Spinal Therapeutics Lab
The Spinal Therapeutics Lab (STL) is a Biomedical Engineering research group at The Ohio State University led by Dr. Devina Purmessur that specializes in studying low back pain (LBP). We focus on understanding the biochemical, biomechanical and cellular mechanisms underlying pathophysiology in discogenic back pain with translation from 2D to 3D and in-vivo models.
The STL works closely with the Spine Research Institute (SRI), Department of Orthopaedics at the OSU Wexner Medical Center, OSU College of Veterinary Medicine, Orthopaedic Research Laboratories at Icahn School of Medicine, Mount Sinai and the Institute of Inflammation and Repair at The University of Manchester.
This collaboration strives to further biomedical research in the spine field, with an objective of developing preventative guidelines, diagnostic tools, surgical tools and techniques, and minimally invasive treatments of low back pain.
Low Back Pain
Chronic low back pain (LBP) is one of the leading musculoskeletal disorders associated with years lived with disability and generates annual healthcare costs over $100 billion in the US alone. According to the National Institute of Health(NIH), the magnitude of burden from LBP has grown worse in recent years. In 1990, a study ranking the most burdensome conditions in the U.S. in terms of mortality or poor health as a result of disease put LBP in sixth place; in 2010, LBP jumped to third place with only ischemic heart disease and chronic obstructive pulmonary disease ranking higher.
Intervertebral Disk Degeneration
Lumbar intervertebral discs (IVD) have been implicated in pathogenesis of LBP. The onset of IVD degeneration can be caused by genetic precursors, acute injury, occupational factors or simply age. Painful disc disease is characterized by a loss of structural integrity and function, a decrease in cellularity and high levels of pro-inflammatory cytokines. However, current treatment strategies are highly invasive with poor surgical outcomes and fail to target the underlying disease pathology and aberrant cell biology.
Spinal Therapeutics Lab Research
STL strives to further IVD research in order to develop diagnostic tools and minimally invasive treatments of IVD degeneration. The identification of disc degeneration and pain biomarkers is crucial for the diagnosis of LBP source. Minimally invasive treatments allow better patient outcomes through faster recovery, shorter hospitalition periods and most importantly reduced damage to adjoining tissue.
Investigation is done through the development of in vitro 2D and 3D models that allow the control of the biochemical, mechanical and matrix microenvironment. These models help the testing of established hypotheses and lead to the development of new questions that fuel research.
STL utilizes 2D culture models to explore new concepts and test preliminary hypotheses. 3D models such as pellet and hydrogel constructs increase model relevance to mimic IVD conditions. Co-culture hydrogel constructs allow for direct cell-cell interaction while maintaining the ability to control model culture conditions.
Stem cell therapy and engineered Intervertebral Discs have been proposed to to treat IVD degeneration. However, there are caveats with such techniques. Pro-anabolic approaches have been proposed such as viral gene editing, however viral transfections can cause mutagenesis and immune rejection. Our work used novel nanotechnology and engineered vesicles to deliver "healthy" factors into IVD cells on the cellular and tissue level to reprogram disease cells back to a native phenotype.
The immune system plays a vital role in regulating body homeostasis. In times of disease/sickness it can be activated to release a cascade of inflammatory cells and molecules that protect and remodel our body to prevent further damage. The intervertebral disc has a unique avascular environment, making it difficult for immune cells to infiltrate this organ. Even so, immune cells have been shown to be present in the disc, however their function remains unknown. Understanding the roles that different immune cells found in the disc have on structure and function of the IVD is vital to developing better treatments for LBP.
The healthy intervertebral disc (IVD) is avascular and aneural, in part due to the inhibitory effects of extracellular matrix components such as Aggrecan. During the progression of IVD degeneration, however, there is a shift in matrix remodeling with a net loss in extracellular matrix components. This matrix breakdown coincides with angiogenesis and neoinnervation into the disc, resulting in discogenic back pain. Although Aggrecan has been shown to inhibit nerve growth, the exact mechanism is still unknown. By examining the inhibitory effects of various components of the extracellular matrix on neurovascular ingrowth, possible therapeutics can be developed.
