Efficiency of dual siRNA mediated gene therapy for intervertebral disc degeneration (IVDD)

Publication date: Available online 12 November 2018

Source: The Spine Journal

Author(s): Banala Rajkiran Reddy, Vemuri Satish Kumar, Dar Ghulam Hassan, Palanisamy Vijayanand, P Murahari, MV Surekha, AV Gurava Reddy, Nalam Madhusudhana Rao, GPV Subbaiah

Abstract

Background context

One of the common causes of LBP is intervertebral disc degeneration. The pathophysiology of disc degeneration involves apoptosis of nucleus pulposes (NP) cells and degradation of extra cellular matrix (ECM). Caspase 3 plays a central role in apoptosis and the ADAMTS 5 (A Disintegrin and Metalloproteinase with Thrombospondin motifs) gene plays a critical role in ECM degradation. Hence, we hypothesized that if one can silence these two genes, both apoptosis and ECM degradation can be prevented, thereby preventing the progression and even reverse disc degeneration.

Purpose

The purpose of this study is to demonstrate the regenerative potential of small interfering RNA (siRNA) designed against Caspase 3 and ADAMTS5 genes in an in vitro and animal model of disc degeneration

Study design

In vitro study followed by in vivo study in a rabbit model

Methods

In vitro studies were done using the human hepatocellular carcinoma (Hep G2) cell line for validating the efficacy of liposomal siRNA in controlling the expression of genes (Caspase 3 and ADAMTS 5). Later, siRNA's validation was done in a rabbit annular punctured model by administering siRNA's individually (Caspase 3 and ADAMTS5) and in combination Caspase3-ADAMTS5) for assessing their synergistic effect in down regulating the gene expression in the degenerative discs. Annular punctured intervertebral discs of the rabbit were injected with siRNA formulations (single and dual) and PBS, one week after initial puncture. Magnetic resonance imaging (MRI) scans were done before and after siRNA treatment (1, 4 and 8 weeks) for assessing the progression of disc degeneration. The histopathology and real time polymerase chain reaction (RT-PCR) studies were done for evaluating their efficacy. We did not receive any funding for conducting the study, and we do not have a conflict of interest with any researchers or scientific groups.

Results

The observations made from both in vitro and in vivo studies indicate the beneficial effects of siRNA formulation in down regulating the expression of Caspase 3 and ADAMTS5 genes. The MRI and histopathological evaluation showed that the disc degeneration was progressive in PBS and AT5-siRNA injected discs but the discs that received Caspase 3-siRNA and dual siRNA (Cas3-AT5-siRNA) formulation showed signs of recovery and regeneration 4 and 8 weeks after injection. The efficacy of siRNA designed against Cas3 and AT5 was also assessed in both in vitro and in vivo experiments by using RT-PCR analysis and the results showed downregulation of Caspase 3 gene in caspase 3-siRNA group, but there was no significant downregulation of ADAMTS 5 gene in ADAMTS5-siRNA group (i.e. indicated by fold change). Synergistic effect was observed in the group that received dual siRNA (Cas3-AT5 siRNA) formulation.

Conclusion

This experiment suggests that intervention by siRNA treatment significantly reduced the extent of apoptosis in the discs.

Clinical Significance

Delivery of siRNA directly into spinal discs has a potential in treating disc degeneration non-surgically.

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