Molecular Basis of Intervertebral Disc Degeneration and Herniations: What Are the Important Translational Questions?

Background

Intervertebral disc degeneration is a common condition with few inexpensive and effective modes of treatment, but current investigations seek to clarify the underlying process and offer new treatment options. It will be important for physicians to understand the molecular basis for the pathology and how it translates to developing clinical treatments for disc degeneration. In this review, we sought to summarize for clinicians what is known about the molecular processes that causes disc degeneration.

Results

A healthy disc requires maintenance of a homeostatic environment, and when disrupted, a catabolic cascade of events occurs on a molecular level resulting in upregulation of proinflammatory cytokines, increased degradative enzymes, and a loss of matrix proteins. This promotes degenerative changes and occasional neurovascular ingrowth potentially contributing to the development of pain. Research demonstrates the molecular changes underlying the harmful effects of aging, smoking, and obesity seen clinically while demonstrating the variable influence of exercise. Finally, oral medications, supplements, biologic treatments, gene therapy, and stem cells hold great promise but require cautious application until their safety profiles are better outlined.

Conclusions

Intervertebral disc degeneration occurs where there is a loss of homeostatic balance with a predominantly catabolic metabolic profile. A basic understanding of the molecular changes occurring in the degenerating disc is important for practicing clinicians because it may help them to inform patients to alter lifestyle choices, identify beneficial or harmful supplements, or offer new biologic, genetic, or stem cell therapies.     

Correction to: Factors Contributing to Psychological Ill#Effects and Resilience of Caregivers of Children with Developmental Disabilities During a Nation#wide Lockdown During the COVID#19 Pandemic

Journal of Autism and Developmental Disorders -     

Limbic covariance network alterations in patients with transient global amnesia

Journal of Neurology - We compared limbic structure volumes and graph theory parameters of the limbic covariance network between patients with transient global amnesia (TGA) and healthy controls,...     

Paraneoplastic syndrome in neuroophthalmology

Journal of Neurology - Paraneoplastic syndrome is a group of clinical symptoms that occur in the state of systemic malignant tumors. Paraneoplastic syndrome of the nervous system can affect any...     

基于免疫级联反应的蚕蛹浆比色法在关节假体周围感染精准诊断中的实验研究北大核心CSCD

目的探讨蚕蛹浆(silkworm larvae plasma,SLP)比色法在关节假体周围感染(periprosthetic joint infection,PJI)精准诊断中的应用价值。方法取90只健康雄性新西兰大白兔,采用Swanson假体行膝关节置换手术;然后根据致病菌不同随机分为3组:A组(金黄色葡萄球菌组)、B组(表皮葡萄球菌组)及C组(大肠埃希菌组),每组30只。术后第3天膝关节腔内注射1 mL不同浓度致病菌制备PJI模型。分别于接种菌液前及接种后7、14、21 d取样进行检测,参照2018年PJI费城国际共识诊断标准首先判定并计算3组实验动物的造模成功率,并采用SLP比色法计算其在PJI精准诊断中的敏感性、特异性、阳性预测值、阴性预测值和诊断效率。结果接种菌液21 d时,A、B、C组分别有26、18、23只实验动物诊断为感染,造模成功率分别为86.7%、60.0%、76.7%,3组间比较差异无统计学意义(χ^(2)=5.724,P=0.073)。PJI比色法结果显示,A组在7 d时出现1只假阳性动物(特异性75.0%),随时间推移(14、21 d)SLP的特异性升至100.0%;14、21 d,另出现了1只假阴性动物(敏感性由100.0%降至96.2%)。B组在7 d时出现1只假阳性动物(特异性91.7%),随着时间推移特异性回升至100.0%;在14、21 d时分别出现1只和4只假阴性动物(敏感性分别为94.4%及83.3%)。C组在7 d时有2只假阳性动物(特异性71.4%),随后回升至100.0%。A、C组在21 d时诊断效率极高(96.7%和100.0%);即使面对B组低毒力的表皮葡萄球菌,21 d时SLP的诊断效率也可保持在90.0%;总体诊断效率很好(95.6%)。结论 SLP比色法诊断PJI具有较高的敏感性、特异性以及诊断效率,是一种极具潜能的PJI诊断方法。