The Intervertebral Disc (IVD) along with being the largest aneural organ in the human body is the largest avascular organ in the human body as well. This means the IVD's sole source of nutrition is from diffusion through the Cartilaginous End Plates between the IVD-Vertebra interface and the periphery. This lack of nutrition results in low levels of glucose and oxygen and high levels of lactic acid in the center of the IVD. Using this information, we strive to understand how the individual cells of the IVD cope with this unique and harsh environment.
Mechanical load is a large part of the IVD environment and has been shown to induce cell response and differentiation. In order to mimic in vivo conditions, a modular soft tissue bioreactor is used to apply mechanical load to the 3D in vitro models including hygrogel cultures and organ cultures.
End Plate Calcificaiton
The normally avascular, aneural intervertebral disc relies on diffusion of metabolites through the cartilage end plate for nutrition. During disc disease, the cartilage end plate becomes increasingly calcified and loses porosity, making diffusion of nutrients difficult and expediting degeneration. We aim to explore the mechanisms of this calcification process and determine potential therapeutic targets.
In Vivo and Ex-Vivo Models
Translational medicine is enabled by the use of in vivo and ex vivo animal models to study disease pathology and options for treatment. Research on biological occurrences within relevant experimental animal models enables insight into the workings of the human condition. Specifically pertaining to the intervertebral disc, pet dogs are commonly treated by veterinary specialists for painful pathologies not entirely different from those experienced by people. Understanding the function of the canine intervertebral disc can promote translation to human painful disc disease while additionally contributing insight into the veterinary patient population.
Kelly Thompson; Sarah Moore; Shirley Tang; Matthew Wiet; Devina Purmessur, 2018, "The chondrodystrophic dog: A clinically relevant intermediate‐sized animal model for the study of intervertebral disc‐associated spinal pain.", JOR Spine. Volume 1, Issue 1.
Wiet MG; Piscioneri A; Khan SN; Ballinger MN; Hoyland JA; Purmessur D., 2017, "Mast Cell-Intervertebral disc cell interactions regulate inflammation, catabolism and angiogenesis in Discogenic Back Pain." Scientific Reports 7, no.12492.
Palacio-Mancheno, P. E.; Evashwick-Rogler, T. W.; Laudier, D. M.; Purmessur, D; and Iatridis, J. C. (2017), "Hyperosmolarity induces notochordal cell differentiation with aquaporin3 upregulation and reduced N-cadherin expression. "J. Orthop. Res.. doi:10.1002/jor.23715
William S. Marras; Benjamin A. Walter; Devina Purmessur; Prasath Mageswaran; Matthew G. Wiet; 2016, "The Contribution of Biomechanical-Biological Interactions of the Spine to Low Back Pain." Human Factors Vol 58, no. 7, 965-975
Alon Lai; Andrew Moon; Devina Purmessur; Branko Skovrlj; Damien M. Laudier; Beth A. Winkelstein; Samuel K. Cho; Andrew C. Hecht; James C. Iatridis; 2016, "Annular puncture with tumor necrosis factor-alpha injection enhances painful behavior with disc degeneration in vivo." The Spine Journal, Volume 16, no. 3, 2016, 420-431.
Alon, Lai; Andrew, Moon; Devina, Purmessur; Branko,Skovrlj; Damien M.Laudier; Beth A.Winkelstein; Samuel K.Cho; Andrew C.Hect; James C.Iatridis, 2015, "Annular puncture with tumor necrosis factor-alpha injection enhances painful behavior with disc degeneration in vivo.", The Spine Journal 16, no.3, 420-431.
Walter, Benjamin A.; Purmessur, Devina; Likhitpanichkul, Morakot; Weinberg, Alan; Cho, Samuel K.; Qureshi, Sheeraz A.; Hecht, Andrew C; Iatridis, James C. PhD, 2015, "Inflammatory Kinetics and Efficacy of Anti-inflammatory Treatments on Human Nucleus Pulposus Cells.", The Spine Journal 40, no.13, 955-963.
Cornejo,M,C; Cho,S,K; Giannarelli,C; Iatridis,J,C; Purmessur,D, 2015, "Soluble factors from the notochordal-rich intervertebral disc inhibit endothelial cell invasion and vessel formation in the presence and absence of pro-inflammatory cytokines."OSTEOARTHRITIS AND CARTILAGE 23, no. 3, 487 - 496.
