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Calcium pentosan polysulfate and sodium pentosan polysulfate may be used to treat intervertebral disc degeneration
Authors:Jia-Guo Zhao  Jia Wang  Qi Xin  Peng Zhang  Sheng-Fei Zhang  Feng Qi  Dong Mao  Zhi-Cheng Zhang
Institution:1. Department of Orthopaedics, Tianjin Hospital, Tianjin, PR China;2. Department of Orthopaedics, Clinical College of Orthopaedics, Tianjin Medical University, Tianjin, PR China;3. Department of Pathology, Tianjin Third Central Hospital, Tianjin, PR China;4. Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, Suzhou, PR China;5. Department of Orthopaedics, Subei People’s Hospital of Jiangsu Province, Yangzhou, PR China;6. Department of Surgery, Jiuting Hospital of Songjiang District, Shanghai, PR China;g Department of Surgery, Zhucheng People’s Hospital, Zhucheng, PR China;h Department of Pathology, Tianjin Hospital, Tianjin, PR China;i Department of Pathology, Clinical College of Orthopaedics, Tianjin Medical University, Tianjin, PR China
Abstract:Intervertebral disc degeneration (IDD) is a major health problem world-wide, and several spinal disorders are closely associated with it. Although people have invested a great deal of time and effort, how to prevent and reverse the IDD for the researchers is still a difficult and hot issue. Intervertebral disc belongs to cartilage tissue, and IDD also is the cartilage degeneration disease. A large quantity of studies have shown that Calcium pentosan polysulfate (CaPPS) and sodium pentosan polysulfate (NaPPS) possess chondroprotective activities and play an important role in maintaining cartilage integrity. We reasonably hypothesize that NaPPS and CaPPS may be used to treat IDD. The possible mechanism may include that: (1) the significant effects of NaPPS and CaPPS in improving capillary blood flow could maintain nutritional supply to intervertebral disc, and preserve intervertebral disc tissue against degeneration; (2) CaPPS and NaPPS preserve cartilage integrity, proteoglycan synthesis, and improve cartilage biomechanical properties; (3) as the multifaceted exosite inhibitors of proteinases NaPPS and CaPPS strongly impede the activity and production of proteinases; (4) promotion of the balance between proteinases and TIMPs also may be involved in treating IDD; (5) NaPPS and CaPPS exhibit potent anti-inflammatory effects, and then reduce inflammation-induced IDD. If the hypothesis were conformed, the symptoms caused by IDD and its related diseases would be a corresponding alleviation or even disappearance, which could greatly alleviate the suffering of patients from disc degeneration diseases. Certainly, many roles of CaPPS and NaPPS, such as effectiveness, safety and side effects, need to be tested, and further works such as animal model and clinical trial, need to be done to prove this hypothesis.
Keywords:ADAMTS  adamalysin with thrombospondin motifs  CaPPS  calcium pentosan polysulfate  IDD  intervertebral disc degeneration  IL-1  interleukin-1  MMPs  matrix metalloproteinases  NaPPS  sodium pentosan polysulfate  PPS  pentosan polysulfate  TIMPs  inhibitors of matrix metalloproteinases  TNF-α  tumor necrosis factor-α
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