Biology of intervertebral disc aging and degeneration - Involvement of the extracellular matrix
Biology of intervertebral disc aging and degeneration - Involvement of the extracellular matrix
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DOI：
10.1097/01.brs.0000146101.53784.b1
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发表时间：
2004-12-01
期刊：
影响因子：
3
通讯作者：
Roughley, PJ
中科院分区：
文献类型：
--
作者：
Roughley, PJ
研究设计.综述了椎间盘发育、成熟和退变过程中发生的生物学变化的现有知识和观点。综述椎间盘细胞外基质的结构和组成发生的变化，并解释这些变化的起源及其功能后果。背景资料摘要。椎间盘的结构，特别是其细胞外基质的组成，在整个生命过程中都会发生变化，最终导致成年人的组织变性。对已发表的科学文献进行回顾。在年轻的椎间盘中，外纤维环和内髓核具有明确的物理和分子特性，尽管这些差异在成年后变得不那么明显。年龄变化是由于大分子，特别是聚集蛋白聚糖的丰度和结构的变化，结构变化可能是由于合成和降解的变化。目前尚不清楚有多少变化是为了适应脊柱生长环境的改变。然而，通常认为降解性变化对椎间盘功能是有害的，成熟无血管椎间盘不能清除和替换积累的降解产物会加剧这种特性。由于遗传、生物力学和营养差异，这些有害变化发生的速度可能在个体之间存在差异。这些改变被认为是椎间盘退变相关组织缺损的基础。椎间盘结构在整个生命过程中的变化最终会导致组织退化，需要医疗干预。目前的研究旨在通过生物学手段恢复退化椎间盘基质的完整性，尽管目前还不清楚最合适的修复组织的结构应该是什么或如何实现。
Study Design. A review of current knowledge and opinions concerning the biologic changes that take place during development, maturation and degeneration of the intervertebral disc.Objective. To provide an overview of the changes that occur in structure and composition of the extracellular matrix of the intervertebral disc and to explain the origin of such changes and their functional consequences.Summary of Background Data. The structure of the intervertebral disc, and, in particular, the composition of its extracellular matrix, changes throughout life, ultimately resulting in tissue degeneration in the adult.Methods. A review of the published scientific literature.Results. In the young disc, the outer anulus fibrosus and inner nucleus pulposus have clear physical and molecular properties, although these differences become less distinct in the adult. The age changes are due to variations in both the abundance and structure of the macromolecules, particularly aggrecan, and the structural variations may be due to changes in both synthesis and degradation. It is not clear how many of the changes are by design to adapt to the altered environment of the growing spine. However, it is commonly thought that the degradative changes are detrimental to disc function, a property that is exacerbated by the inability of the mature avascular disc to remove and replace accumulated degradation products. The rate at which these detrimental changes occur may vary between individuals because of genetic, biomechanical, and nutritional differences. Such changes are thought to form the basis of tissue loss associated with disc degeneration.Conclusion. Changes in intervertebral disc structure throughout life ultimately result in tissue degeneration and the need for medical intervention. Current research is aimed at trying to restore the integrity of the degenerate disc matrix by biologic means, although at present it is not clear what the structure of the most appropriate repair tissue should be or how it can be achieved.