DUDLI-LAB
Newest Publication
Optimized hydrogel viscoelasticity and interlocking patch repair enhance compressive range of motion in injured discs and prevent re-herniation under physiological load in an Ex Vivo model
Danilo Menghini, Esteban Ongini, Jan Devan, Pamela Bitterli, Matteo D’Este, Oliver Distler, Mazda Farshad, Sibylle Grad, Jess Snedeker & Stefan Dudli
Purpose
Evaluate how variations in hydrogels viscoelasticity for nucleus pulposus (NP) replacement affect biomechanical function and re-herniation resistance when combined with a mechanically competent annulus fibrosus (AF) repair technique in an intervertebral disc explant model.
Methods
Bovine caudal discs (n = 48) were divided into three repair groups (each n = 12) and one no-repair group (n = 12). Repair groups were treated with hyaluronic acid-tyramine hydrogel (HA-Tyr) of varying viscosities (low, medium, high), and AF was repaired using a mechanically interlocked patch (iPatch) made of polyethylene terephthalate fibers. Disc biomechanics were assessed under rotational and compressive-tensile cycles for each specimen (A) in intact state, (B) after experimental herniation/discectomy, and (C) after treatment. Afterwards, load capacity until NP herniation or hydrogel extrusion was determined.
Results
Discectomy significantly altered axial and torsional parameters compared to intact discs. Combined iPatch/hydrogel treatment improved axial parameters by reducing range of motion (ROM), neutral zone length, and restoring compressive stiffness, whereas tensile stiffness remained unaffected. Significant differences in ROM were found between unrepaired discs and medium or high viscoelasticity hydrogels. Torsional parameters improved likewise. Low viscoelasticity hydrogel showed the highest load resistance (8.5 MPa) and lowest herniation probability. Under physiological load, only medium viscoelasticity hydrogels did not herniate.
Conclusion
Higher viscoelastic hydrogels enhance compressive ROM and axial compressive stiffness after discectomy but increase herniation risk. Medium viscoelastic hydrogels resist physiological loads without herniating while still enhancing ROM. This study highlights the need to optimize NP replacement and suggests a combination that opens promising therapeutic avenues for future applications.
All Publications
Identification of two biological subgroups of complex regional pain syndrome type 1 by transcriptomic profiling of skin and blood in women
Pérez Vertti Valdés, M., Jüngel, A., Bitterli, P. et al. Identification of two biological subgroups of complex regional pain syndrome type 1 by transcriptomic profiling of skin and blood in women. Mol Med 31, 94 (2025). https://doi.org/10.1186/s10020-025-01148-y
Massively parallel flow-cytometry-based screening of hematopoietic lineage cell populations from up to 25 donors simultaneously
Devan J, Sandalova M, Bitterli P, Herger N, Mengis T, Brender K, Heggli I, Distler O, Dudli S. Massively parallel flow-cytometry-based screening of hematopoietic lineage cell populations from up to 25 donors simultaneously. Methods. 2025 Feb;234:45-53. doi: 10.1016/j.ymeth.2024.11.014. Epub 2024 Nov 27. PMID: 39608688.
How to build a framework to establish a patient research partner network in rheumatology research: a report of a 2-year implementation project
Buerki K, Toitou M, de Wit M, Grealis S, Ludwig S, Britt C, Klett F, Steeb I, Maletic T, Eisenring A, Timpert-Argust PJ, Diem D, Micheroli R, Dudli S, Bruni C, Camarillo-Retamosa E, Dobrota R, Hoffmann-Vold AM, Ciurea A, Ospelt C, Distler O, Elhai M. How to build a framework to establish a patient research partner network in rheumatology research: a report of a 2-year implementation project. RMD Open. 2025 Feb 10;11(1):e005263. doi: 10.1136/rmdopen-2024-005263. PMID: 39929597; PMCID: PMC11815435.
The Expression of Toll-like Receptors in Cartilage Endplate Cells: A Role of Toll-like Receptor 2 in Pro-Inflammatory and Pro-Catabolic Gene Expression
Mengis, T., Bernhard, L., Nüesch, A., Heggli, I., Herger, N., Devan, J., Marcus, R., Laux, C. J., Brunner, F., Farshad, M., Distler, O., Le Maitre, C. L., & Dudli, S. (2024). The Expression of Toll-like Receptors in Cartilage Endplate Cells: A Role of Toll-like Receptor 2 in Pro-Inflammatory and Pro-Catabolic Gene Expression. Cells, 13(17), 1402. https://doi.org/10.3390/cells13171402
Intervertebral disc microbiome in Modic changes: Lack of result replication underscores the need for a consensus in low-biomass microbiome analysis
Mengis T, Zajac N, Bernhard L, Heggli I, Herger N, Devan J, Marcus R, Brunner F, Laux C, Farshad M, Distler O, Dudli S. Intervertebral disc microbiome in Modic changes: Lack of result replication underscores the need for a consensus in low-biomass microbiome analysis. JOR Spine. 2024 Apr 4;7(2):e1330. doi: 10.1002/jsp2.1330. PMID: 38585427; PMCID: PMC10995447.
