This work was supported by AO Foundation and AOSpine International. Babak Saravi received fellowship support from the German Spine Foundation and the German Osteoarthritis Foundation. Gernot Lang was supported by the Berta-Ottenstein-Programme for Advanced Clinician Scientists, Faculty of Medicine, University of Freiburg, Germany.

Experiments were performed using bovine tails obtained from local abattoirs. The biological materials used in the current study are taken from the food chain and require no ethical approval in Swiss and European law.
1. Dissection of the bovine intervertebral disc
<ol>
	<li>Rinse the whole tail thoroughly with tap water to remove dirt and hair on the surface. 
	NOTE: With intact, distal ends, a maximum of 9 IVDs (coccygeal 1-9) per tail can be used for the experiments depending on the d...

<ol>
	<li>Vos, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Global,+regional,+and+national+incidence,+prevalence,+and+years+lived+with+disability+for+328+diseases+and+injuries+for+195+countries,+1990-2016:+a+systematic+analysis+for+the+Global+Burden+of+Disease+Study+2016.">Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.</a> The Lancet. 390 (10100), 1211-1259 (2017).</li><li>Hoy, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measuring+the+global+burden+of+low+back+pain.">Measuring the global burden of low back pain.</a> Best Practice &amp; Research Clinical Rheumatology. 24 (2), 155-165 (2010).</li><li>Thiese, M. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevalence+of+low+back+pain+by+anatomic+location+and+intensity+in+an+occupational+population.">Prevalence of low back pain by anatomic location and intensity in an occupational population.</a> BMC Musculoskeletal Disorders. 15 (1), 283 (2014).</li><li>Katz, J. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lumbar+Disc+Disorders+and+Low-Back+Pain:+Socioeconomic+Factors+and+Consequences.">Lumbar Disc Disorders and Low-Back Pain: Socioeconomic Factors and Consequences.</a> The Journal of Bone and Joint Surgery (American). 88, 21 (2006).</li><li>Vlaeyen, J. W. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Low+back+pain.">Low back pain.</a> Nature Reviews Disease Primers. 4 (1), 52 (2018).</li><li>Khan, A. N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inflammatory+biomarkers+of+low+back+pain+and+disc+degeneration:+a+review:+Biomarkers+of+disc+degeneration+and+back+pain.">Inflammatory biomarkers of low back pain and disc degeneration: a review: Biomarkers of disc degeneration and back pain.</a> Annals of the New York Academy of Sciences. 1410 (1), 68-84 (2017).</li><li>Kim, H. S., Wu, P. H., Jang, I. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Lumbar+Degenerative+Disease+Part+1:+Anatomy+and+Pathophysiology+of+Intervertebral+Discogenic+Pain+and+Radiofrequency+Ablation+of+Basivertebral+and+Sinuvertebral+Nerve+Treatment+for+Chronic+Discogenic+Back+Pain:+A+Prospective+Case+Series+and+Review+of+Literature.">Lumbar Degenerative Disease Part 1: Anatomy and Pathophysiology of Intervertebral Discogenic Pain and Radiofrequency Ablation of Basivertebral and Sinuvertebral Nerve Treatment for Chronic Discogenic Back Pain: A Prospective Case Series and Review of Literature.</a> International Journal of Molecular Sciences. 21 (4), 1483 (2020).</li><li>Adams, M. A., Roughley, P. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+is+Intervertebral+Disc+Degeneration,+and+What+Causes+It.">What is Intervertebral Disc Degeneration, and What Causes It.</a> Spine. 31 (18), 2151-2161 (2006).