Journal
GLOBAL SPINE JOURNAL
Volume 3, Issue 3, Pages 175-184Publisher
GEORG THIEME VERLAG KG
DOI: 10.1055/s-0033-1347299
Keywords
inflammatory mediators; intervertebral disk degeneration; degenerative disk disease; discogenic pain; cytokines; innervation
Categories
Funding
- Swiss National Science Foundation [310030_130813 / 45244402]
- AOSpine [SRN 02/103, SRN_2011_04_104981]
- CIHR [MOP-119564]
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Although degeneration of the intervertebral disk has historically been described as a misbalance between anabolic and catabolic factors, the role of inflammatory mediators has long been neglected. However, past research clearly indicates that inflammatory mediators such as interleukin (IL)-1 beta, IL-6, IL-8 and tumor necrosis factor-a are expressed at higher levels in diseased intervertebral disks. Both disk cells as well as invading macrophages can be the source of the detected cytokines. Importantly, occurrence of inflammatory mediators in the disk can worsen the progress of degeneration by inducing the expression of matrix degrading enzymes as well as by inhibiting extracellular matrix synthesis. In addition, inflammatory mediators play a crucial role in pain development during intervertebral disk herniation (i.e., sciatica) and disk degeneration (i.e., discogenic pain). This review provides information on the most relevant inflammatory mediators during different types of disk diseases and explains how these factors can induce disk degeneration and the development of discogenic and sciatic/radiculopathic pain.
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