Zhang Cong, Zhang Rende, Zhao Guanghai, Wu Zuolong, Song Wei, Ran Rui, Zhou Kaisheng, Zhang Haihong
Department of Orthopedics, The Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou, China.
Orthopaedics Key Laboratory of Gansu Province, The Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou, China.
Front Cell Dev Biol. 2025 Jun 3;13:1586193. doi: 10.3389/fcell.2025.1586193. eCollection 2025.
Intervertebral disc degeneration (IDD) and low back pain are prevalent issues globally, affecting a significant portion of the adult population. Recent research has highlighted the crucial role of circadian rhythms in the degenerative processes of intervertebral discs (IVDs). Circadian rhythms are regulated by a coordinated network of oscillators, consisting of a central clock system and various peripheral clock systems. These rhythms are influenced by environmental factors, particularly the light/dark cycle, and disruptions can lead to cumulative stress and imbalances within the body. The IVD tissue contains an autonomous oscillating peripheral clock, and evidence suggests that disruptions in these circadian rhythms can accelerate tissue aging and increase the risk of IDD. Studies have shown that reduced expression of clock genes, such as BMAL1, is an independent risk factor for IDD progression. Furthermore, circadian disruptions can imbalance anabolic and catabolic processes within IVDs, leading to tissue degeneration. Understanding the role of circadian rhythms in IDD may provide valuable insights into potential therapeutic strategies for preventing or mitigating disc degeneration. The review explores the entrainment of circadian rhythms with external physiological signals and their impact on disc physiology. Notably, disruptions in circadian rhythms have been linked to accelerated disc degeneration, with implications for tissue aging, metabolic imbalances, and inflammatory responses. Furthermore, the paper discusses potential therapeutic strategies, including chronotherapy, which aims to synchronize treatment interventions with circadian rhythms to optimize outcomes in IDD management. Understanding the intricate interplay between circadian rhythms and IDD could pave the way for innovative treatment approaches, ultimately improving patient care.
椎间盘退变（IDD）和腰痛是全球普遍存在的问题，影响着很大一部分成年人口。最近的研究强调了昼夜节律在椎间盘（IVD）退变过程中的关键作用。昼夜节律由一个协调的振荡器网络调节，该网络由一个中央时钟系统和各种外周时钟系统组成。这些节律受环境因素影响，特别是光/暗周期，而节律紊乱会导致体内累积压力和失衡。IVD组织含有一个自主振荡的外周时钟，有证据表明这些昼夜节律的紊乱会加速组织衰老并增加IDD的风险。研究表明，时钟基因如BMAL1表达降低是IDD进展的一个独立危险因素。此外，昼夜节律紊乱会使IVD内的合成代谢和分解代谢过程失衡，导致组织退变。了解昼夜节律在IDD中的作用可能为预防或减轻椎间盘退变的潜在治疗策略提供有价值的见解。这篇综述探讨了昼夜节律与外部生理信号的同步及其对椎间盘生理的影响。值得注意的是，昼夜节律紊乱与椎间盘退变加速有关，对组织衰老、代谢失衡和炎症反应有影响。此外，本文讨论了潜在的治疗策略，包括时间疗法，其目的是使治疗干预与昼夜节律同步，以优化IDD管理的结果。了解昼夜节律与IDD之间的复杂相互作用可为创新治疗方法铺平道路，最终改善患者护理。