</li><li>Wu, P. H., Kim, H. S., Jang, I. T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intervertebral+Disc+Diseases+Part+2:+A+Review+of+the+Current+Diagnostic+and+Treatment+Strategies+for+Intervertebral+Disc+Disease.">Intervertebral Disc Diseases Part 2: A Review of the Current Diagnostic and Treatment Strategies for Intervertebral Disc Disease.</a> International Journal of Molecular Sciences. 21 (6), 2135 (2020).</li><li>Lurie, J. D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Surgical+Versus+Nonoperative+Treatment+for+Lumbar+Disc+Herniation:+Eight-Year+Results+for+the+Spine+Patient+Outcomes+Research+Trial.">Surgical Versus Nonoperative Treatment for Lumbar Disc Herniation: Eight-Year Results for the Spine Patient Outcomes Research Trial.</a> Spine. 39 (1), 3-16 (2014).</li><li>Risbud, M. V., Shapiro, I. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Role+of+cytokines+in+intervertebral+disc+degeneration:+pain+and+disc+content.">Role of cytokines in intervertebral disc degeneration: pain and disc content.</a> Nature Reviews Rheumatology. 10 (1), 44-56 (2014).</li><li>Ponnappan, R. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+organ+culture+system+to+model+early+degenerative+changes+of+the+intervertebral+disc.">An organ culture system to model early degenerative changes of the intervertebral disc.</a> Arthritis Research &amp; Therapy. 13 (5), 171 (2011).</li><li>O'Connell, G. D., Vresilovic, E. J., Elliott, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+Animals+Used+in+Disc+Research+to+Human+Lumbar+Disc+Geometry.">Comparison of Animals Used in Disc Research to Human Lumbar Disc Geometry.</a> Spine. 32 (3), 328-333 (2007).</li><li>Stannard, J. T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+a+whole+organ+culture+model+for+intervertebral+disc+disease.">Development of a whole organ culture model for intervertebral disc disease.</a> Journal of Orthopaedic Translation. 5, 1-8 (2016).</li><li>Li, Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Preclinical+ex-vivo+Testing+of+Anti-inflammatory+Drugs+in+a+Bovine+Intervertebral+Degenerative+Disc+Model.">Preclinical ex-vivo Testing of Anti-inflammatory Drugs in a Bovine Intervertebral Degenerative Disc Model.</a> Frontiers in Bioengineering and Biotechnology. 8, 583 (2020).</li><li>Li, Z., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+an+ex+vivo+cavity+model+to+study+repair+strategies+in+loaded+intervertebral+discs.">Development of an ex vivo cavity model to study repair strategies in loaded intervertebral discs.</a> European Spine Journal. 25 (9), 2898-2908 (2016).</li><li>Kazezian, Z., Li, Z., Alini, M., Grad, S., Pandit, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Injectable+hyaluronic+acid+down-regulates+interferon+signaling+molecules,+IGFBP3+and+IFIT3+in+the+bovine+intervertebral+disc.">Injectable hyaluronic acid down-regulates interferon signaling molecules, IGFBP3 and IFIT3 in the bovine intervertebral disc.</a> Acta Biomaterialia. 52, 118-129 (2017).</li><li>Caprez, S., Menzel, U., Li, Z., Grad, S., Alini, M., Peroglio, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Isolation+of+high-quality+RNA+from+intervertebral+disc+tissue+via+pronase+predigestion+and+tissue+pulverization.">Isolation of high-quality RNA from intervertebral disc tissue via pronase predigestion and tissue pulverization.</a> JOR Spine. 1 (2), 1017 (2018).