Immunomorphogenesis in Degenerative Disc Disease: The Role of Proinflammatory Cytokines and Angiogenesis Factors

Abstract

Back pain (BP) due to degenerative disc disease (DDD) is a severe, often disabling condition. The aim of this study was to determine the association between the expression level of proinflammatory cytokines (IL-1β, IL-6, and IL-17), angiogenesis markers (VEGF-A and CD31) in intervertebral disc (IVD) tissue and IVD degeneration in young people with discogenic BP. In patients who underwent discectomy for a disc herniation, a clinical examination, magnetic resonance imaging of the lumbar spine, histological and immunohistochemical analyses of these factors in IVD were performed in comparison with the parameters of healthy group samples (controls). Histology image analysis of IVD fragments of the DDD group detected zones of inflammatory infiltration, combined with vascularization, the presence of granulation tissue and clusters of chondrocytes in the tissue of nucleus pulposus (NP). Statistically significant increased expression of IL-1β, IL-6, IL-17, VEGF-A and CD31 was evident in the samples of the DDD group compared with the controls, that showed a strong correlation with the histological disc degeneration stage. Our results denote an immunoinflammatory potential of chondrocytes and demonstrates their altered morphogenetic properties, also NP cells may trigger the angiogenesis.

Back pain in young people: approaches to diagnosis and treatment

“…Отдельного Л е к ц и я | L e c t i o n внимания заслуживают молодые пациенты с ранним тяжелым ОА позвоночника: с хронической постоянной ежедневной болью в поясничной области и грыжами МПД, по данным МРТ выявляются не только грыжи МПД, но и эрозии замыкательных пластин тел позвонков и реактивный асептический спондилит тел позвонков, прилежащих к экструдированному диску, в сочетании с поражением фасеточных суставов и краевыми остеофитами [34]. Несмотря на многокомпонентную природу БС, в ее основе лежит низкоинтенсивное иммунное воспаление [35]. Этот механизм особенно важен при ОА позвоночника (в том числе у молодых пациентов), при других дегенеративных и диспластических процессах.…”

Histopathology of the Intervertebral Disc of Nothobranchius furzeri, a Fish Model of Accelerated Aging

“…Degenerative processes of the spine not only include OA of the facet joints but also alterations of the intervertebral discs [10][11][12]. In the early phases of disc degeneration a balance shift of anabolic and catabolic activity of extracellular matrix molecules and chondrocytes occurs, which also involves the presence of pro-inflammatory cytokines, including IL-1, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-15, IL-17, interferon-γ and TNFα [13,14]. Pravdyuk et al described the presence of IL-1β, IL-6 and IL-17 in all discs of degenerative disc disease patients, which was associated with the histological stage of the intervertebral disc degradation [14].…”

“…A common symptom of spine diseases is back pain, which frequently is caused by degenerative lesions of the spine [14,15]. Lumbar spondylolisthesis, defined as a slip of a lumbar vertebral body relative to the vertebral body below, may also be involved in the degeneration of the spinal structure [16].…”