The Role of Adipokines in Intervertebral Disc Degeneration

Abstract

Intervertebral disc degeneration (IDD) is an important cause of low back pain. Recent evidence suggests that in addition to abnormal and excessive mechanical loading, inflammation may be a key driver for both IDD and low back pain. Obesity, a known mechanical risk factor of IDD, is now increasingly being recognized as a systemic inflammatory state with adipokines being postulated as likely inflammatory mediators. The aim of this review was to summarize the current literature regarding the inflammatory role of adipokines in the pathophysiology of IDD. A systematic literature search was performed using the OVID Medline, EMBASE and PubMed databases to identify all studies assessing IDD and adipokines. Fifteen studies were included in the present review. Leptin was the most commonly assessed adipokine. Ten of 15 studies were conducted in humans; three in rats and two in both humans and rats. Studies focused on a variety of topics ranging from receptor identification, pathway analysis, genetic associations, and proteonomics. Currently, data from both human and animal experiments demonstrate significant effects of leptin and adiponectin on the internal milieu of intervertebral discs. However, future studies are needed to determine the molecular pathway relationships between adipokines in the pathophysiology of IDD as avenues for future therapeutic targets.

Immuohistochemical score of matrix metalloproteinase-1 may indicate the severity of symptomatic cervical and lumbar disc degeneration

“…Previous reports disclosed a lack of correlation between MRI/MCs scale and HDS [36,37]. Possible explanations for this finding are as follows: (1) sampling discrepancy, expected to be obvious in cases involving the lumbar spine because the protruded portion, rather than the whole disc, is removed; (2) use of qualitative and less complex grading criteria to obtain MRI/MCs scale [22]; (3) dehydration of the IVD detected on MRI (based on T2-weighted protocols) may simply represent the aging process rather than pathological IVD degeneration [38,39]; (4) fissures and cell clusters within the IVD seen under a microscope may not be detected with current MRI methodologies [24].…”

“…Risk factors for IVD degeneration include aging, genetic factors, nutrition, toxins, metabolic disorders, low-grade infection, neurogenic inflammation, autoimmune disease, and mechanical factors [3]. Obesity, a known mechanical risk factor, is recognized as a systemic inflammatory state mediated by adipokines [4].…”

Leptin and the intervertebral disc: a biochemical link exists between obesity, intervertebral disc degeneration and low back pain—an in vitro study in a bovine model

“…There is a fledging evidence base as to the role of leptin and the other adipokines in IVD degeneration. In a recent review, Sharma found only 15 in vitro studies investigating this relationship [61]. The author concluded that leptin can have significant effects on IVDs, but cautioned mechanistic and translational work is required to further understand this relationship.…”

Williams Flexion Exercise for Low Back Pain: A Possible Implementation in Rural Areas

“…Several studies have pointed out that higher BMI and low height are associated with the prevalence and severity of LBP [14]. Other than the increased axial load of the spine in case of high BMI, a high degree of adiposity was shown to increase the level of adipokines which may increase the rate of intervertebral degeneration causing LBP [15]. Furthermore, adipokines increased the risk of a mood disorder like depression which may affect the severity of chronic pain such as LBP [16].…”