Setton Lori A, Chen Jun
Department of Biomedical Engineering, Division of Orthopaedic Surgery, Duke University, Durham, North Carolina 27708-0281, USA.
Spine (Phila Pa 1976). 2004 Dec 1;29(23):2710-23. doi: 10.1097/01.brs.0000146050.57722.2a.
A review is presented on current knowledge of the micromechanical factors in the intervertebral disc, their role in modifying cell biology, and changes with degeneration.
To identify current knowledge, knowledge gaps, and areas for future research in micromechanics of the intervertebral disc.
Mechanical factors play important roles in the initiation and progression of intervertebral disc degeneration. Evidence suggests that substantial biologic remodeling occurs in the intervertebral disc in response to mechanical stimuli that may play a critical role in determining the fate of a degenerating intervertebral disc. Information is needed on the precise mechanical stimuli that these cells experience and the mechanisms that govern their responses.
A review is presented of cell morphology, cell mechanics, and the internal strains and other mechanical factors predicted to occur at the cell level. A review of intervertebral disc cell responses to well-controlled physical stimuli is also presented with a focus on in vitro studies of explants and isolated cells.
Important differences in cell morphology, mechanics, micromechanical factors, and mechanobiology are noted to occur between cells of the nucleus pulposus and anulus fibrosus. Changes in these features with degeneration are critically understudied, particularly degeneration-associated changes in cell morphology, cell mechanics, and altered physiology with mechanical loading.
Information on the mechanisms that govern cell responses to mechanical stimuli in the intervertebral disc are just emerging. Studies must address determination of the factors that control micromechanical stimuli, but also mechanisms by which mechanics may interact with genetic factors to regulate expression and remodeling of extracellular matrix molecules, cytokines and mediators of pain and inflammation in degenerating tissue.
本文综述了目前关于椎间盘微机械因素的知识、它们在改变细胞生物学方面的作用以及随退变的变化。
确定目前关于椎间盘微力学的知识、知识空白以及未来研究领域。
机械因素在椎间盘退变的起始和进展中起重要作用。有证据表明，椎间盘会因机械刺激而发生显著的生物重塑，这可能在决定退变椎间盘的命运中起关键作用。需要了解这些细胞所经历的精确机械刺激以及控制其反应的机制。
本文综述了细胞形态、细胞力学以及预计在细胞水平发生的内部应变和其他机械因素。还综述了椎间盘细胞对严格控制的物理刺激的反应，重点是外植体和分离细胞的体外研究。
注意到髓核和纤维环细胞在细胞形态、力学、微机械因素和机械生物学方面存在重要差异。这些特征随退变的变化研究严重不足，特别是退变相关的细胞形态、细胞力学变化以及机械加载导致的生理改变。
关于椎间盘细胞对机械刺激反应机制的信息刚刚出现。研究必须确定控制微机械刺激的因素，还要研究力学与遗传因素相互作用以调节退变组织中细胞外基质分子、细胞因子以及疼痛和炎症介质的表达和重塑的机制。
