Contribution of collagen fibers to the compressive stiffness of cartilaginous tissues

Cartilaginous tissues such as the intervertebral disk are predominantly loaded under compression. Yet, they contain abundant collagen fibers, which are generally assumed to contribute to tensile loading only. Fiber tension is thought to originate from swelling of the proteoglycan-rich nucleus. However, in aged or degenerate disk, proteoglycans are depleted, whereas collagen content changes little. The question then rises to which extend the collagen may contribute to the compressive stiffness of the tissue. We hypothesized that this contribution is significant at high strain magnitudes and that the effect depends on fiber orientation. In addition, we aimed to determine the compression of the matrix. Bovine inner and outer annulus fibrosus specimens were subjected to incremental confined compression tests up to 60 % strain in radial and circumferential direction. The compressive aggregate modulus was determined per 10 % strain increment. The biochemical composition of the compressed specimens and uncompressed adjacent tissue was determined to compute solid matrix compression. The stiffness of all specimens increased nonlinearly with strain. The collagen-rich outer annulus was significantly stiffer than the inner annulus above 20 % compressive strain. Orientation influenced the modulus in the collagen-rich outer annulus. Finally, it was shown that the solid matrix was significantly compressed above 30 % strain. Therefore, we concluded that collagen fibers significantly contribute to the compressive stiffness of the intervertebral disk at high strains. This is valuable for understanding the compressive behavior of collagen-reinforced tissues in general, and may be particularly relevant for aging or degenerate disks, which become more fibrous and less hydrated.     

Mechanisms for mechanical damage in the intervertebral disc annulus fibrosus

Intervertebral disc degeneration results in disorganization of the laminate structure of the annulus that may arise from mechanical microfailure. Failure mechanisms in the annulus were investigated using composite lamination theory and other analyses to calculate stresses in annulus layers, interlaminar shear stress, and the region of stress concentration around a fiber break. Scanning electron microscopy (SEM) was used to evaluate failure patterns in the annulus and evaluate novel structural features of the disc tissue. Stress concentrations in the annulus due to an isolated fiber break were localized to approximately 5 microm away from the break, and only considered a likely cause of annulus fibrosus failure (i.e., radial tears in the annulus) under extreme loading conditions or when collagen damage occurs over a relatively large region. Interlaminar shear stresses were calculated to be relatively large, to increase with layer thickness (as reported with degeneration), and were considered to be associated with propagation of circumferential tears in the annulus. SEM analysis of intervertebral disc annulus fibrosus tissue demonstrated a clear laminate structure, delamination, matrix cracking, and fiber failure. Novel structural features noted with SEM also included the presence of small tubules that appear to run along the length of collagen fibers in the annulus and a distinct collagenous structure representative of a pericellular matrix in the nucleus region.     

Live free or die: stretch-induced apoptosis occurs when adaptive reorientation of annulus fibrosus cells is restricted

High matrix strains in the intervertebral disc occur during physiological motions and are amplified around structural defects in the annulus fibrosus (AF). It remains unknown if large matrix strains in the human AF result in localized cell death. This study investigated strain amplitudes and substrate conditions where AF cells were vulnerable to stretch-induced apoptosis. Human degenerated AF cells were subjected to 1 Hz-cyclic tensile strains for 24h on uniformly collagen coated substrates and on substrates with 40 μm stripes of collagen that restricted cellular reorientation. AF cells were capable of responding to stretch (stress fibers and focal adhesions aligned perpendicular to the direction of stretch), but were vulnerable to stretch-induced apoptosis when cytoskeletal reorientation was restricted, as could occur in degenerated states due to fibrosis and crosslink accumulation and at areas where high strains occur (around structural defects, delaminations, and herniations).     

