Degenerative disc disease (DDD) is one of the main cause of chronic low back pain, which is a major cause of lowering the quality of life and limiting the social activities of back pain patients. With the rapid growth of the elderly population due to the development of medical and health technologies, degenerative diseases are emerging as an important issue not only for improving the quality of life of the elderly population but also for social cost reduction.
Among them, DDD is one of the typical degenerative diseases that many older people suffer from, and is caused by the degeneration of the intervertebral disc (IVD), a shock absorbing tissue between the vertebrae that provides flexibility to the spine. The disc consists of nucleus pulposus (NP) consisting mainly of proteoglycan (PG) and annulus fibrosus (AF), which is mainly composed of collagen, surrounding the NP. Aging or physical stress, accompanied by biochemical degeneration, causes degeneration of these disc tissues leading to disease.
To date, there have been various attempts to treat DDD, including conservative treatments such as drug therapy, injection therapy, physiotherapy, simple surgery, and artificial disc replacement. However, there is no fundamental cure to restore a degenerated disc. Recently, regenerative therapy using growth hormone or stem cells has been studied but is still in preclinical or clinical trials. Disc tissue is known to have difficulty to regenerate or repair because of the closed nature of the tissue, which is not developed with blood vessels. Therefore, for the fundamental treatment of DDD, there is a need for a regenerative treatment method that is simple and easy to apply to clinical application, so we wanted to develop an in vivo material capable of regenerating degenerated disc tissue.
Peniel2000 (P2K) is a synthetic peptide substance that prevents disc degeneration, induces disc regeneration and also relieves pain, a typical symptom of DDD. This effect is due to the modulation of the signal transduction pathway of TGF-β1, a protein that promotes disc degeneration. P2K blocks Smad1/5/8 pathway, which is a pathway that promotes disc degeneration, by binding to TGF-β1, and induces disc regeneration by activating the Smad2/3 pathway that induces disc regeneration. P2K also has pain relief effects by reducing the pain factor NGF gene expression.