Purmessur,Devina; Cornejo,Marisa,C; Cho,Samuel,K; Roughley,Peter,J; Linhardt,Robert,J; Hecht,Andrew,C; Iatridis,James,C,2015, "Intact glycosaminoglycans from intervertebral disc-derived notochordal cell-conditioned media inhibit neurite growth while maintaining neuronal cell viability." SPINE JOURNAL 15, no. 5, 1060 - 1069.
Lai,Alon; Moon,Andrew; Purmessur,Devina; Skovrlj,Branko; Winkelstein,Beth,A; Cho,Samuel,K; Hecht,Andrew,C; Iatridis,James,C, 2015, "Assessment of Functional and Behavioral Changes Sensitive to Painful Disc Degeneration."JOURNAL OF ORTHOPAEDIC RESEARCH 33, no. 5, 755 - 764.
Lu,Young; Guzman,Javier,Z; Purmessur,Devina; Iatridis,James,C; Hecht,Andrew,C; Qureshi,Sheeraz,A; Cho,Samuel,K, 2014, "Nonoperative Management of Discogenic Back Pain A Systematic Review." SPINE 39, no. 16, 1314 - 1324.
Illien-Jünger,Svenja; Lu,Young; Purmessur,Devina; Mayer,Jillian,E; Walter,Benjamin,A; Roughley,Peter,J; Qureshi,Sheeraz,A; Hecht,Andrew,C; Iatridis,James,C, 2014, "Detrimental effects of discectomy on intervertebral disc biology can be decelerated by growth factor treatment during surgery: a large animal organ culture model.." spine journal 14, no. 11, 2724 -2732.
Guterl,Clare,C; Torre,Olivia,M; Purmessur,Devina; Dave,Khyati; Likhitpanichkul,Morakot; Hecht,Andrew,C; Nicoll,Steven,B; Iatridis,James,C, 2014, "Characterization of Mechanics and Cytocompatibility of Fibrin-Genipin Annulus Fibrosus Sealant with the Addition of Cell Adhesion Molecules." TISSUE ENGINEERING PART A 20, no. 17-18, 2536 - 2545.
Illien-Juenger,Svenja; Lu,Young; Purmessur,Devina; Mayer,Jillian,E; Walter,Benjamin,A; Roughley,Peter,J; Qureshi,Sheeraz,A; Hecht,Andrew,C; Iatridis,James,C, 2014, "Detrimental effects of discectomy on intervertebral disc biology can be decelerated by growth factor treatment during surgery: a large animal organ culture model." SPINE JOURNAL 14, no. 11,2724 - 2732.
Purmessur,Devina; Guterl,Clare,C; Cho,Samuel,K; Cornejo,Marisa,C; Lam,Ying,W; Ballif,Bryan,A; Laudier,Damien,M; Iatridis,James,C, 2013, "Dynamic pressurization induces transition of notochordal cells to a mature phenotype while retaining production of important patterning ligands from development." ARTHRITIS RESEARCH & THERAPY 15, no. 5, R122-
Abbott,Rosalyn,D; Purmessur,Devina; Monsey,Robert,D; Brigstock,David,R; Laudier,Damien,M; Iatridis,James,C, 2013, "Degenerative Grade Affects the Responses of Human Nucleus Pulposus Cells to Link-N, CTGF, and TGF beta 3." JOURNAL OF SPINAL DISORDERS & TECHNIQUES 26, no. 3, E86 - E94.
Purmessur,D; Walter,B,A; Roughley,P,J; Laudier,D,M; Hecht,A,C; Iatridis,James, 2013, "A role for TNF alpha in intervertebral disc degeneration: A non-recoverable catabolic shift." BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS433, no. 1, 151 - 156.
Purmessur,D; Cornejo,M,C; Cho,S,K; Hecht,A,C; Iatridis,J,C, 2013, "Notochordal cell-derived therapeutic strategies for discogenic back pain.." Global spine journal 3, no. 3, 201 - 218.
