Incorporation of Bone Marrow Stem Cell-Derived Exosomes into GelMA Hydrogel Effectively Attenuates Disc Degeneration in the Vertebrae of Rats

Abstract Chronic back pain and related disabilities are largely caused by intervertebral disc degeneration (IVDD). However, effective treatments remain limited. Existing treatment modalities, encompassing both conservative and surgical approaches, often fail to effectively arrest disease progression and may be associated with significant adverse effects. Recent studies have underscored the potential of tissue engineering and exosomes derived from bone marrow mesenchymal stem cells (BMSC-exos) as a promising strategy for the repair of intervertebral discs. This study aims to employ bioengineering techniques to enhance the retention and achieve sustained release of exosomes in the context of IVDD treatment. Our team developed a gelatin methacryloyl (GelMA) hydrogel system containing exosomes. Then Exosomes were mixed with GelMA to prepare a composite hydrogel (Exo-GelMA). This hydrogel-based system facilitates the targeted delivery of therapeutic agents to the degenerated disc, thereby modulating the proliferation, migration, and matrix synthesis of nucleus pulposus cells (NPCs). In a model of IVDD induced by puncture, this system notably slowed down the degeneration process and demonstrated considerable potential as a non-surgical treatment modality for IVDD, offering a promising strategy to attenuate the progression of IVDD and facilitate disc repair.