</li><li>Lopa, S., Ceriani, C., Cecchinato, R., Zagra, L., Moretti, M., Colombini, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stability+of+housekeeping+genes+in+human+intervertebral+disc,+endplate+and+articular+cartilage+cells+in+multiple+conditions+for+reliable+transcriptional+analysis.">Stability of housekeeping genes in human intervertebral disc, endplate and articular cartilage cells in multiple conditions for reliable transcriptional analysis.</a> European Cells &amp; Materials. 31, 395-406 (2016).</li><li>Lang, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+intervertebral+disc+whole+organ+culture+system+to+investigate+proinflammatory+and+degenerative+disc+disease+condition.">An intervertebral disc whole organ culture system to investigate proinflammatory and degenerative disc disease condition.</a> Journal of Tissue Engineering and Regenerative Medicine. 12 (4), 2051-2061 (2018).</li><li>Du, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Proinflammatory+intervertebral+disc+cell+and+organ+culture+models+induced+by+tumor+necrosis+factor+alpha.">Proinflammatory intervertebral disc cell and organ culture models induced by tumor necrosis factor alpha.</a> JOR Spine. 3, 1104 (2020).</li><li>Purmessur, D., Walter, B. A., Roughley, P. J., Laudier, D. M., Hecht, A. C., Iatridis, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+role+for+TNF&#945;+in+intervertebral+disc+degeneration:+A+non-recoverable+catabolic+shift.">A role for TNF&#945; in intervertebral disc degeneration: A non-recoverable catabolic shift.</a> Biochemical and Biophysical Research Communications. 433 (1), 151-156 (2013).</li><li>Walter, B. A., Likhitpanichkul, M., Illien-Junger, S., Roughley, P. J., Hecht, A. C., Iatridis, J. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=TNF&#945;+Transport+Induced+by+Dynamic+Loading+Alters+Biomechanics+of+Intact+Intervertebral+Discs.">TNF&#945; Transport Induced by Dynamic Loading Alters Biomechanics of Intact Intervertebral Discs.</a> PLOS One. 10 (3), 0118358 (2015).</li><li>Gullbrand, S. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+large+animal+model+that+recapitulates+the+spectrum+of+human+intervertebral+disc+degeneration.">A large animal model that recapitulates the spectrum of human intervertebral disc degeneration.</a> Osteoarthritis and Cartilage. 25 (1), 146-156 (2017).</li><li>Willems, N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Safety+of+intradiscal+injection+and+biocompatibility+of+polyester+amide+microspheres+in+a+canine+model+predisposed+to+intervertebral+disc+degeneration:+intradiscal+application+of+pea+microspheres.">Safety of intradiscal injection and biocompatibility of polyester amide microspheres in a canine model predisposed to intervertebral disc degeneration: intradiscal application of pea microspheres.</a> Journal of Biomedical Materials Research Part B: Applied Biomaterials. 105 (4), 707-714 (2017).</li><li>Michalek, A. J., Buckley, M. R., Bonassar, L. J., Cohen, I., Iatridis, J. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effects+of+needle+puncture+injury+on+microscale+shear+strain+in+the+intervertebral+disc+annulus+fibrosus.">The effects of needle puncture injury on microscale shear strain in the intervertebral disc annulus fibrosus.</a> The Spine Journal. 10 (12), 1098-1105 (2010).</li><li>Illien-J&#252;nger, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+combined+effects+of+limited+nutrition+and+high-frequency+loading+on+intervertebral+discs+with+endplates.">The combined effects of limited nutrition and high-frequency loading on intervertebral discs with endplates.</a> Spine. 35 (19), 1744-1752 (2010).