Sharma Anirudh
Division of Orthopaedic Surgery, University of Manitoba, Winnipeg, MB R3A 1R9, Canada.
Med Sci (Basel). 2018 Apr 24;6(2):34. doi: 10.3390/medsci6020034.
Intervertebral disc degeneration (IDD) is an important cause of low back pain. Recent evidence suggests that in addition to abnormal and excessive mechanical loading, inflammation may be a key driver for both IDD and low back pain. Obesity, a known mechanical risk factor of IDD, is now increasingly being recognized as a systemic inflammatory state with adipokines being postulated as likely inflammatory mediators. The aim of this review was to summarize the current literature regarding the inflammatory role of adipokines in the pathophysiology of IDD. A systematic literature search was performed using the OVID Medline, EMBASE and PubMed databases to identify all studies assessing IDD and adipokines. Fifteen studies were included in the present review. Leptin was the most commonly assessed adipokine. Ten of 15 studies were conducted in humans; three in rats and two in both humans and rats. Studies focused on a variety of topics ranging from receptor identification, pathway analysis, genetic associations, and proteonomics. Currently, data from both human and animal experiments demonstrate significant effects of leptin and adiponectin on the internal milieu of intervertebral discs. However, future studies are needed to determine the molecular pathway relationships between adipokines in the pathophysiology of IDD as avenues for future therapeutic targets.
椎间盘退变（IDD）是腰痛的一个重要原因。最近的证据表明，除了异常和过度的机械负荷外，炎症可能是IDD和腰痛的关键驱动因素。肥胖是已知的IDD机械风险因素，现在越来越被认为是一种全身性炎症状态，脂肪因子被假定为可能的炎症介质。本综述的目的是总结当前关于脂肪因子在IDD病理生理学中的炎症作用的文献。使用OVID Medline、EMBASE和PubMed数据库进行了系统的文献检索，以识别所有评估IDD和脂肪因子的研究。本综述纳入了15项研究。瘦素是最常被评估的脂肪因子。15项研究中有10项在人类中进行；3项在大鼠中进行，2项在人类和大鼠中都进行。研究集中在从受体识别、途径分析、基因关联和蛋白质组学等各种主题上。目前，来自人类和动物实验的数据都证明了瘦素和脂联素对椎间盘内部环境有显著影响。然而，需要进一步的研究来确定脂肪因子在IDD病理生理学中的分子途径关系，作为未来治疗靶点的途径。