Proteomic analysis of serum in a population-based cohort did not reveal a biomarker for Modic changes
Schulze F, Määttä J, Grad S, Heggli I, Brunner F, Farshad M, Distler O, Karppinen J, Lotz J, Dudli S. Proteomic analysis of serum in a population-based cohort did not reveal a biomarker for Modic changes. JOR Spine. 2024 Jul 15;7(3):e1337. doi: 10.1002/jsp2.1337. PMID: 39015135; PMCID: PMC11250394.
Impacts of priming on distinct immunosuppressive mechanisms of mesenchymal stromal cells under translationally relevant conditions
Herger N, Heggli I, Mengis T, Devan J, Arpesella L, Brunner F, Distler O, Dudli S. Impacts of priming on distinct immunosuppressive mechanisms of mesenchymal stromal cells under translationally relevant conditions. Stem Cell Res Ther. 2024 Mar 5;15(1):65. doi: 10.1186/s13287-024-03677-5. PMID: 38443999; PMCID: PMC10916130.
Low back pain patients with Modic type 1 changes exhibit distinct bacterial and non-bacterial subtypes
I. Heggli, T. Mengis, C.J. Laux, L. Opitz, N. Herger, D. Menghini, R. Schuepbach, N.A. Farshad Amacker , F. Brunner, A.J. Fields, M. Farshad, O. Distler, S. Dudli
Osteoarthr Cartil Open. 2024;6(1):100434. Published 2024 Jan 18. doi:10.1016/j.ocarto.2024.100434
https://www.sciencedirect.com/science/article/pii/S2665913124000013
The role of the complement system in disc degeneration and Modic changes
Irina Heggli, Graciosa Q. Teixeira, James C. Iatridis, Cornelia Neidlinger‐Wilke and Stefan Dudli
JOR Spine. 2024 Mar; 7(1): e1312. Published online 2024 Feb 2. doi: 10.1002/jsp2.1312
Bone marrow stromal cells in Modic type 1 changes promote neurite outgrowth
Mengis T, Herger N, Heggli I, Devan J, Spirig JM, Laux CJ, Brunner F, Farshad M, Distler O, Dudli S.
Front Cell Dev Biol. 2023 Oct 25;11:1286280. doi: 10.3389/fcell.2023.1286280. eCollection 2023. PMID: 37965581
https://www.frontiersin.org/articles/10.3389/fcell.2023.1286280/full
Cartilaginous endplates: A comprehensive review on a neglected structure in intervertebral disc research
Crump KB, Alminnawi A, Bermudez-Lekerika P, Compte R, Gualdi F, McSweeney T, Muñoz-Moya E, Nüesch A, Geris L, Dudli S, Karppinen J, Noailly J, Le Maitre C, Gantenbein B.
JOR Spine. 2023 Oct 21. DOI: 10.1002/jsp2.1294. eCollection 2023 Dec.
Modic type 2 changes are fibroinflammatory changes with complement system involvement adjacent to degenerated vertebral endplates
Irina Heggli, Christoph J. Laux, Tamara Mengis, Agnieszka Karol, Frédéric Cornaz, Nick Herger, Borbala Aradi‐Vegh, Jonas Widmer, Marco D. Burkhard, Nadja A. Farshad‐Amacker, Sibylle Pfammatter, Witold E. Wolski, Florian Brunner, Oliver Distler, Mazda Farshad, and Stefan Dudli
JOR spine, 2023. DOI: 10.1002/jsp2.1237
The role of the bone in complex regional pain syndrome 1-A systematic review
Gil Kollmann, Maria M Wertli, Stefan Dudli, Oliver Distler, Florian Brunner
Eur J Pain. 2023 Mar 31. DOI: 10.1002/ejp.2116. Online ahead of print.
Harmonization and Standardization of Nucleus pulposus Cell Culture Methods.
