We previously demonstrated that VEGF and its receptors were expressed in human herniated discs (HD). TNF-a induced VEGF, resulting in neovascularization of disc tissues in a model of HD. The goal of the current research was to investigate the precise role of TNF-a-induced VEGF and the mechanism of angiogenesis in disc tissues. We performed ELISAs, Western blots, and immunohistological examinations to assess the role of TNF-a-induced VEGF using organ disc cultures with wild type, TNF receptor 1-null (TNF-RI null ), or TNF receptor 2-null (TNF-RII null ) mice. VEGF induction was inhibited when we used TNF-RI null -derived disc tissues. NF-kB pathway inhibitors also strongly suppressed VEGF induction. Thus, TNF-a induced VEGF expression in disc cells primarily through the NF-kB pathway. In addition, VEGF immunoreactivity was detected predominantly in annulus fibrosus cells and increased after TNF-a stimulation. TNF-a treatment also resulted in CD31 expression on endothelial cells and formation of an anastomosing network. In contrast, angiogenic activity was strongly inhibited in the presence of NF-kB inhibitors or anti-VEGF antibody. Our data show angiogenesis activity in disc tissues is regulated by VEGF and the NF-kB pathway, both of which are induced by TNF-a. The level of angiogenic activity in disc tissues was closely related to aging. Because neovascularization of HD is indispensable for HD resorption, the prognosis of HD and the rate of the resorption process in patients may vary as a function of the patient's age. ß
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