Pathophysiological mechanisms of intervertebral disc degeneration
A.M. Tkachev1,2, A.V. Epifanov3, E.S. Akarachkova4, A.V. Smirnova1, A.V. Ilyushin1, D.S. Archakov2
1Diagnostic and Treatment Centre MIBS-Volgograd LLC, Volgograd
2TMM-Clinic LLC, Volgograd
3Epifanov’s Clinic LLC, Samara
4International Association for the Study and Effective Control of the Stress and Related Disorders, Moscow
High prevalence of back pain due to the presence of herniated intervertebral discs (IVD) contributes to a large number of researches aimed at the development of new treatment methods. Interest in сell therapy for IVD repair has contributed to the study of their biology and has greatly expanded our knowledge in this area over the past decade. The article presents the latest data on healthy IVD structure and the mechanisms and factors that lead to its degeneration process (disruption in blood supply to the vertebrae and/or end plate; increase in cell nutrient requirements). IVD degeneration process is complex and determined within a wide range of factors. Thus, the ways to this process reversal should be manifold and vary depending on the disease phenotype and the degree of its progression. It was shown that IVDs blood supply deteriorates in accordance with their degeneration degree, which also highlights the role of nutrient insufficiency in the IVDs restoration. Current methods of IVDs regeneration improvement and promising scientific research directions, which allow improving the treatment efficacy for patients with this pathology in the future, are presented.
Keywords: intervertebral disc, degeneration, pathophysiology, regeneration.
For citation: Tkachev A.M., Epifanov A.V., Akarachkova E.S. et al. Pathophysiological mechanisms of intervertebral disc degeneration. RMJ. Medical Review. 2019;4(II):72–77.
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17. Alkhatib B., Rosenzweig D.H., Krock E. et al. Acute mechanical injury of the human intervertebral disc: link to degeneration and pain. Eur Cell Mater. 2014;28:98–110.
18. Martirosyan N.L., Patel A.A., Carotenuto A. et al. Genetic Alterations in Intervertebral Disc Disease. Front Surg. 2016;3:59.
19. Mayer J.E., Iatridis J.C., Chan D. et al. Genetic polymorphisms associated with intervertebral disc degeneration. Spine J. 2013;13(3):299–317.
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21. Munir S., Rade M., Määttä J.H. et al. Intervertebral Disc Biology: Genetic Basis of Disc Degeneration. Curr Mol Biol Rep. 2018;4(4):143–150.
22. Risbud M.V., Shapiro I.M. Role of cytokines in intervertebral disc degeneration: pain and disc content. Nat Rev Rheumatol. 2014;10(1):44–56.
23. Videman T., Sarna S., Battié M.C. et al. The long-term effects of physical loading and exercise lifestyles on back-related symptoms, disability, and spinal pathology among men. Spine. 1995;20(6):699–709.
24. Jakoi A.M., Pannu G., D’Oro A. et al. The Clinical Correlations between Diabetes, Cigarette Smoking and Obesity on Intervertebral Degenerative Disc Disease of the Lumbar Spine. Asian Spine J. 2017;11(3):337–347.
25. Stolarczyk E. Adipose tissue inflammation in obesity: a metabolic or immune response? Curr Opin Pharmacol. 2017;37:35–40.
26. Feng C., Liu H., Yang M. et al. Disc cell senescence in intervertebral disc degeneration: Causes and molecular pathways. Cell Cycle. 2016;15(13):1674–1684.
27. Wang A.M., Cao P., Yee A. et al. Detection of extracellular matrix degradation in intervertebral disc degeneration by diffusion magnetic resonance spectroscopy. Magn Reson Med. 2015;73(5):1703–1712.
28. Zhu Q., Gao X., Levene H.B. et al. Influences of Nutrition Supply and Pathways on the Degenerative Patterns in Human Intervertebral Disc. Spine (Phila Pa 1976). 2016;41(7):568–576.
29. Wang W., Hao J., Zheng S. et al. Association Between Cartilage Intermediate Layer Protein and Degeneration of Intervertebral Disc: A Meta-analysis. Spine (Phila Pa 1976). 2016;41(20):1244–1248.
30. Boubriak O.A., Watson N., Sivan S.S. et al. Factors regulating viable cell density in the intervertebral disc: blood supply in relation to disc height. J Anat. 2013;222(3):341–348.
31. Stephan S., Johnson W.E., Roberts S. The influence of nutrient supply and cell density on the growth and survival of intervertebral disc cells in 3D culture. Eur Cell Mater. 2011;22:97–108.
32. Kauppila L.I. Atherosclerosis and disc degeneration/low-back pain — a systematic review. Eur J Vasc Endovasc Surg. 2009;37(6):661–670.
33. Grunhagen T., Shirazi-Adl A., Fairbank J.C., Urban J.P. Intervertebral disk nutrition: a review of factors influencing concentrations of nutrients and metabolites. Orthop Clin North Am. 2011;42(4):465–477.
34. Turgut M., Uysal A., Uslu S. et al. The effects of calcium channel antagonist nimodipine on end-plate vascularity of the degenerated intervertebral disc in rats. J Clin Neurosci. 2003;10(2):219–223.
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