Basatvat S, Binch ALA, Snuggs J, Owen D, Williams R, Richardson SM, Hoyland JA, Gansau J, Buckley CT, Glaeser JD, Sheyn D, Wang D, Vo N , Jacobsen T, Chahine NO, Presciutti SM, Drissi H, Yoon T, Illien-Junger S, Gawri R, Lang G, Hernandez PA, Fearing BV, Setton LA, Dudli S, Schol J, Sakai D, Guerrero J, Gantenbein B, Li Z, Peroglio M, Grad S, Kraus P, Lufkin T, O'Connell GD, Dahia C, Kaito T, Kushioka J, Wachs RA, DiStefano T, Panebianco C, Iatridis JC, Bowles RD, Sun Y, Leung VY, Haglund L, Mizuno S, Huang CY, Alvarez-Garcia O, Silverman L, Li X, Garcia JP, Creemers LB, Ito K, Medzikovic A, van Maanen JC, Laagland LT, Bach FC, Tryfonidou MA, L. Le Maitre C.
JOR Spine. e1238, DOI: 10.1002/jsp2.1238
FGF2 overrides key pro-fibrotic features of bone marrow stromal cells isolated from Modic type 1 change patients
I Heggli, U Blache, N Herger, T Mengis, PK Jaeger, R Schuepbach, N Farshad-Amacker, F Brunner, JG Snedeker, M Farshad, O Distler, S Dudli
European Cells and Materials Vol. 44 2022 (pages 101-114) DOI: 10.22203/eCM.v044a07
Protocol for Biospecimen Collection and Analysis within the BACPAC Research Program.
Fields AJ, Dudli S, Schrepf A, Kim A, Pham B, Gallego E, Mendoza S, Meropol SB, Darwin J, Sowa G, Vo NV.
Pain Med. 2022 Dec 16:pnac197. doi: 10.1093/pm/pnac197. Online ahead of print.
PMID: 36525387
Role of C-reactive protein in the bone marrow of Modic type 1 changes.
Dudli S, Heggli I, Laux CJ, Spirig JM, Wanivenhaus F, Betz M, Germann C, Farshad-Amacker NA, Herger N, Mengis T, Brunner F, Farshad M, Distler O.J Orthop Res. 2022
Sep 5. doi: 10.1002/jor.25437. Online ahead of print.
PMID: 36062874
CD90-positive stromal cells associate with inflammatory and fibrotic changes in modic changes.
Dudli S, Karol A, Giudici L, Heggli I, Laux CJ, Spirig JM, Wanivenhaus F, Betz M, Germann C, Farshad-Amacker N, Brunner F, Distler O, Farshad M.Osteoarthr Cartil Open. 2022 Jun 22;4(3):100287. doi: 10.1016/j.ocarto.2022.100287. eCollection 2022 Sep.
PMID: 36474945
Intervertebral disc cell chondroptosis elicits neutrophil response in Staphylococcus aureus spondylodiscitis.
Schweizer TA, Andreoni F, Acevedo C, Scheier TC, Heggli I, Maggio EM, Eberhard N, Brugger SD, Dudli S, Zinkernagel AS.
Front Immunol. 2022 Jul 28;13:908211. doi: 10.3389/fimmu.2022.908211. eCollection 2022.
PMID: 35967370
Should Degenerated Intervertebral Discs of Patients with Modic Type 1 Changes Be Treated with Mesenchymal Stem Cells?
Herger N, Bermudez-Lekerika P, Farshad M, Albers CE, Distler O, Gantenbein B, Dudli S.
Int J Mol Sci. 2022 Feb 28;23(5):2721. doi: 10.3390/ijms23052721.
PMID: 35269863
Development of a standardized histopathology scoring system for intervertebral disc degeneration in rat models: An initiative of the ORS spine section.
Lai A, Gansau J, Gullbrand SE, Crowley J, Cunha C, Dudli S, Engiles JB, Fusellier M, Goncalves RM, Nakashima D, Okewunmi J, Pelletier M, Presciutti SM, Schol J, Takeoka Y, Yang S, Yurube T, Zhang Y, Iatridis JC.
JOR Spine. 2021 May 26;4(2):e1150. doi: 10.1002/jsp2.1150. eCollection 2021 Jun.
PMID: 34337335
Karppinen J, Koivisto K, Ketola J, Haapea M, Paananen M, Herzig KH, Alini M, Lotz J, Dudli S, Samartzis D, Risteli J, Majuri ML, Alenius H, Kyllönen E, Järvinen J, Niinimäki J, Grad S.
Eur Spine J. 2021 Apr;30(4):1018-1027. doi: 10.1007/s00586-020-06713-z. Epub 2021 Jan 9.
PMID: 33423134
Pro-Inflammatory and Neurotrophic Factor Responses of Cells Derived from Degenerative Human Intervertebral Discs to the Opportunistic Pathogen Cutibacterium acnes
Capoor MN, Konieczna A, McDowell A, Ruzicka F, Smrcka M, Jancalek R, Maca K, Lujc M, Ahmed FS, Birkenmaier C, Dudli S, Slaby O.