Modeling interlamellar interactions in angle-ply biologic laminates for annulus fibrosus tissue engineering

Mechanical function of the annulus fibrosus of the intervertebral disc is dictated by the composition and microstructure of its highly ordered extracellular matrix. Recent work on engineered angle-ply laminates formed from mesenchymal stem cell (MSC)-seeded nanofibrous scaffolds indicates that the organization of collagen fibers into planes of alternating alignment may play an important role in annulus fibrosus tissue function. Specifically, these engineered tissues can resist tensile deformation through shearing of the interlamellar matrix as layers of collagen differentially reorient under load. In the present work, a hyperelastic constitutive model was developed to describe the role of interlamellar shearing in reinforcing the tensile response of biologic laminates, and was applied to experimental results from engineered annulus constructs formed from MSC-seeded nanofibrous scaffolds. By applying the constitutive model to uniaxial tensile stress–strain data for bilayers with three different fiber orientations, material parameters were generated that characterize the contributions of extrafibrillar matrix, fibers, and interlamellar shearing interactions. By 10 weeks of in vitro culture, interlamellar shearing accounted for nearly 50% of the total stress associated with uniaxial extension in the anatomic range of ply angle. The model successfully captured changes in function with extracellular matrix deposition through variations in the magnitude of model parameters with culture duration. This work illustrates the value of engineered tissues as tools to further our understanding of structure–function relations in native tissues and as a test-bed for the development of constitutive models to describe them.     

Human annulus fibrosus material properties from biaxial testing and constitutive modeling are altered with degeneration

The annulus fibrosus (AF) of the intervertebral disk undergoes large and multidirectional stresses and strains. Uniaxial tensile tests are limited for measuring AF material properties, because freely contracting edges can prevent fiber stretch and are not representative of in situ boundary conditions. The objectives of this study were to measure human AF biaxial tensile mechanics and to apply and validate a constitutive model to determine material properties. Biaxial tensile tests were performed on samples oriented along the circumferential–axial and the radial–axial directions. Data were fit to a structurally motivated anisotropic hyperelastic model composed of isotropic extra-fibrillar matrix, nonlinear fibers, and fiber–matrix interactions (FMI) normal to the fibers. The validated model was used to simulate shear and uniaxial tensile behavior, to investigate AF structure–function, and to quantify the effect of degeneration. The biaxial stress–strain response was described well by the model (R ²?>?0.9). The model showed that the parameters for fiber nonlinearity and the normal FMI correlated with degeneration, resulting in an elongated toe-region and lower stiffness with degeneration. The model simulations in shear and uniaxial tension successfully matched previously published circumferential direction Young’s modulus, provided an explanation for the low values in previously published axial direction Young’s modulus, and was able to simulate shear mechanics. The normal FMI were important contributors to stress and changed with degeneration, therefore, their microstructural and compositional source should be investigated. Finally, the biaxial mechanical data and constitutive model can be incorporated into a disk finite element model to provide improved quantification of disk mechanics.     

The micromechanical role of the annulus fibrosus components under physiological loading of the lumbar spine

To date, studies that have investigated the kinematics of spinal motion segments have largely focused on the contributions that the spinal ligaments play in the resultant motion patterns. However, the specific roles played by intervertebral disk components, in particular the annulus fibrosus, with respect to global motion is not well understood in spite of the relatively large literature base with respect to the local ex vivo mechanical properties of the tissue. The primary objective of this study was to implement the nonlinear and orthotropic mechanical behavior of the annulus fibrosus in a finite element model of an L4/L5 functional spinal unit in the form of a strain energy potential where the individual mechanical contributions of the ground substance and fibers were explicitly defined. The model was validated biomechanically under pure moment loading to ensure that the individual role of each soft tissue structure during load bearing was consistent throughout the physiologically relevant loading range. The fibrous network of the annulus was found to play critical roles in limiting the magnitude of the neutral zone and determining the stiffness of the elastic zone. Under flexion, lateral bending, and axial rotation, the collagen fibers were observed to bear the majority of the load applied to the annulus fibrosus, especially in radially peripheral regions where disk bulging occurred. For the first time, our data explicitly demonstrate that the exact fiber recruitment sequence is critically important for establishing the range of motion and neutral zone magnitudes of lumbar spinal motion segments.     