Richardson,Stephen,M; Purmessur,Devina; Baird,Pauline; Probyn,Ben; Freemont,Anthony,J; Hoyland,Judith,A, 2012, "Degenerate Human Nucleus Pulposus Cells Promote Neurite Outgrowth in Neural Cells." PLOS ONE 7, no. 10, e47735 -
Abbott,Rosalyn,Delia; Purmessur,Devina; Monsey,Robert,Daniel; Iatridis,James,Christopher, 2012, "Regenerative potential of TGF beta 3 + Dex and notochordal cell conditioned media on degenerated human intervertebral disc cells." JOURNAL OF ORTHOPAEDIC RESEARCH 30, no. 3, 482 - 488.
Purmessur,Devina; Schek,Rachel,M; Abbott,Rosalyn,D; Ballif,Bryan,A; Godburn,Karolyn,E; Iatridis,James,C, 2011, "Notochordal conditioned media from tissue increases proteoglycan accumulation and promotes a healthy nucleus pulposus phenotype in human mesenchymal stem cells." ARTHRITIS RESEARCH & THERAPY 13, no. 3, R81 -
Walter,B,A; Korecki,C,L; Purmessur,D; Roughley,P,J; Michalek,A,J; Iatridis,J,C, 2011, "Complex loading affects intervertebral disc mechanics and biology." OSTEOARTHRITIS AND CARTILAGE 19, no. 8, 1011 - 1018.
Iatridis,James,C; Michalek,A,J; Purmessur,D; Korecki,C,L, 2009, "Localized Intervertebral Disc Injury Leads to Organ Level Changes in Structure, Cellularity, and Biosynthesis." CELLULAR AND MOLECULAR BIOENGINEERING 2, no. 3, 437 - 447.
Purmessur,Devina; Freemont,Anthony,J; Hoyland,Judith,A, 2008, "Expression and regulation of neurotrophins in the nondegenerate and degenerate human intervertebral disc." ARTHRITIS RESEARCH & THERAPY 10, no. 4, R99 -
Purmessur,D; Hoyland,J,A; Freemont,A,J, 2006, "Disc cell/neural cell interactions in the intervertebral disc (IVD) and their role in degeneration of the IVD." JOURNAL OF PATHOLOGY 210, 25 - 25.
Parker,S,M; Purmessur,D; Millward-Sadler,S,J; LeMaitre,C,L; Freemont,A,J; Hoyland,J,A, 2006, "The identification of large conductance potassium (MaxiK) channels in human intervertebral disc (IVD) cells." JOURNAL OF PATHOLOGY 210, 24 - 24.
We are Recruiting
Devina Purmessur, PhD
BS (Honors): Medical Biochemistry, University of Sheffield UK
MS (with Distinction): Immunology and Allergy, University of Nottingham UK
PhD: Molecular Pathology, University of Manchester UK
Postdoctoral training: Spine Bioengineering labs of Dr James Iatridis, University of Vermont and Icahn School of Medicine at Mount Sinai NYC, USA
My background is in cell and molecular biology of the intervertebral disc (IVD) with a particular focus on understanding the pathobiology of disease mechanisms for therapeutic effect. I am currently an Assistant Professor (Tenure track) in the Department of Biomedical Engineering and Spine Research Institute at the Ohio State University. I collaborate with Dr William Marras, Professor in Intergrated systems engineering and Director of the Spine Research Institute, clinicians in the Department of Orthopedics Dr Safdar Khan, and Elizabeth Yu, and Veterinary surgeon Dr Sarah Moore. I recently transitioned from Instructor in the Department of Orthopedics in New York where I worked with Dr James Iatridis to develop a Spine pain program at Icahn School of Medicine at Mount Sinai (ISMMS). Our research interests lie in understanding how the IVD microenvironment (cellular, biochemical and mechanical) in development, growth and aging influence pain pathways in discogenic back pain with a focus on neurovascular ingrowth and sensitization and developing suitable in vitro and clinically relevant in vivo animal models for clinical translation of therapeutic strategies.
Nina Tang - Lab Manager
Nina is a Research Assisstant and Lab Manager in the Spine Therapeutics Lab who graduated from The Ohio State University with a B.S in Biomedical Engineering in 2017. Her objective in life is to pursue a career in medicine that integrates biomedical engineering qualities in an effort to advance global healthcare for the underprivileged community. Her research interest include biological pathways of discogenic back pain, biomaterials, tissue engineering and cancer genetics. In her free time she enjoys training in martial arts, playing tennis and art.