</li><li>Gantenbein, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Organ+culture+bioreactors--platforms+to+study+human+intervertebral+disc+degeneration+and+regenerative+therapy.">Organ culture bioreactors--platforms to study human intervertebral disc degeneration and regenerative therapy.</a> Current Stem Cell Research &amp; Therapy. 10 (4), 339-352 (2015).</li><li>Boubriak, O. A., Watson, N., Sivan, S. S., Stubbens, N., Urban, J. P. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Factors+regulating+viable+cell+density+in+the+intervertebral+disc:+blood+supply+in+relation+to+disc+height.">Factors regulating viable cell density in the intervertebral disc: blood supply in relation to disc height.</a> Journal of Anatomy. 222 (3), 341-348 (2013).</li><li>Maroudas, A., Stockwell, R. A., Nachemson, A., Urban, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Factors+involved+in+the+nutrition+of+the+human+lumbar+intervertebral+disc:+cellularity+and+diffusion+of+glucose+in+vitro.">Factors involved in the nutrition of the human lumbar intervertebral disc: cellularity and diffusion of glucose in vitro.</a> Journal of Anatomy. 120, 113-130 (1975).</li><li>Beckstein, J. C., Sen, S., Schaer, T. P., Vresilovic, E. J., Elliott, D. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+Animal+Discs+Used+in+Disc+Research+to+Human+Lumbar+Disc:+Axial+Compression+Mechanics+and+Glycosaminoglycan+Content.">Comparison of Animal Discs Used in Disc Research to Human Lumbar Disc: Axial Compression Mechanics and Glycosaminoglycan Content.</a> Spine. 33 (6), 166-173 (2008).</li><li>Walter, B. A., Illien-J&#252;nger, S., Nasser, P. R., Hecht, A. C., Iatridis, J. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+and+validation+of+a+bioreactor+system+for+dynamic+loading+and+mechanical+characterization+of+whole+human+intervertebral+discs+in+organ+culture.">Development and validation of a bioreactor system for dynamic loading and mechanical characterization of whole human intervertebral discs in organ culture.</a> Journal of Biomechanics. 47 (9), 2095-2101 (2014).</li><li>Rajan, N. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Toll-Like+Receptor+4+(TLR4)+Expression+and+Stimulation+in+a+Model+of+Intervertebral+Disc+Inflammation+and+Degeneration.">Toll-Like Receptor 4 (TLR4) Expression and Stimulation in a Model of Intervertebral Disc Inflammation and Degeneration.</a> Spine. 38 (16), 1343-1351 (2013).</li><li>vanden Akker, G. G., Rorije, A. J., Davidson, E. N. B., vander Kraan, P. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Phenotypic+marker+genes+distinguish+inner+and+outer+annulus+fibrosus+from+nucleus+pulposus+tissue+in+the+bovine+intervertebral+disc.">Phenotypic marker genes distinguish inner and outer annulus fibrosus from nucleus pulposus tissue in the bovine intervertebral disc.</a> Osteoarthritis and Cartilage. 25, 402 (2017).</li><li>Du, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+cell+phenotype+induction+with+TGF-&#946;1+and+collagen-polyurethane+scaffold+for+annulus+fibrosus+rupture+repair.">Functional cell phenotype induction with TGF-&#946;1 and collagen-polyurethane scaffold for annulus fibrosus rupture repair.</a> European Cells &amp; Materials. 39, 1-17 (2020).</li><li>Risbud, M. V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Defining+the+phenotype+of+young+healthy+nucleus+pulposus+cells:+recommendations+of+the+Spine+Research+Interest+Group+at+the+2014+annual+ORS+meeting.">Defining the phenotype of young healthy nucleus pulposus cells: recommendations of the Spine Research Interest Group at the 2014 annual ORS meeting.</a> Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society. 33 (3), 283-293 (2015).</li></ol>

