Antioxidant biomaterials in intervertebral disc regeneration: current status and future clinical translation

Intervertebral disc degeneration (IVDD) is a leading cause of chronic back pain and long-term disability, imposing a substantial burden on healthcare systems worldwide. At the core of this degenerative process lies oxidative stress, a pathological condition driven by excessive accumulation of reactive oxygen species (ROS). This redox imbalance initiates a destructive cascade within the intervertebral disc, resulting in injury, premature senescence, and death of nucleus pulposus cells. The loss of these critical cells subsequently provokes inflammatory responses and degradation of the extracellular matrix, ultimately compromising the structural integrity of the disc. Although conventional clinical interventions effectively alleviate symptoms, they typically fail to target the underlying biological mechanisms or halt disease progression. This unmet therapeutic need has spurred growing interest in antioxidant materials, which offer a more proactive approach by directly neutralizing ROS and restoring redox homeostasis. Beyond mere ROS scavenging, these materials also mitigate inflammation and foster a microenvironment supportive of tissue regeneration. Current research efforts are increasingly focused on the rational design of such antioxidant systems, particularly their integration with advanced cell-based therapies to enhance regenerative outcomes. A detailed assessment of how these materials modulate specific pathological pathways is essential to clarify their practical utility and inherent limitations. Translating promising laboratory results into clinical practice remains a major challenge, necessitating rigorous evaluation of their performance in complex biological settings. Refining these antioxidant strategies may ultimately pave the way for a paradigm shift, from symptomatic relief to genuine functional restoration in patients with IVDD.