Mechanical damage to the intervertebral disc annulus fibrosus subjected to tensile loading

Damage of the annulus fibrosus is implicated in common spinal pathologies. The objective of this study was to obtain a quantitative relationship between both the number of cycles and the magnitude of tensile strain resulting in damage to the annulus fibrosus. Four rectangular tensile specimens oriented in the circumferential direction were harvested from the outer annulus of 8 bovine caudal discs (n = 32) and subjected to one of four tensile testing protocols: (i) ultimate tensile strain (UTS) test; (ii) baseline cyclic test with 4 series of 400 cycles of baseline cyclic loading (peak strain = 20% UTS); (iii & iv) acute and fatigue damage cyclic tests consisting of 4 x 400 cycles of baseline cyclic loading with intermittent loading to 1 and 100 cycles, respectively, with peak tensile strain of 40%, 60%, and 80% UTS. Normalized peak stress for all mechanically loaded specimens was reduced from 0.89 to 0.11 of the baseline control levels, and depended on the magnitude of damaging strain and number of cycles at that damaging strain. Baseline, acute, and fatigue protocols resulted in permanent deformation of 3.5%, 6.7% and 9.6% elongation, respectively. Damage to the laminate structure of the annulus in the absence of biochemical activity in this study was assessed using histology, transmission electron microscopy, and biochemical measurements and was most likely a result of separation of annulus layers (i.e., delamination). Permanent elongation and stress reduction in the annulus may manifest in the motion segment as sub-catastrophic damage including increased neutral zone, disc bulging, and loss of nucleus pulposus pressure. The preparation of rectangular tensile strip specimens required cutting of collagen fibers and may influence absolute values of results, however, it is not expected to affect the comparisons between loading groups or dose-response reported.     

A homogenization model of the annulus fibrosus

The objective of this study was to use a homogenization model of the anisotropic mechanical behavior of annulus fibrosus (AF) to address some of the issues raised in structural finite element and fiber-reinforced strain energy models. Homogenization theory describes the effect of microstructure on macroscopic material properties by assuming the material is composed of repeating representative volume elements. We first developed the general homogenization model and then specifically prescribed the model to in-plane single lamella and multi-lamellae AF properties. We compared model predictions to experimentally measured AF properties and performed parametric studies. The predicted tensile moduli (E theta and E z) and their dependence on fiber volume fraction and fiber angle were consistent with measured values. However, the model prediction for shear modulus (G thetaz) was two orders of magnitude larger than directly measured values. The values of E theta and E z were strongly dependent on the model input for matrix modulus, much more so than the fiber modulus. These parametric analyses demonstrated the contribution of the matrix in AF load support, which may play a role when protoeglycans are decreased in disc degeneration, and will also be an important design factor in tissue engineering. We next compared the homogenization model to a 3-D structural finite element model and fiber-reinforced energy models. Similarities between the three model types provided confidence in the ability of these models to predict AF tissue mechanics. This study provides a direct comparison between the several types of AF models and will be useful for interpreting previous studies and elucidating AF structure-function relationships in disc degeneration and for functional tissue engineering.     

Fatigue loading of tendon results in collagen kinking and denaturation but does not change local tissue mechanics

Fatigue loading is a primary cause of tendon degeneration, which is characterized by the disruption of collagen fibers and the appearance of abnormal (e.g., cartilaginous, fatty, calcified) tissue deposits. The formation of such abnormal deposits, which further weakens the tissue, suggests that resident tendon cells acquire an aberrant phenotype in response to fatigue damage and the resulting altered mechanical microenvironment. While fatigue loading produces clear changes in collagen organization and molecular denaturation, no data exist regarding the effect of fatigue on the local tissue mechanical properties. Therefore, the objective of this study was to identify changes in the local tissue stiffness of tendons after fatigue loading. We hypothesized that fatigue damage would reduce local tissue stiffness, particularly in areas with significant structural damage (e.g., collagen denaturation). We tested this hypothesis by identifying regions of local fatigue damage (i.e., collagen fiber kinking and molecular denaturation) via histologic imaging and by measuring the local tissue modulus within these regions via atomic force microscopy (AFM). Counter to our initial hypothesis, we found no change in the local tissue modulus as a consequence of fatigue loading, despite widespread fiber kinking and collagen denaturation. These data suggest that immediate changes in topography and tissue structure – but not local tissue mechanics – initiate the early changes in tendon cell phenotype as a consequence of fatigue loading that ultimately culminate in tendon degeneration.     

