Oxidative stress in intervertebral disc degeneration: Molecular mechanisms, pathogenesis and treatment

Abstract

Low back pain (LBP) is a leading cause of labour loss and disability worldwide, and it also imposes a severe economic burden on patients and society. Among symptomatic LBP, approximately 40% is caused by intervertebral disc degeneration (IDD). IDD is the pathological basis of many spinal degenerative diseases such as disc herniation and spinal stenosis. Currently, the therapeutic approaches for IDD mainly include conservative treatment and surgical treatment, neither of which can solve the problem from the root by terminating the degenerative process of the intervertebral disc (IVD). Therefore, further exploring the pathogenic mechanisms of IDD and adopting targeted therapeutic strategies is one of the current research hotspots. Among the complex pathophysiological processes and pathogenic mechanisms of IDD, oxidative stress is considered as the main pathogenic factor. The delicate balance between reactive oxygen species (ROS) and antioxidants is essential for maintaining the normal function and survival of IVD cells. Excessive ROS levels can cause damage to macromolecules such as nucleic acids, lipids, and proteins of cells, affect normal cellular activities and functions, and ultimately lead to cell senescence or death. This review discusses the potential role of oxidative stress in IDD to further understand the pathophysiological processes and pathogenic mechanisms of IDD and provides potential therapeutic strategies for the treatment of IDD.

Stimuli-Responsive Delivery Systems for Intervertebral Disc Degeneration

“…Moreover, decreased levels of antioxidant substances aggravate the oxidative microenvironment in IVDD. 83 Thus, therapeutic strategies for reducing ROS and ROS-induced inflammation are considered promising options for attenuating disc catabolism and restoring disc anabolism. High levels of ROS can be a suitable stimulus for drug delivery systems.…”

Application and development of hydrogel biomaterials for the treatment of intervertebral disc degeneration: a literature review

“…On the other hand, degeneration of the IVD is also associated with sterile inflammation and oxidative stress. As the IVD is in a hypoxic environment, this results in metabolites not being excreted efficiently ( Bartels et al, 1998 ; Wang et al, 2023b ). The accumulation of harmful substances leads to inflammation, which affects cellular function.…”

Analysis of global research hotspots and trends in immune cells in intervertebral disc degeneration: A bibliometric study

“…It has been reported that high levels of reactive oxygen species (ROS) can cause damage to cellular nucleic acids, lipids, proteins, and other macromolecules, severely affecting normal cellular activity and function, and ultimately leading to the onset of cellular senescence or death. 74 Oxidative stress is also considered to be one of the key links in the development of IDD, and it often happens in conjunction with other mechanisms. For instance, it has been found that oxidative stress induces ferroptosis, which has an important role in the pathology of IDD.…”