The Role of Type I Diabetes in Intervertebral Disc Degeneration

Abstract

Study Design. An experimental laboratory study. Objective. To investigate the pathogenesis of intervertebral disc degeneration (IDD) in a murine model of type 1 diabetes mellitus (DM), namely nonobese diabetic (NOD) mouse. Summary of Background Data. IDD is a leading contributor of low back pain, which represents one of the most disabling symptoms within the adult population. DM is a chronic metabolic disease currently affecting one in 10 adults in the United States. It is associated with an increased risk of developing IDD, but the underlying process remains poorly understood. Methods. Total disc glycosaminoglycan content, proteoglycan synthesis, aggrecan fragmentation, glucose transporter gene expression, and apoptosis were assessed in NOD mice and wild-type euglycemic control mice. Spinal structural and molecular changes were analyzed by micro-computed tomography, histological staining (Safranin-O and fast green), and quantitative immunofluorescence (anti-ADAMTS-4 and -5 antibodies). Results. Compared with euglycemic controls, NOD mice showed increased disc apoptosis and matrix aggrecan fragmentation. Disc glycosaminoglycan content and histological features of NOD mice did not significantly differ from those of euglycemic littermates. Conclusion. These data demonstrate that DM may contribute to IDD by increasing aggrecan degradation and promoting cell apoptosis, which may represent early indicators of the involvement of DM in the pathogenesis of IDD. Level of Evidence: N/A

Physical Activity for the Treatment of Chronic Low Back Pain in Elderly Patients: A Systematic Review

“…Osteocalcin is a bone-derived hormone-like protein. It could favor physiological functions increasing the bone formation [57], regulating the muscle decrease related to age [58], and reducing the risk of diabetes type II [4,59]. Chahla et al [60] reported in their study that osteocalcin is higher in patients who perform regular PA, with an increase in bone mineralization, muscle function, and reduction of risk of diabetes type II.…”

Beneficial Effects of Physical Activity in Diabetic Patients

“…The physical fitness term, refers to a series of attributes that can be achieved by training, such as endurance and strength, abilities that are closely related to PA [ 5 ]. However, PA in overweight or obese individuals with diabetes often represents an insurmountable problem since these subjects suffer of several musculoskeletal disorders such as osteoarthritis [ 10 ], chronic low back pain due to intervertebral disc degeneration [ 11 ], and other musculoskeletal disorders [ 12 , 13 ].…”

Molecular basis of degenerative spinal disorders from a proteomic perspective (Review)

“…Activation of the AGE-RAGE signaling pathway in diabetic polyneuropathy, a complication of diabetes, is commonly observed, and increased AGE-RAGE signaling exacerbates degenerative disorders of peripheral neurons (90). In fact, a recent study reported no significant difference in the GAG content or histological features between discs from non-obese diabetic mice and euglycemic littermates, but noted increases in cellular apoptosis and matrix aggrecan fragmentation (91). To determine the link between diabetes and IDD, the role of the AGE-RAGE signaling pathway in IDD requires further research.…”