Bovine annulus fibrosus hydration affects rate-dependent failure mechanics in tension

The high water content of the intervertebral disc is essential to its load bearing function and viscoelastic mechanical behavior. One of the primary biochemical changes associated with disc degeneration is the loss of proteoglycans, which leads to tissue dehydration. While previous studies have reported the effects of in vivo degeneration on annulus fibrosus (AF) failure mechanics, the independent role of water remains unclear, as does the tissue’s rate-dependent failure response. Our first objective was to determine the effect of loading rate on AF failure properties in tension; our second objective was to quantify the effect of water content on failure properties. Water content was altered through enzymatic digestion of glycosaminoglycans (GAGs) and through osmotic loading. Bovine AF specimens were tested monotonically to failure along the circumferential direction at 0.00697%/s or 6.97%/s. Increased loading rate resulted in a ∼50% increase in linear-region modulus, failure stress, and strain energy density across all treatment groups (p < 0.001). Decreased GAG and water contents resulted in decreased modulus, failure stress, and strain energy density; however, these differences were only observed at the low loading rate (p < 0.05; no changes at high rate). Osmotic loading was used to evaluate the effect of hydration independently from GAG composition, resulting in similar decreases in water content, modulus, and strain energy density. This suggests that hydration is essential for maintaining tissue stiffness and energy absorption capacity, rather than strength, and that GAGs contribute to tissue strength independently from mediating water content.     

Ex-vivo observation of calcification process in chick tibia slice: Augmented calcification along collagen fiber orientation in specimens subjected to static stretch

Bone formation through matrix synthesis and calcification in response to mechanical loading is an essential process of the maturation in immature animals, although how mechanical loading applied to the tissue increases the calcification and improves mechanical properties, and which directions the calcification progresses within the tissue are largely unknown. To address these issues, we investigated the calcification of immature chick bone under static tensile stretch using a newly developed real-time observation bioreactor system. Bone slices perpendicular to the longitudinal axis obtained from the tibia in 2- to 4-day-old chick legs were cultured in the system mounted on a microscope, and their calcification was observed up to 24 h while they were stretched in the direction parallel to the slice. Increase in the calcified area, traveling distance and the direction of the calcification and collagen fiber orientation in the newly calcified region were analyzed. There was a significant increase in calcified area in the bone explant subjected to tensile strain over ∼3%, which corresponds to the threshold strain for collagen fibers showing alignment in the direction of stretch, indicating that the fiber alignment may enhance tissue calcification. The calcification progressed to a greater distance to the stretching direction in the presence of the loading. Moreover, collagen fiber orientation in the calcified area in the loaded samples was coincided with the progression angle of the calcification. These results clearly show that the application of static tensile strain enhanced tissue calcification, which progresses along collagen fibers aligned to the loading direction.     

Barriers to mesenchymal stromal cells for low back pain

Intervertebral disc degeneration is the main cause of low back pain. In the past 20 years, the injection of mesenchymal stromal cells (MSCs) into the nucleus pulposus of the degenerative disc has become the main approach for the treatment of low back pain. Despite the progress made in this field, there are still many barriers to overcome. First, intervertebral disc is a highly complex load-bearing composite tissue composed of annulus fibrosus, nucleus pulposus and cartilaginous endplates. Any structural damage will change its overall biomechanical function, thereby causing progressive degeneration of the entire intervertebral disc. Therefore, MSC-based treatment strategies should not only target the degenerated nucleus pulposus but also include degenerated annulus fibrosus or cartilaginous endplates. Second, to date, there has been relatively little research on the basic biology of annulus fibrosus and cartilaginous endplates, although their pathological changes such as annular tears or fissures, Modic changes, or Schmorl's nodes are more commonly associated with low back pain. Given the high complexity of the structure and composition of the annulus fibrosus and cartilaginous endplates, it remains an open question whether any regeneration techniques are available to achieve their restorative regeneration. Finally, due to the harsh microenvironment of the degenerated intervertebral disc, the delivered MSCs die quickly. Taken together, current MSC-based regenerative medicine therapies to regenerate the entire disc complex by targeting the degenerated nucleus pulposus alone are unlikely to be successful.     

