Telomere Shortening and Increased Oxidative Stress in Lumbar Disc Degeneration

Abstract

Lumbar disc degeneration (LDD) contributes to low back pain. This study aimed to determine relative telomere length (RTL), oxidative stress status, and antioxidant levels and examine the relationships between RTL, oxidative stress, and the severity in LDD patients. A total of 100 subjects, 50 LDD patients and 50 healthy controls, were enrolled in the case–control study. Blood leukocyte RTL was analyzed using quantitative real-time polymerase chain reaction. Lipid peroxidation was determined by malondialdehyde (MDA) assay. Plasma 8-hydroxy 2′-deoxyguanosine (8-OHdG) values were determined using enzyme-linked immunosorbent assay. Total antioxidant capacity (TAC) and ferric reducing antioxidant power (FRAP) in plasma were also measured. The LDD patients had significantly shorter telomeres than the healthy controls (p = 0.04). Blood leukocyte RTL was inversely correlated with the LDD severity (r = −0.41, p = 0.005). Additionally, plasma MDA and 8-OHdG levels were markedly greater in LDD patients than in the controls (p = 0.01 and p = 0.002, respectively). Furthermore, the plasma MDA level showed a positive correlation with the radiographic severity (r = 0.49, p = 0.001). There was a positive correlation between plasma 8-OHdG and the severity (r = 0.60, p < 0.001). Moreover, plasma TAC and FRAP levels were significantly lower in LDD patients than in the controls (p = 0.04). No significant differences in plasma TAC and FRAP were observed among the three groups of LDD severity. We found that RTL was negatively correlated with the severity while plasma MDA and 8-OHdG levels were positively correlated with the severity. These findings suggest that blood leukocyte RTL, plasma MDA, and 8-OHdG may have potential as noninvasive biomarkers for the assessment of severity in LDD.

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

“…The content of 8‐oxoG in body fluid of patients with oxidative stress‐related psychiatric disorders, chronic kidney disease, gestational diabetes, and neurodegenerative diseases increased 74–77 . In addition, a case–control study found that plasma 8‐oxodG levels in patients with lumbar disc herniation were significantly higher than those in healthy controls 78 . Recently, it was found that the level of 8‐oxodG in human NPCs induced by IL‐1β is significantly increased, while the level of 8‐oxodG is decreased after treatment with antioxidants 79 .…”

“…87 In a recent study, plasma levels of malondialdehyde (MDA), a lipid peroxidation product, were significantly higher in patients with lumbar disc herniation compared with healthy controls. 78 In addition, tertbutyl hydroperoxide (TBHP) and H 2 O 2 could also increase the MDA level in rat IVD cells. [88][89][90] These studies all suggest that oxidative stress can lead to lipid peroxidation within IVD, which in turn promotes IDD progression.…”

“…[74][75][76][77] In addition, a case-control study found that plasma 8-oxodG levels in patients with lumbar disc herniation were significantly higher than those in healthy controls. 78 Recently, it was found that the level of 8-oxodG in human NPCs induced by IL-1β is significantly increased, while the level of 8-oxodG is decreased after treatment with antioxidants. 79 These studies suggest that oxidative damage to nucleic acids may be involved in IDD progression.…”

“…Compared with free radicals, RCS have a longer lifetime and higher stability, which facilitates their intracellular diffusion and consequent modification of DNA, lipids and proteins 87 . In a recent study, plasma levels of malondialdehyde (MDA), a lipid peroxidation product, were significantly higher in patients with lumbar disc herniation compared with healthy controls 78 . In addition, tert‐butyl hydroperoxide (TBHP) and H 2 O 2 could also increase the MDA level in rat IVD cells 88–90 .…”

Vitamin D Inadequacy Affects Skeletal Muscle Index and Physical Performance in Lumbar Disc Degeneration

“…Lumbar disc degeneration (LDD) is one of the fundamental causes of low back pain. Clinically, symptoms of LDD are low back pain, difficulty walking, and impaired musculoskeletal muscle, leading to severe pain and decreased quality of life [ 2 , 3 ]. Several multifactorial factors contributing to the pathogenesis of LDD include mechanical stress, obesity, aging, previous injury, and genetic factors.…”