We here provided a detailed protocol to simulate degenerative and inflammatory IVDD. This protocol can be applied for detailed examinations of inflammatory pathways leading to the destructive effects on the disc. Moreover, the protocol can help to determine promising therapeutic targets involved in the progression of the disease.
We recently showed that human recombinant TNF-&#945; could induce inflammation in both bovine and human NP cells21, which is in accordance wit...

Low back pain (LBP) can affect individuals of all ages and is a leading cause for disability worldwide1,2,3. The total cost associated with LBP exceeds $100 billion per year4,5. Symptomatic intervertebral disc (IVD) degeneration (IDD), a condition characterized by inflammation and tissue degradation, is a major cause of LBP6,7. Specifically, IDD is characterized by a gradually evolving breakdown of the IVD&#39;s extracellular matrix (ECM), induced and triggered by multiple factors that lead to an accelerated pathology, neurological disorders, and eventually disability. Furthermore, IDD is associated with the release of proinflammatory cytokines, altered spine biomechanics, angiogenesis, and nerve ingrowth, which increases pain sensation, altogether causing chronic LBP (active discopathy)6,8. To date, treatment options include discectomy and subsequent fusion of the adjacent vertebrae, implantation of an IVD prosthesis, or non-surgical approaches, such as non-steroidal anti-inflammatory drugs, opioids, and muscle relaxants for patients with IDD9. Both current standard therapeutic options, surgical and non-surgical, are only partly effective and fail to address the underlying biological problem9,10. Early-stage degenerative disc disease is characterized by an initial inflammatory tissue response, especially an increase in tumor necrosis factor-alpha (TNF-alpha) expression11. These early disc changes primarily occur at the cellular level without disrupting the disc architecture and could previously be mimicked by nutritional deficiency under pro-inflammatory conditions12. Therefore, precise simulation of the in vivo situation to investigate these degeneration mechanisms and find suitable therapeutic targets is crucial. Additionally, to these simulations of molecular properties, the mechanical loading environment of the discs plays a key role in pathological and physiological changes of IVD. Consequently, combining these approaches would bring us one step forward to mimic the complex microenvironment of IVDs in vivo. There are currently no studies considering the aspect of dynamic loading along with the pro-inflammatory and nutritional setting to the best of our knowledge.
Although large animal models allow the investigation of potential relevant in vivo interactions, they are costly and work intensive. Moreover, as the use of animal models in research has long been a matter of controversy, the reduction of the number of animals needed to answer important research questions is of great interest. Finally, there is currently no ideal animal model to mimic IDD in IVD research13,14. Therefore, it is necessary to establish a cost-effective and reliable replacement, such as an organ culture model to simulate IDD and associated inflammatory and degenerative processes. Recently, the application of the present protocol on the establishment of a proinflammatory and degenerative organ culture model to simulate early-stage intervertebral disc disease allowed us to investigate the effect of anti-inflammatory drugs in the IDD organ culture15.
Here, we describe how to obtain bovine intervertebral discs and induce the state of early-stage IDD via a catabolic and proinflammatory microenvironment caused by direct intradiscal injection of tumor necrosis factor-alpha (TNF-&#945;) and degenerative loading in a bioreactor under low nutritive medium conditions. Figure 1 illustrates the experimental model and shows the bioreactor used to simulate degenerative and physiological loading conditions.
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/62100/62100fig01.jpg" /> 
Figure 1: Illustration of the experimental setup. A: bovine tail; B: dissected bovine intervertebral discs; C: transfer of the disc to a well-plate with culture medium; D: loading the simulation in a bioreactor; E: intradiscal injection technique; F: IVD after injection of PBS/trypan blue dye to reveal distribution. IDD: intervertebral disc degeneration. <a href="https://www.jove.com/files/ftp_upload/62100/62100fig01large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>1-Bromo-3-chloropropane(BCP)</td>