Experimental analysis of the transverse mechanical behaviour of annulus fibrosus tissue

Uniaxial tensile and relaxation tests were carried out on annulus fibrosus samples carved out in the circumferential direction. Images were shot perpendicularly to the loading direction. Digital image correlation techniques accurately measured the evolution of full displacement fields in both transverse directions: plane of fibres and plane of lamellae. In the fibre plane, strains were governed by the reorientation of fibres along the loading direction. This implies strong transverse shrinkage with quasi-linear behaviour. Conversely, a wide range of behaviour was observed in the lamella plane: from shrinkage to swelling. Strong nonlinear evolutions were generally obtained. The strain field in the lamella plane generally presented a central strip section with more pronounced swelling. Our physical interpretation relies on the porous nature of annulus tissue and its anisotropic stiffness. Indeed, the liquid over-pressure generated inside the sample by the strong shrinkage in the fibre plane discharges in the perpendicular direction since rigidity is lower in the lamella plane. Regarding the strain field measured in the lamella plane, this interpretation agrees with (a) symmetric strain distribution with respect to the longitudinal axis of samples, (b) the reversal in behaviour from shrinkage to swelling and (c) the decrease in strain during relaxation tests associated with outward flows. The variety of transverse behaviours observed experimentally could result from uncertainties regarding the initial reference state of tissue samples. Since the mechanical behaviour is highly nonlinear, experimental results underline that a slight uncertainty concerning the pre-stress applied to samples can lead to wide variability in the mechanical properties identified.     

Moderately degenerated lumbar motion segments: Are they truly unstable?

The two main load bearing tissues of the intervertebral disc are the nucleus pulposus and the annulus fibrosus. Both tissues are composed of the same basic components, but differ in their organization and relative amounts. With degeneration, the clear distinction between the two tissues disappears. The changes in biochemical content lead to changes in mechanical behaviour of the intervertebral disc. The aim of the current study was to investigate if well-documented moderate degeneration at the biochemical and fibre structure level leads to instability of the lumbar spine. By taking into account biochemical and ultrastructural changes to the extracellular matrix of degenerating discs, a set of constitutive material parameters were determined that described the individual tissue behaviour. These tissue biomechanical models were then used to simulate dynamic behaviour of the degenerated spinal motion segment, which showed instability in axial rotation, while a stabilizing effect in the other two principle bending directions. When a shear load was applied to the degenerated spinal motion segment, no sign of instability was found. This study found that reported changes to the nucleus pulposus and annulus fibrosus matrix during moderate degeneration lead to a more stable spinal motion segment and that such biomechanical considerations should be incorporated into the general pathophysiological understanding of disc degeneration and how its progress could affect low back pain and its treatments thereof.     

Strain transfer in the annulus fibrosus under applied flexion

A detailed understanding of the anatomical and mechanical environment in the intervertebral disc at the scale of the cell is necessary for the design of tissue engineering repair strategies and to elucidate the role of mechanical factors in pathology. The objective of this study was to measure and compare the macroscale to microscale strains in the outer annulus fibrosus in various cellular regions of intact discs over a range of applied flexion. Macroscale strains were measured on the annulus fibrosus surface, and contrasted to in situ microscale strains using novel confocal microscopy techniques for dual labeling of the cell and the extracellular matrix. Fiber oriented surface strains were significantly higher than in situ fiber strains, which implies a mechanism of load redistribution that minimizes strain along the fibers. Non-uniformity of the strains and matrix distortion occurred immediately and most interestingly varied little with increase in flexion (3–16°), suggesting that inter-fiber shear is important in the initial stages of strain redistribution. Fiber oriented intercellular strains were significantly larger and compressive compared to in situ strains in other regions of the extracellular matrix indicating that the mechanical environment in this region may be unique. Further examination of the structural morphology in this pericellular region is needed to fully understand the pathway of strain transfer from the tissue to the cell. This study provides new knowledge on the complex in situ micro-mechanical environment of the annulus fibrosus that is essential to understanding the mechanobiological behavior of this tissue.     