Katie Lakstins - Ph.D Student
Katie is currently pursuing her PhD in Biomedical Engineering. She received her undergraduate degree from Rose-Hulman Institute of Technology in 2016. Outside the lab she enjoys spending time with friends, being involved in the Biomedical Engineering Graduate School Association, doing crossfit, rock climbing, hiking, and hanging out with her two cats.
Kelly Thompson - MS/DVM Student
Kelly Thompson is a combined Master of Science and DVM student at The Ohio State University College of Veterinary Medicine. In the lab she studies the immune and inflammatory responses within the canine degenerate intervertebral disc. Outside of the lab, Kelly enjoys dancing, reading, attending concerts, and spending time with her rabbit.
Emma Wittman is a Biomedical Engineering pre-medicine major, expecting to graduate in May 2019. Emma studies the effects of L-Lactate on the intervertebral disc and the role it plays in disc degeneration. Outside of lab she enjoys volunteering at Grant Medical Center, playing on the Ohio State Club Softball team, and promoting fellow females through her sorority.
Justin Richards is a forth year Biology major. He is interested in all things having to do with orthopedics, specifically as they pertain to physiology of the musculoskeletal system. On campus, He is involved as a member of Beta Theta Pi, and President of Ministry in Mission, organizing mission trips to Haiti for students on Ohio State's campus. After his undergraduate degree, he would like to pursue medical school with the goal of becoming an orthopedic surgeon
Lauren is a forth year Biomedical Engineering major, Neuroscience minor at The Ohio State University. She is working with Katie to study the effect of the calcification of the cartilage end plate on the degeneration of the intervertebral disc. Outside of the lab, Lauren is a member of Phi Sigma Rho Sorority and H2O Church. She enjoys reading, hiking, exploring, and music.
Gilian is a second year Biology major in the ASC Honors Program. In the lab, she helps research pain pathways in the intervertebral disc relating to immmune cell modulation. On campus, Gilian is a part of various student organizations such as Helix and CHAARG. She also enjoys listening to music, reading and running.
Brian King - Undergraduate Research Assistant
Brian King graduated from OSU with a B.S in Biomedical Engineering and a minor in Neuroscience. His interest in neural regeneration and engineering drew him to this lab’s research into sensitivity and infiltration of neurons associated with lower back pain. He is currently an engineer at EPIC.
Pavel Sul - Lab Manager
Pavel graduated from The Ohio State University with a B.S. in Biomedical Engineering and worked as a Research Assistant and Laboratory Manager of the Spinal Therapeutics Laboratory afterwards. In the lab he is focused on the development and validation of an intervertebral disc co-culture model. Outside of work Pavel enjoys hiking, snowboarding and traveling. He is now an engineer at MIPAR
Matt Wiet - MS Student
Matt was a graduate student in the Biomedical Engineering department focusing on the field of Molecular, Cell and Tissue Engineering. His responsibility in the lab was to characterize the interaction between immune cells and the intervertebral disc cells in order to better understand lower back pain and intervertebral disc degeneration. Outside of the lab he enjoys playing soccer with his wife, as both were/are professional soccer players, and his goal is to one day become a medical scientist as an orthopedic surgeon. He is currently attending medical school at The Ohio State University.
Tayler Yeater- Undergraduate Research Assistant
Taylor Yeater was a Biomedical Engineering major at The Ohio State University who graduated in May 2017. In the lab she studied the degenerate and healthy microenvironments of the intervertebral disc in relation to neurite outgrowth. Outside of the lab she was an officer for Society of Women Engineers, The Ohio State University chapter. She is currently pursuing her PhD at the University of Florida.
Andrew Piscioneri - Undergraduate Research Assistant
Andrew Piscioneri was a Biomedical Engineering major and Neuroscience minor at The Ohio State University who graduated in May 2017. Andrew studied the effects of the Intervertebral Disc microenvironement on metabolism and signaling in healthy and degenerative states. Outside of the lab, Andrew volunteered at The Ohio State Wexner Medical Center and raised money for the University at The Ohio State Caller Center. He is now an engineer at Edwards Lifesciences in Irvine, California