Sun Hong, Guo Jiajie, Xiong Zhilin, Zhuang Yong, Ning Xu, Liu Miao
Department of Orthopaedics Affiliated Hospital of Guizhou Medical University Guiyang China.
School of Clinical Medicine, Guizhou Medical University Guiyang China.
JOR Spine. 2024 Dec 18;7(4):e70011. doi: 10.1002/jsp2.70011. eCollection 2024 Dec.
Intervertebral disc degeneration (IDD) is a progressive age-related disorder characterized by the reduction in the number of nucleus pulposus cells (NPCs) and degradation of extracellular matrix (ECM), thereby leading to chronic pain and disability. The pathogenesis of IDD is multifaceted, and current therapeutic strategies remain limited. The nucleus pulposus (NP), primarily composed of NPCs, proteoglycans, and type II collagen, constitutes essential components for maintaining intervertebral disc (IVD) function and spinal motion. The disturbed homeostasis of NPCs is closely associated with IDD. Accumulating evidence increasingly suggests the crucial role of programmed cell death (PCD) in regulating the homeostasis of NPCs.
This review aimed to elucidate various forms of PCD and their respective roles in IDD, and investigate diverse strategies targeting the cell death of NPCs for IDD treatment.
MATERIALS & METHODS: We collected the relevant literature regarding PCD and their roles in the development of IDD. Subsequently, we comprehensively summarized the intricate association between PCD and IDD, and also explored the potential and application of cell therapy and traditional Chinese medicine (TCM) in the prevention and treatment of IDD.
Current literature indicated that the PCD of NPCs was closely associated with the pathogenesis of IDD. Additionally, the development of targeted pharmaceuticals based on the mechanisms of PCD could effectively impede the loss of NPCs.
This review demonstrated that targeting the PCD of NPCs may be a promising strategy for the treatment of IDD.
椎间盘退变（IDD）是一种与年龄相关的进行性疾病，其特征是髓核细胞（NPCs）数量减少和细胞外基质（ECM）降解，从而导致慢性疼痛和功能障碍。IDD的发病机制是多方面的，目前的治疗策略仍然有限。髓核（NP）主要由NPCs、蛋白聚糖和II型胶原蛋白组成，是维持椎间盘（IVD）功能和脊柱运动的重要组成部分。NPCs内环境稳态的紊乱与IDD密切相关。越来越多的证据表明程序性细胞死亡（PCD）在调节NPCs内环境稳态中起关键作用。
本综述旨在阐明PCD的各种形式及其在IDD中的各自作用，并研究针对NPCs细胞死亡的不同策略用于IDD治疗。
我们收集了有关PCD及其在IDD发生发展中作用的相关文献。随后，我们全面总结了PCD与IDD之间的复杂关联，并探讨了细胞治疗和中药（TCM）在IDD预防和治疗中的潜力及应用。
当前文献表明NPCs的PCD与IDD的发病机制密切相关。此外，基于PCD机制开发的靶向药物可有效阻止NPCs的丢失。
本综述表明，针对NPCs的PCD可能是一种有前景的IDD治疗策略。
