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椎间盘退变与炎症微环境:表达、病理及治疗策略

Intervertebral disc degeneration and inflammatory microenvironment: expression, pathology, and therapeutic strategies.

作者信息

Chen Xin, Wang Zihan, Deng Rongrong, Yan Hongjie, Liu Xin, Kang Ran

机构信息

The Third Clinical Medical College, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, Jiangsu, People's Republic of China.

Department of Orthopedics, Nanjing Lishui Hospital of Traditional Chinese Medicine, Nanjing, 210028, Jiangsu, People's Republic of China.

出版信息

Inflamm Res. 2023 Sep;72(9):1811-1828. doi: 10.1007/s00011-023-01784-2. Epub 2023 Sep 4.

Abstract

BACKGROUND

Intervertebral disc degeneration (IDD) is a leading cause of low back pain (LBP), posing a significant socioeconomic burden. Recent studies highlight the crucial role of inflammatory microenvironment in IDD progression.

METHOD

A keyword-based search was performed using the PubMed database for published articles.

RESULTS AND CONCLUSIONS

Dysregulated expression of inflammatory cytokines disrupts intervertebral disc (IVD) homeostasis, causing atrophy, fibrosis, and phenotypic changes in nucleus pulposus cells. Modulating the inflammatory microenvironment and restoring cytokine balance hold promise for IVD repair and regeneration. This comprehensive review systematically examines the expression regulation, pathological effects, therapeutic strategies, and future challenges associated with the inflammatory microenvironment and relevant cytokines in IDD. Key inflammatory cytokines, including interleukins (IL), tumor necrosis factor-alpha (TNF-α), and chemokines, exhibit significant pathological effects in IDD. Furthermore, major therapeutic modalities such as chemical antagonists, biologics, plant extracts, and gene transcription therapies are introduced to control and ameliorate the inflammatory microenvironment. These approaches provide valuable insights for identifying potential targets in future anti-inflammatory treatments for IDD.

摘要

背景

椎间盘退变(IDD)是下腰痛(LBP)的主要原因,带来了巨大的社会经济负担。最近的研究强调了炎症微环境在IDD进展中的关键作用。

方法

使用PubMed数据库对已发表文章进行基于关键词的搜索。

结果与结论

炎症细胞因子的表达失调破坏了椎间盘(IVD)的内环境稳态,导致髓核细胞萎缩、纤维化和表型改变。调节炎症微环境和恢复细胞因子平衡有望实现IVD的修复和再生。这篇综述系统地研究了与IDD中炎症微环境和相关细胞因子相关的表达调控、病理效应、治疗策略及未来挑战。关键的炎症细胞因子,包括白细胞介素(IL)、肿瘤坏死因子-α(TNF-α)和趋化因子,在IDD中表现出显著的病理效应。此外,还介绍了化学拮抗剂、生物制剂、植物提取物和基因转录疗法等主要治疗方式,以控制和改善炎症微环境。这些方法为识别未来IDD抗炎治疗的潜在靶点提供了有价值的见解。

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