An intelligent nanoliposome alleviates disc degeneration and discogenic pain by inhibiting neurovascular ingrowth via a “Soil-conditioning, seed-modulating, and weeds-suppressing” strategy

Intervertebral disc degeneration (IVDD), a primary cause of debilitating low back pain, is driven by a vicious cycle involving a harsh microenvironment ("soil") and dysfunctional nucleus pulposus cells ("seeds"), which together promote pathological neurovascular ingrowth ("weeds") and pain. A therapeutic strategy that can simultaneously "condition the soil" and "modulate the seed" is therefore paramount. Thus, we engineered a biomimetic intelligent nanoliposome (NM-LP^TK/RSV-MnCDs) for this dual purpose. The platform is camouflaged with NPC membranes for precise "seed"-homing and incorporates a reactive oxygen species (ROS)-responsive linker for on-demand drug release within the degenerative "soil." It co-delivers carbonized Mn-containing nanodots (MnCDs) to "condition the soil" by scavenging ROS, and resveratrol (RSV) to "modulate the seed" by suppressing pro-neurovascular signaling. The nanoplatform demonstrated outstanding efficacy in vitro and in two distinct murine IVDD models. It effectively scavenged ROS, inhibited axonal and vascular growth, and preserved matrix synthesis. In vivo, it significantly attenuated disc degeneration, suppressed pathological neurovascular ingrowth, and alleviated pain-related behaviors. Mechanistically, we found this synergistic "soil-conditioning" and "seed-modulating" effect was mediated through the inactivation of the Hippo-YAP signaling pathway, which restored redox homeostasis and blocked aberrant remodeling. This study establishes a targeted, intelligent nanoplatform that synergistically alleviates IVDD and discogenic pain by restoring the disc ecosystem via Hippo pathway inhibition, presenting a precise therapeutic paradigm for degenerative disc disease and its associated neuropathic pain.