Inflammation in intervertebral disc degeneration and regeneration

Abstract

Intervertebral disc (IVD) degeneration is one of the major causes of low back pain, a problem with a heavy economic burden, which has been increasing in prevalence as populations age. Deeper knowledge of the complex spatial and temporal orchestration of cellular interactions and extracellular matrix remodelling is critical to improve current IVD therapies, which have so far proved unsatisfactory. Inflammation has been correlated with degenerative disc disease but its role in discogenic pain and hernia regression remains controversial. The inflammatory response may be involved in the onset of disease, but it is also crucial in maintaining tissue homeostasis. Furthermore, if properly balanced it may contribute to tissue repair/regeneration as has already been demonstrated in other tissues. In this review, we focus on how inflammation has been associated with IVD degeneration by describing observational and in vitro studies as well as in vivo animal models. Finally, we provide an overview of IVD regenerative therapies that target key inflammatory players.

TRPC6 in simulated microgravity of intervertebral disc cells

“…Senescence in vivo is not only associated with the degree of disc degeneration [45], but also varies between NP and AF [20]. Furthermore, pro-inflammatory cytokines may trigger cell senescence [45], and these may not only be secreted by resident IVD cells, but also by invading immune cells found predominantly in IVD herniation samples [46]. Despite the differences in basal levels of senescence and proliferation capacity stemming from disparities in patient characteristics, we were able to show that microgravity and TRPC channel inhibition both increased cell senescence and decreased cell proliferation.…”

Anti-inflammatory Chitosan/Poly-γ-glutamic acid nanoparticles control inflammation while remodeling extracellular matrix in degenerated intervertebral disc

“…In this context, inflammatory players (including TNF, IL-1 and IL-6) have been suggested as possible targets [5,7]. For example, intradiscal injections of steroids or glucocorticoids are currently performed to decrease intradiscal inflammation in patients with nucleus pulposusinduced spinal nerve root injury [8,9].…”

Low back pain: possibilities of pathogenetic treatment

“…В рамках различных процессов, ведущих к развитию дегенеративной болезни МПД, обсуждаются различные факторы, такие как кальцификация замыкательных пла-стинок, приводящая к нарушению физиологического транспорта питательных веществ, интенсивная механиче-ская нагрузка, генетическая предиспозиция, факторы об-раза жизни, инфекции, а также процессы, связанные со старением [13]. Независимо от причины универсальным механизмом, участвующим в формировании болевых и других неврологических проявлений БНС, являются вос-палительные реакции.…”