Shelby Tara, Mills Emily S, Ton Andy, Wang Jeffrey C, Hah Raymond J, Qureshi Sheeraz A, Alluri Ram K
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Hospital for Special Surgery, New York, NY, USA.
Global Spine J. 2023 Sep;13(7):2096-2099. doi: 10.1177/21925682231152826. Epub 2023 Jan 18.
Narrative review.
The purpose of this review is to outline the role of sex hormones, particularly estrogen, in the pathogenesis of degenerative disc disease (DDD).
A narrative review of studies discussing sex hormones and intervertebral disc (IVD) degeneration was conducted through a search of bibliographic databases to identify various mechanisms involved in effectuating DDD.
Estrogen-deficient states negatively impact various aspects of IVD function. These internal hormone environments reflect routine changes that commonly arise with physiologic aging and can compromise IVD structural integrity through a host of processes. Additionally, allosteric molecules such as micro-RNAs (mi-RNAs) and G protein-coupled estrogen receptors (GPER) antagonists can bind to estrogen receptors and inhibit protective downstream effects with estrogen receptor signaling. Furthermore, cursory studies have observed chondrogenic effects with testosterone supplementation, although the specific mechanism remains unclear.
Regulation of sex hormones, namely estrogen and testosterone, significantly impacts the structural integrity and function of IVDs. Uncovering underlying interactions driving these regulatory processes can facilitate development of novel, clinical therapies to treat DDD.
叙述性综述。
本综述的目的是概述性激素，尤其是雌激素，在退行性椎间盘疾病（DDD）发病机制中的作用。
通过检索文献数据库，对讨论性激素与椎间盘（IVD）退变的研究进行叙述性综述，以确定导致DDD的各种机制。
雌激素缺乏状态对IVD功能的各个方面产生负面影响。这些体内激素环境反映了生理衰老过程中常见的常规变化，并可通过一系列过程损害IVD的结构完整性。此外，诸如微小RNA（mi-RNA）和G蛋白偶联雌激素受体（GPER）拮抗剂等变构分子可与雌激素受体结合，并抑制雌激素受体信号传导的保护性下游效应。此外，初步研究观察到补充睾酮有软骨生成作用，但其具体机制尚不清楚。
性激素，即雌激素和睾酮的调节，对IVD的结构完整性和功能有显著影响。揭示驱动这些调节过程的潜在相互作用有助于开发治疗DDD的新型临床疗法。