			<td>Sigma-Aldrich, St. Louis, USA</td>
			<td>B9673</td>
			<td></td>
		</tr>
		<tr>
			<td>Ascorbate-2-phosphate</td>
			<td>Sigma-Aldrich, St. Louis, USA</td>
			<td>A8960</td>
			<td></td>
		</tr>
		<tr>
			<td>Band saw</td>
			<td>Exakt Apparatebau, Norderstedt, Germany</td>
			<td>model 30/833</td>
			<td></td>
		</tr>
		<tr>
			<td>Betadine</td>
			<td>Munndipharma, Frankfurt, Germany</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Bovine IL-8 Do.it-Yourself ELISA</td>
			<td>Kingfisher Biotech, St. Paul, USA</td>
			<td>DIY1028B-003</td>
			<td></td>
		</tr>
		<tr>
			<td>Corning ITS Premix</td>
			<td>Corning Inc., New York, USA</td>
			<td>354350</td>
			<td></td>
		</tr>
		<tr>
			<td>DMEM high glucose</td>
			<td>Gibco by life technologies, Carlsbad, USA</td>
			<td>10741574</td>
			<td></td>
		</tr>
		<tr>
			<td>DMEM low glucose</td>
			<td>Gibco by life technologies, Carlsbad, USA</td>
			<td>11564446</td>
			<td></td>
		</tr>
		<tr>
			<td>Ethanol for molecular biology</td>
			<td>Sigma-Aldrich, St. Louis, USA</td>
			<td>09-0851</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal Bovine Serum (FBS)</td>
			<td>Gibco by life technologies, Carlsbad, USA</td>
			<td>A4766801</td>
			<td></td>
		</tr>
		<tr>
			<td>Non-essential amino acid solution</td>
			<td>Gibco by life technologies, Carlsbad, USA</td>
			<td>11140050</td>
			<td></td>
		</tr>
		<tr>
			<td>Penicillin/Streptomycin(P/S)</td>
			<td>gibco by life technologies, Carlsbad, USA</td>
			<td>11548876</td>
			<td></td>
		</tr>
		<tr>
			<td>Phosphate Buffer Solution, tablet</td>
			<td>Sigma-Aldrich, St. Louis, USA</td>
			<td>P4417</td>
			<td></td>
		</tr>
		<tr>
			<td>Pronase</td>
			<td>Sigma-Aldrich, St. Louis, USA</td>
			<td>10165921001</td>
			<td></td>
		</tr>
		<tr>
			<td>Primocin</td>
			<td>InvivoGen, Sandiego, USA</td>
			<td>ant-pm-05</td>
			<td></td>
		</tr>
		<tr>
			<td>Pulsavac Jet Lavage System</td>
			<td>Zimmer, IN,USA</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>TissueLyser II</td>
			<td>Quiagen, Venlo, Netherlands</td>
			<td>85300</td>
			<td></td>
		</tr>
		<tr>
			<td>Streptavidinn-HRP</td>
			<td>Kingfisher Biotech, St. Paul, USA</td>
			<td>AR0068-001</td>
			<td></td>
		</tr>
		<tr>
			<td>Superscript VILO</td>
			<td>Invitrogen by life Technologies, Carlsbad, USA</td>
			<td>10704274</td>
			<td></td>
		</tr>
		<tr>
			<td>cDNA Synthesis Kit</td>
			<td>Applied Biosystems by life technologies</td>
			<td>10400745</td>
			<td></td>
		</tr>
		<tr>
			<td>TaqMan Universal Master Mix</td>
			<td>Applied Biosystems by life technologies</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>TNF-alpha, recombinant human protein</td>
			<td>R&#38;D systems, Minnesota, USA</td>
			<td>210-TA-005</td>
			<td></td>
		</tr>
		<tr>
			<td>TRI Reagent</td>
			<td>Molecular Research Center, Cincinnati, USA</td>
			<td>TR 118</td>
			<td></td>
		</tr>
		<tr>
			<td>Tris-EDTA buffer solution</td>
			<td>sigma-Aldrich, St. Louis, USA</td>
			<td>93283</td>
			<td></td>
		</tr>
		<tr>
			<td>Gene bIL-6</td>
			<td>Applied Biosystems by life technologies</td>
			<td>Custom made probes</td>
			<td>Primer fw (5&#8242;&#8211;3&#8242;) TTC CAA AAA TGG AGG AAA AGG A 
			Primer rev (5&#8242;&#8211;3&#8242;) TCC AGA AGA CCA GCA GTG GTT 
			Probe (5&#8242;FAM/3&#8242;TAMRA) CTT CCA ATC TGG GTT CAA TCA GGC GATT</td>
		</tr>
		<tr>
			<td>Gene bIL8</td>
			<td>Applied Biosystems by life technologies</td>
			<td>Bt03211906_m1</td>
			<td></td>
		</tr>
		<tr>
			<td>Gene bTNF-alpha</td>
			<td>Applied Biosystems by life technologies</td>
			<td>Custom made probes</td>
			<td>Primer fw (5&#8242;&#8211;3&#8242;) CCT CTT CTC AAG CCT CAA GTA ACA A 
			Primer rev (5&#8242;&#8211;3&#8242;) GAG CTG CCC CGG AGA GTT 
			Probe (5&#8242;FAM/3&#8242;TAMRA) ATG TCG GCT ACA ACG TGG GCT ACC G</td>
		</tr>
		<tr>
			<td>GENE bIL1beta</td>
			<td>Applied Biosystems by life technologies</td>
			<td>Custom made probes</td>
			<td>Primer fw (5&#8242;&#8211;3&#8242;) TTA CTA CAG TGA CGA GAA TGA GCT GTT 
			Primer rev (5&#8242;&#8211;3&#8242;) GGT CCA GGT GTT GGA TGC A 
			Probe (5&#8242;FAM/3&#8242;TAMRA) CTC TTC ATC TGT TTA GGG TCA TCA GCC TCA A</td>
		</tr>
		<tr>
			<td>RPLP0</td>
			<td>Applied Biosystems by life technologies</td>
			<td>Bt03218086_m1</td>
			<td></td>
		</tr>
	</tbody>
</table>

