Abstract:
:Low back pain is generally attributed to intervertebral disc (IVD) degeneration. This is a multifactorial disease induced by genetic and environmental factors and that progresses with aging. Disc degeneration is characterized by a limited ability of IVD cells to produce functional matrix while producing abnormal amounts of matrix-degrading enzymes. The prolonged imbalance between anabolism and catabolism in degenerative discs alters their composition and hydration. In turn, this results in increased angiogenesis and the loss of the disc's ability to maintain its aneural condition. Inflammation in the IVD, in particular the presence of pro-inflammatory cytokines, was found to favor innervation and also sensitization of the nociceptive pathways, thereby exacerbating degenerative symptoms. In this review, we discuss anti-inflammatory approaches to encounter disc catabolism, potential treatments to lower discogenic pain and pro-anabolic approaches in the form of protein delivery, gene therapy and cell delivery, to trigger regeneration in the IVD.
journal_name
Adv Drug Deliv Revjournal_title
Advanced drug delivery reviewsauthors
Fontana G,See E,Pandit Adoi
10.1016/j.addr.2014.08.008subject
Has Abstractpub_date
2015-04-01 00:00:00pages
146-58eissn
0169-409Xissn
1872-8294pii
S0169-409X(14)00182-3journal_volume
84pub_type
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journal_title:Advanced drug delivery reviews
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journal_title:Advanced drug delivery reviews
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journal_title:Advanced drug delivery reviews
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journal_title:Advanced drug delivery reviews
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