Thompson Kelly, Moore Sarah, Tang Shirley, Wiet Matthew, Purmessur Devina
Department of Veterinary Clinical Sciences The Ohio State University Columbus Ohio.
Department of Biomedical Engineering, College of Engineering The Ohio State University Columbus Ohio.
JOR Spine. 2018 Mar;1(1):e1011. doi: 10.1002/jsp2.1011. Epub 2018 Mar 28.
Low back pain (LBP) is the leading cause of disability worldwide, with an estimated 80% of the American population suffering from a painful back condition at some point during their lives. The most common cause of LBP is intervertebral disc (IVD) degeneration (IVDD), a condition that can be difficult to treat, either surgically or medically, with current available therapies. Thus, understanding the pathological mechanisms of IVDD and developing novel treatments are critical for improving outcome and quality of life in people living with LBP. While experimental animal models provide valuable mechanistic insight, each model has limitations that complicate translation to the clinical setting. This review focuses on the chondrodystrophic canine clinical model of IVDD as a promising model to assess IVD-associated spinal pain and translational therapeutic strategies for LBP. The canine IVD, while smaller in size than human, goat, ovine, and bovine IVDs, is larger than most other small animal IVDD models and undergoes maturational changes similar to those of the human IVD. Furthermore, both dogs and humans develop painful IVDD as a spontaneous process, resulting in similar characteristic pathologies and clinical signs. Future exploration of the canine model as a model of IVD-associated spinal pain and biological treatments using the canine clinical model will further demonstrate its translational capabilities with the added ethical benefit of treating an existing veterinary patient population with IVDD.
下背痛(LBP)是全球致残的主要原因,估计80%的美国人口在其一生中的某个时候会患有背痛疾病。LBP最常见的原因是椎间盘(IVD)退变(IVDD),目前可用的治疗方法无论是手术还是药物治疗,这种情况都很难治疗。因此,了解IVDD的病理机制并开发新的治疗方法对于改善LBP患者的治疗效果和生活质量至关重要。虽然实验动物模型提供了有价值的机制见解,但每个模型都有局限性,这使得向临床环境的转化变得复杂。本综述重点关注IVDD的软骨发育不良犬临床模型,该模型是评估与IVD相关的脊柱疼痛和LBP转化治疗策略的一个有前景的模型。犬IVD虽然比人类、山羊、绵羊和牛的IVD小,但比大多数其他小动物IVDD模型大,并且经历与人类IVD相似的成熟变化。此外,狗和人类都会自发地发展为疼痛性IVDD,导致相似的特征性病理和临床症状。未来将犬模型作为与IVD相关的脊柱疼痛模型进行探索,并使用犬临床模型进行生物治疗,将进一步证明其转化能力,并具有治疗现有患有IVDD的兽医患者群体的额外伦理益处。