. In vitro cell tests demonstrated that, the hydrogel significantly down-regulated the expression of catabolic markers, maintained the level of anabolic markers, preserved cell proliferation and vitality, reduced apoptotic rate of NP cells under pathologically hydrostatic and dynamic loading environments compared to cells cultured on untreated plate or silicone chamber. In vivo animal studies revealed that injection of GPG efficiently maintained NP structural integrity, IVD height and relative water content in IDD models, and stimulated the fibrous repair in NPD models. This study showed that GPG, with high injectability, NP-like viscoelastic characteristics, good energy-dissipating properties and swelling capacities, preserved NP cells vitality against pathological loading, and had therapeutic effects on IVD repair in IDD and NPD models. Effective clinical strategy for treatment of intervertebral disc degeneration (IVDD) is still lacking. This study demonstrates that injection of a hydrogel with nucleus pulposus-matched viscoelastic property could remarkably prevent the IVDD progress. Prepared with simple chemistry and procedure, the cell/drug-free GPG with high bio-safety and shear-thinning enabled injectability bears great translational potential for the clinical treatment of IVDD via a minimally invasive approach.

The circadian clock maintains homeostasis in peripheral tissues, including articular cartilage. Cartilage as a highly mechanical loaded tissue experiences diurnal rhythmic mechanical loading activity/rest cycle patterns, which gives external time cue on chondrocytes. Given the cartilage clock driven by loading patterns, we hypothesize that abnormal mechanical loading, a major risk factor for osteoarthritis (OA), can disrupt the cartilage clock, further contributing to OA progression. We used both noninvasive in vivo mechanical loading system and PER2Luc reporter mice for ex vivo bioluminescence recording. RNA sequencing was performed in mouse primary chondrocytes treated with 1.0 MPa static compression, and identified core clock molecule REV-ERBα, which was confirmed in human and murine OA cartilage samples. Chondrocytes were treated with Rev-erbα small interfering RNA (si-Rev-erbα), and adeno-associated virus carrying Rev-erbα-specific short hairpin RNA (AAV-shRev-erbα) was injected intra-articularly in mice to knock down Rev-erbα. Relevant signaling pathways regulating REV-ERBα were analyzed by RNA sequencing data. Intraperitoneal injection of SR8278, a specific REV-ERBα antagonist, was performed in mice after mechanical overloading for OA treatment. Excessive mechanical loading disrupted the circadian rhythm of articular cartilage. The core clock molecule REV-ERBα was increased in OA cartilage and knockdown of Rev-erbαalleviated compression-induced chondrocyte dysfunction. Inhibition of MAPK-MYC pathway by U0126 or SB203580 attenuated compression-induced REV-ERBα up-regulation and cartilage clock disruption. Finally, pharmacological inhibition of REV-ERBα expression by SR8278 restored cartilage clock upon abnormal loading and mitigated OA progression. REV-ERBα is a key factor in the association between mechanical overloading-induced circadian disruption and OA pathology. This study illustrates the essential mechanism of impaired circadian rhythm under overloading and provides a possibly impactful therapeutic approach for the treatment of OA. Inhibition REV-ERBα expression by clock-based therapeutic drug SR8278 or MAPK-MYC pathway inhibitors could ameliorate mechanical overloading-induced circadian disruption of cartilage and OA degeneration, indicating a clinical conversion potential for OA treatment.

Mutations in Slc26a2 cause a spectrum of autosomal-recessive chondrodysplasia with a significant and negligible influence on the quality of life. It has been reported that Slc26a2 deficiency triggers the ATF6 branch of the UPR, which may, in turn, activate the negative regulator of the FGFR3 signaling pathway. However, the correlation between the deletion of Slc26a2 and the augmentation of downstream phosphorylation of FGFR3 has not been investigated in vivo. First, we constructed Slc26a2 and Fgfr3 double knockout mouse lines and observed gross views of the born mice and histological staining of the tibial growth plates. The second approach was to construct tamoxifen-inducible Cre-ER^T2 mouse models to replicate SLC26A2-related non-lethal dysplastic conditions. Pharmacological intervention was performed by administering the FGFR3 inhibitor NVP-BGJ398. The effect of NVP-BGJ398 on chondrocytes was assessed by Alcian blue staining, proliferation, apoptosis, and chondrocyte-specific markers and then verified by western blotting for variations in the downstream markers of FGFR3. The growth process was detected using X-rays, micro-CT examination, histomorphometry staining of growth plates, and immunofluorescence. Genetic ablation of Fgfr3 in embryonic Slc26a2-deficient chondrocytes slightly attenuated chondrodysplasia. Subsequently, in the constructed mild dysplasia model, we found that postnatal intervention with Fgfr3 gene in Slc26a2-deficient chondrocytes partially alleviated chondrodysplasia. In chondrocyte assays, NVP-BGJ398 suppressed the defective phenotype of Slc26a2-deficient chondrocytes and restored the phosphorylation downstream of FGFR3 in a concentration-dependent manner. In addition, in vivo experiments showed significant alleviation of impaired chondrocyte differentiation, and micro-CT analysis showed a clear improvement in trabecular bone microarchitectural parameters. Our results suggested that inhibition of FGFR3 signaling pathway overactivation and NVP-BGJ398 has promising therapeutic implications for the development of SLC26A2-related skeletal diseases in humans. Our data provide genetic and pharmacological evidence that targeting FGFR3 signaling via NVP-BGJ398 could be a route for the treatment of SLC26A2-associated skeletal disorders, which promisingly advances translational applications and therapeutic development.