a proinflammatory, degenerative organ culture model to simulate early-stage intervertebral disc disease.

Symptomatic intervertebral disc (IVD) degeneration (IDD) is a major socioeconomic burden and is characterized by inflammation and tissue degradation. Due to the lack of causative therapies, there is an urgent need for innovative experimental organ culture models to study the mechanisms involved in the progression of the disease, find therapeutic targets, and reduce the need for animal models. We here present a novel, three-dimensional organ culture model protocol mimicking the proinflammatory and catabolic microenvironment, which is present during IDD. 
Initially, bovine caudal IVDs were dissected, cleaned, and cultured in the tissue culture medium. Dynamic physiologic or pathologic loading was applied in a custom-made bioreactor for 2 hours per day. IVDs were assigned to a control group (high glucose medium, physiological loading, phosphate-buffered saline injection) and a pathological group (low glucose medium, pathological loading, tumor necrosis factor-alpha injection) for four days. Gene expression analysis from collected nucleus pulposus cells of the IVDs and enzyme-linked immunosorbent assay of the conditioned organ culture media was performed. 
Our data revealed a higher expression of inflammatory markers and reduced disc heights after loading in the pathological group compared to the control group. This protocol is reliable to simulate IVD inflammation and degeneration and can be further expanded to broaden its application scope.

