Pan Hongyu, Li Hongtao, Guo Sheng, Wang Chenglong, Long Longhai, Wang Xiaoqiang, Shi Houyin, Zhang Kaiquan, Chen Hui, Li Sen
Department of Spinal Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Department of Spinal Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Exp Gerontol. 2023 Apr;174:112119. doi: 10.1016/j.exger.2023.112119. Epub 2023 Feb 9.
Low back pain (LBP) is one of the most common health problems in people's lives, which brings a massive burden to clinicians, and the leading cause of LBP is intervertebral disc degeneration (IDD). IDD is mainly caused by factors such as aging, mechanical stress, and lack of nutrition. The pathological mechanism of IDD is very complex, involving inflammatory response, cell metabolism disorder, and so on. Unfortunately, in the current treatment of IDD, only relieving symptoms as the primary means of relieving a patient's pain cannot effectively inhibit or reverse the progression of IDD. Tumor necrosis factor-α (TNF-α) is a multifunctional pro-inflammatory factor involved in many diseases' pathological processes. With the in-depth study of the pathological mechanism of IDD, more and more evidence has shown that TNF-α is an essential activator of IDD, which is related to the metabolic disorder, inflammatory responses, apoptosis, and other pathological processes of extracellular dissociation in the intervertebral disc. Therefore, anti-TNF-α therapy is an effective therapeutic target for alleviating IDD, especially in inhibiting extracellular matrix degradation and reducing inflammatory responses. This article reviews the pathological role of TNF-α in IDD and the latest research progress of TNF-α inhibitors in treating IDD.
下腰痛（LBP）是人们生活中最常见的健康问题之一，给临床医生带来了巨大负担，而LBP的主要原因是椎间盘退变（IDD）。IDD主要由衰老、机械应力和营养缺乏等因素引起。IDD的病理机制非常复杂，涉及炎症反应、细胞代谢紊乱等。不幸的是，在目前IDD的治疗中，仅以缓解症状作为减轻患者疼痛的主要手段，无法有效抑制或逆转IDD的进展。肿瘤坏死因子-α（TNF-α）是一种多功能促炎因子，参与多种疾病的病理过程。随着对IDD病理机制研究的深入，越来越多的证据表明TNF-α是IDD的关键激活因子，与椎间盘细胞外基质分解代谢紊乱、炎症反应、细胞凋亡等病理过程有关。因此，抗TNF-α治疗是缓解IDD的有效治疗靶点，尤其在抑制细胞外基质降解和减轻炎症反应方面。本文综述了TNF-α在IDD中的病理作用以及TNF-α抑制剂治疗IDD的最新研究进展。
