Biologic modification of animal models of intervertebral disc degeneration
Biologic modification of animal models of intervertebral disc degeneration
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DOI：
10.2106/jbjs.f.00043
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发表时间：
2006-01-01
影响因子：
5.3
通讯作者：
Kang, JD
中科院分区：
文献类型：
--
作者：
Larson, JW;Levicoff, EA;Kang, JD
椎间盘退变是一个慢性过程，可表现为特发性腰痛、坐骨神经痛、椎间盘突出、椎管狭窄和脊髓病等临床疾病。对于这些和其他由椎间盘退变引起的致残病症，可用的治疗方案（包括椎间盘切除术和脊柱融合术）有限，具有高度侵入性，取得的成功有限，并且只能解决急性症状，而无法阻止退变过程。尽管椎间盘退变的精确病理生理学尚未明确，但聚集蛋白聚糖（髓核的主要蛋白多糖）的逐渐下降似乎是最终的共同途径。动物模型以及椎间盘退变过程的体外研究已经产生了许多逆转椎间盘退变的潜在有用靶标。当前的一种研究趋势是使用已建立的椎间盘退变动物模型来研究治疗方式在逆转退变过程中的作用，通常使用影响椎间盘合成代谢和分解代谢途径的基因或基因产物的传递。本文回顾了基因产物传递系统和基因治疗改变椎间盘退变动物模型生物过程的能力，并探讨了该领域的未来趋势。
Intervertebral disc degeneration is a chronic process that can become manifest in clinical disorders such as idiopathic low back pain, sciatica, disc herniation, spinal stenosis, and myelopathy. The limited available treatment options (including discectomy and spinal fusion) for these and other disabling conditions that arise from intervertebral disc degeneration are highly invasive, achieve limited success, and only address acute symptoms while doing nothing to halt the process of degeneration. Although the precise pathophysiology of intervertebral disc degeneration has yet to be clearly delineated, the progressive decline in aggrecan, the primary proteoglycan of the nucleus pulposus, appears to be a final common pathway. Animal models as well as in vitro studies of the process of disc degeneration have yielded many potentially useful targets for the reversal of disc degeneration. One current research trend is the use of established animal models of disc degeneration to study the role of therapeutic modalities in reversing the process of degeneration, often with use of the delivery of genes or gene products that influence the anabolic and catabolic pathways of the disc. This article reviews the ability of gene-product delivery systems and gene therapy to alter biologic processes in animal models of disc degeneration and examines future trends in this field.