Int J Mol Sci. 2021 Feb 26;22(5):2347. doi: 10.3390/ijms22052347.
PMID: 33652921
Serum Biomarkers for Connective Tissue and Basement Membrane Remodeling are Associated with Vertebral Endplate Bone Marrow Lesions as Seen on MRI (Modic Changes).
Dudli S, Ballatori A, Bay-Jensen AC, McCormick ZL, O'Neill CW, Demir-Deviren S, Krug R, Heggli I, Juengel A, Karppinen J, Brunner F, Farshad M, Distler O, Lotz JC, Fields AJ.
Int J Mol Sci. 2020 May 27;21(11):3791. doi: 10.3390/ijms21113791.
PMID: 32471173
The Effect of Zoledronic Acid on Serum Biomarkers among Patients with Chronic Low Back Pain and Modic Changes in Lumbar Magnetic Resonance Imaging.
Koivisto K, Karppinen J, Haapea M, Järvinen J, Kyllönen E, Tervonen O, Niinimäki J, Alini M, Lotz J, Dudli S, Samartzis D, Risteli J, Majuri ML, Alenius H, Grad S.
Diagnostics (Basel). 2019 Dec 4;9(4):212. doi: 10.3390/diagnostics9040212.
PMID: 31817123
Pulsed electromagnetic fields reduce acute inflammation in the injured rat-tail intervertebral disc.
Chan AK, Tang X, Mummaneni NV, Coughlin D, Liebenberg E, Ouyang A, Dudli S, Lauricella M, Zhang N, Waldorff EI, Ryaby JT, Lotz JC.
JOR Spine. 2019 Dec 2;2(4):e1069. doi: 10.1002/jsp2.1069. eCollection 2019 Dec.
PMID: 31891118
Quantification of Propionic Acid in the Bovine Spinal Disk After Infection of the Tissue With Propionibacteria acnes Bacteria.
Magnitsky S, Dudli S, Tang X, Kaur J, Diaz J, Miller S, Lotz JC.
Spine (Phila Pa 1976). 2018 Jun 1;43(11):E634-E638. doi: 10.1097/BRS.0000000000002448.
PMID: 29019804
Modic type 1 change is an autoimmune response that requires a proinflammatory milieu provided by the 'Modic disc'.
Dudli S, Liebenberg E, Magnitsky S, Lu B, Lauricella M, Lotz JC.
Spine J. 2018 May;18(5):831-844. doi: 10.1016/j.spinee.2017.12.004. Epub 2017 Dec 15.
PMID: 29253635
Inflammatory response of disc cells against Propionibacterium acnes depends on the presence of lumbar Modic changes.
Dudli S, Miller S, Demir-Deviren S, Lotz JC.
Eur Spine J. 2018 May;27(5):1013-1020. doi: 10.1007/s00586-017-5291-4. Epub 2017 Sep 7.
PMID: 28884220
Machine Learning-Based Classification of 38 Years of Spine-Related Literature Into 100 Research Topics.
Sing DC, Metz LN, Dudli S.
Spine (Phila Pa 1976). 2017 Jun 1;42(11):863-870. doi: 10.1097/BRS.0000000000002079.
PMID: 28125523
ISSLS PRIZE IN BASIC SCIENCE 2017: Intervertebral disc/bone marrow cross-talk with Modic changes.
Dudli S, Sing DC, Hu SS, Berven SH, Burch S, Deviren V, Cheng I, Tay BKB, Alamin TF, Ith MAM, Pietras EM, Lotz JC.
Eur Spine J. 2017 May;26(5):1362-1373. doi: 10.1007/s00586-017-4955-4. Epub 2017 Jan 31.
PMID: 28138783
Dudli S, Fields AJ, Samartzis D, Karppinen J, Lotz JC.
Eur Spine J. 2016 Nov;25(11):3723-3734. doi: 10.1007/s00586-016-4459-7. Epub 2016 Feb 25.
PMID: 26914098
Propionibacterium acnes infected intervertebral discs cause vertebral bone marrow lesions consistent with Modic changes.
Dudli S, Liebenberg E, Magnitsky S, Miller S, Demir-Deviren S, Lotz JC.
J Orthop Res. 2016 Aug;34(8):1447-55. doi: 10.1002/jor.23265. Epub 2016 Aug 3.
PMID: 27101067
Dudli S, Ferguson SJ, Haschtmann D.
Spine J. 2014 Jul 1;14(7):1256-64. doi: 10.1016/j.spinee.2013.07.488. Epub 2014 Feb 28.
PMID: 24583791