Improved prediction of the collagen fiber architecture in the aortic heart valve

Living tissues show an adaptive response to mechanical loading by changing their internal structure and morphology. Understanding this response is essential for successful tissue engineering of load-bearing structures, such as the aortic valve. In this study, mechanically induced remodeling of the collagen architecture in the aortic valve was investigated. It was hypothesized that, in uniaxially loaded regions, the fibers aligned with the tensile principal stretch direction. For biaxial loading conditions, on the other hand, it was assumed that the collagen fibers aligned with directions situated between the principal stretch directions. This hypothesis has already been applied successfully to study collagen remodeling in arteries. The predicted fiber architecture represented a branching network and resembled the macroscopically visible collagen bundles in the native leaflet. In addition, the complex biaxial mechanical behavior of the native valve could be simulated qualitatively with the predicted fiber directions. The results of the present model might be used to gain further insight into the response of tissue engineered constructs during mechanical conditioning.     

Glycation increases human annulus fibrosus stiffness in both experimental measurements and theoretical predictions

One of the primary age-related changes to collagenous tissues is the increased concentration of advanced glycation endproducts (AGEs). Although AGEs have been shown to increase the mechanical stiffness of many tissues, their influence on the mechanical properties of the annulus fibrosus has not been measured experimentally. In previous theoretical work, we hypothesized that the mechanical influence of AGEs on the annulus could be represented in an additive strain energy function with a separate crosslinking term, but the material coefficients associated with this term were not correlated with AGE concentration. In the current study, we measured the tensile stress-strain response of the human annulus in the axial direction both before and after glycation with methylglyoxal. Using nonlinear regression, the strain energy function was simultaneously applied to these new data and to data from a wide range of experimental protocols reported in the literature to determine values for the material coefficients appearing in the constitutive equation. Nonenzymatic collagen crosslinking induced a statistically significant change in annular material properties. Furthermore, the concentration of AGEs correlated positively with the material coefficients found in the terms of the strain energy function that we associate with collagen crosslinking. These data suggest that AGEs contribute to age-related disc stiffening as well as validate the hypothesis that biochemical constituents can be related mathematically to tissue behavior. In the future, this structurally guided constitutive relationship may provide further insight into the structure-function relationships of the annulus fibrosus.     

The involvement of interleukin-1 and interleukin-4 in the response of human annulus fibrosus cells to cyclic tensile strain: an altered mechanotransduction pathway with degeneration

Introduction  

Recent evidence suggests that intervertebral disc (IVD) cells derived from degenerative tissue are unable to respond to physiologically relevant mechanical stimuli in the 'normal' anabolic manner, but instead respond by increasing matrix catabolism. Understanding the nature of the biological processes which allow disc cells to sense and respond to mechanical stimuli (a process termed 'mechanotransduction') is important to ascertain whether these signalling pathways differ with disease. The aim here was to investigate the involvement of interleukin (IL)-1 and IL-4 in the response of annulus fibrosus (AF) cells derived from nondegenerative and degenerative tissue to cyclic tensile strain to determine whether cytokine involvement differed with IVD degeneration.     

Application of a fiber-reinforced continuum theory to multiple deformations of the annulus fibrosus.

Accurate tissue stress predictions for the annulus fibrosus are essential for understanding the factors that cause or contribute to disc degeneration and mechanical failure. Current computational models used to predict in vivo disc stresses utilize material laws for annular tissue that are not rigorously validated against experimental data. Consequently, predictions of disc stress resulting from physical activities may be inaccurate and therefore unreliable as a basis for defining mechanical-biologic injury criteria. To address this need we present a model for the annulus as an isotropic ground substance reinforced with two families of collagen fibers, and an approach for determining the material constants by simultaneous consideration of multiple experimental data sets. Two strain energy functions for the annulus are proposed and used in the theory to derive the constitutive equations relating the stress to pure stretch deformations. These equations are applied to four distinct experimental protocols and the material constants are determined from a simultaneous, nonlinear regression analysis. Good agreement between theory and experiment is achieved when the invariants are included within multiple, separate exponentials in the strain energy function.