The role of structure and function changes of sensory nervous system in intervertebral disc-related low back pain. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Zhang, S.; Hu, B.; Liu, W.; Wang, P.; Lv, X.; Chen, S.; Shao, Z.
• Is Part Of: Osteoarthritis and cartilage. Volume 29:Issue 1(2021)
• Page Start: 17
• Page End: 27
• Publication Date: 2021-01
• Subjects: Low back pain -- Intervertebral disc degeneration -- Disc innervation -- Nerve sensitization -- Neuroinflammation; LBP low back pain -- IVD intervertebral disc -- IVDD intervertebral disc degeneration -- DRG dorsal root ganglion -- AF annulus fibrosus -- NP nucleus pulposus -- CEP cartilage endplate -- ECM extracellular matrix -- MRI magnetic resonance imaging -- LDH lumbar disc herniation -- SP substance P -- CGRP calcitonin gene-related peptide -- NGF nerve growth factor -- BDNF brain-derived neurotrophic factor -- VEGF vascular endothelial growth factor -- TNF tumor necrosis factor -- IL interleukin -- IFN interferon -- PGE2 prostaglandin E2 -- TRP transient receptor potential -- ASIC acid-sensing ion channel -- VGSC voltage-gated sodium channel -- TGF transforming growth factor; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Arthrose -- Périodiques; Articulations -- Maladies -- Périodiques; 616.7223005
• DOI: 10.1016/j.joca.2020.09.002
• Languages: English
• ISSNs: 1063-4584

Abstract

Summary: Low back pain (LBP) is a common musculoskeletal symptom, which can be developed in multiple clinical diseases. It is widely recognized that intervertebral disc (IVD) degeneration (IVDD) is one of the leading causes of LBP. However, the pathogenesis of IVD-related LBP is still controversial, and the treatment means are also insufficient to date. In recent decades, the role of structure and function changes of sensory nervous system in the induction and the maintenance of LBP is drawing more and more attention. With the progress of IVDD, IVD cell exhaustion and extracellular matrix degradation result in IVD structural damage, while neovascularization, innervation and inflammatory activation further deteriorate the microenvironment of IVD. New nerve ingrowth into degenerated IVD amplifies the impacts of IVD-derived nociceptive molecules on sensory endings. Moreover, IVDD is usually accompanied with disc herniation, which could injure and inflame affected nerves. Under mechanical and pro-inflammatory stimulation, the pain-transmitting pathway exhibits a sensitized function state and ultimately leads to LBP. Hence, relevant pathogenic factors, such as neurotrophins, ion channels, inflammatory factors, etc., are supposed to serve as promising therapeutic targets for LBP. The purpose of this review is to comprehensively summarize the current evidence on 1) the pathological changes of sensory nervous system during IVDD and their association with LBP, and 2) potential therapeutic strategies for LBP targeting relevant pathogenic factors.