Degenerative loading in low glucose medium combined with TNF-&#945; injection caused a significant increase of the gene expression of proinflammatory markers interleukin 6 (IL-6) and interleukin 8 (IL-8) compared to the physiological control group in NP cells after 4 days of culture (Figure 2). In contrast, we did not observe significant changes for the proinflammatory genes interleukin 1&#946; (IL-1&#946;) and TNF-&#945; in NP cells (data not shown). Furthermore, degenerative culture condit...

Watch this Scientific Journal Video about A Proinflammatory, Degenerative Organ Culture Model to Simulate Early-Stage Intervertebral Disc Disease. at JoVE.com

A Proinflammatory, Degenerative Organ Culture Model to Simulate Early-Stage Intervertebral Disc Disease.

This protocol presents a novel experimental model of proinflammatory, degenerative bovine organ culture to simulate early-stage intervertebral disc degeneration.

Symptomatic intervertebral disc (IVD) degeneration (IDD) is a major socioeconomic burden and is characterized by inflammation and tissue degradation. Due ...

The protocol aims to simulate in vivo conditions of intervertebral disc degeneration to investigate its pathophysiology without the need for animal models. Compared with in vitro cell culture, the bioreactor organ culture technique maintains the cells in their native biological and biomechanical microenvironment in addition to the supply of a controllable and reproducible culture condition. Start with rinsing the entire bovine tail thoroughly with tap water to remove dirt and hair on the surface, then immerse the tail in 1%betadine solution for 10 minutes to disinfect the surface.Use a scalpel number 20 to remove the soft tissue from the caudal spine to facilitate the identification of the intervertebral discs, or IVDs. Remove the spinous and transverse processes of the vertebrae with a bone removal plier. Cut transversely with bone pliers through the middle of each vertebral body to obtain individual motion segments, then put the collected motion segments in a Petri dish with a gauze wetted in Ringer's solution.Locate the IVD in vertebrae by moving the motion segments gently, then identify the location of the growth plate by touching and finding the convex side of the bony end plate. Cool the blade of the bandsaw with Ringer's solution and use it to make two parallel cuts in the growth plate of the IVDs, one on each side. Transfer the IVDs to a clean Petri dish with clean gauze wetted with Ringer's solution.Scrape off the vertebral body and growth plate using the scalpel blade, leaving the end plate intact. Position the two surfaces flat and parallel for the loading procedure and transfer scraped IVDs to a fresh Petri dish with gauze wetted with Ringer's solution. Measure the disc height and diameter with a caliper, then clean the blood clots in the vertebrae bone with Ringer's solution using a jet lavage system.Disinfect IVDs in PBS and 10%penicillin streptomycin with shaking for 15 minutes. Rinse off the high concentration antibiotics with PBS and 1%penicillin streptomycin. Transfer discs to IVD chambers containing five milliliters of IVD culture medium and place them in the bioreactor system with an incubator at 37 degrees Celsius with 85%humidity and 5%carbon dioxide.Culture the disks for four days within a bioreactor system by maintaining different loading conditions according to the experimental groups. In the physiological control group, culture the IVDs with high glucose medium using a loading protocol of 0.02 to 0.2 megapascals and 0.2 hertz for two hours per day. In the pathological group, culture the IVDs with low glucose medium using a loading protocol of 0.32 to 0.5 megapascals and five hertz for two hours per day.Between the loading procedures, place the IVDs in six-well plates with seven milliliters of IVD culture medium for free swelling recovery. Measure the disc height daily with a caliper after the free swelling period and after dynamic loading for the experimental duration. After the first dynamic loading cycle on day one, directly place the IVDs in a Petri dish in a vertical position and stabilize them with a tweezer.Inject recombinant TNF-alpha with a 30-gauge insulin needle slowly at a speed of approximately 70 microliters per minute into the IVDs of the pathological group. After injecting, pull the syringe halfway back and pull the plunger to create a vacuum that prevents the injected solution from leaking, then remove the syringe completely from the IVD. Degenerative loading combined with limited nutrition supply and a TNF-alpha injection caused a significant increase in the gene expression of pro-inflammatory markers interleukin six and interleukin eight in NP tissue after four days of culture.The interleukin eight protein release into the conditioned medium showed a marked increase in the pathological group on day two and day four. Disc height reduction after loading was higher in the pathological group compared to the physiological group, and the differences were more pronounced after days two and three compared with day one, indicating a progressive effect of the degenerative and inflammatory conditions. A standardized dissection technique is important for reproducible IVD whole-organ culture models.A bioreactor is required to apply physiological and degenerative loadings on IVDs to simulate various in vivo biomechanical conditions. This technique can be applied on human IVD explants which is of high clinical relevance. It's a novel preclinical model for developing effective treatments on early stage disc degeneration.

a-proinflammatory-degenerative-organ-culture-model-to-simulate-early

Research

JoVE Journal

Medicine

3.5K visualizações.  AO Research Institute Davos, Davos, Switzerland. O protocolo visa simular condições in vivo de degeneração do disco intervertebral para investigar sua fisiopatologia sem a necessidade de modelos animais. Em comparação com a cultura celular in vitro, a técnica de cultura de órgãos bioreatores mantém as células em seu microambiente biológico e biomecânico nativo, além do fornecimento de uma condição cultural controlável e reprodutível. Comece enxaguando toda a cauda bovina completamente com água da torneira para remover suj...