Smoking and intervertebral disc degeneration
Smoking and intervertebral disc degeneration
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DOI：
10.1054/mehy.2000.1253
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发表时间：
2001-04-01
影响因子：
4.7
通讯作者：
Alho, AV
中科院分区：
文献类型：
--
作者：
Fogelholm, RR;Alho, AV
例如，吸烟者患下腰痛的风险增加，这可能是由椎间盘退变和脊柱不稳引起的。缺血、细胞凋亡、间盘大分子合成障碍以及间盘基质蛋白及其抑制物之间的失衡可能参与了间盘退变的发病机制。伴随着退变，原发的无血管间盘变成了有血管的。有证据表明，吸烟者的视盘变性比不吸烟者更严重。吸烟通过从肺泡毛细血管中的中性粒细胞释放蛋白水解酶，并通过抑制最有效的蛋白酶抑制剂α-1-抗蛋白酶的活性来增加血清蛋白分解活性。我们假设，吸烟者的高血清蛋白分解活性获得了先前退化的新生血管视盘，并加速了降解过程。蛋白分解活性的增加也可能削弱脊柱韧带，导致脊柱不稳定。这些过程可能解释了吸烟者腰痛风险增加的原因。(C)2001哈考出版有限公司。
Cigarette smokers have an increased risk of low back pain which may be caused by disc degeneration and spinal instability, for example. Ischemia, apoptosis, faulty synthesis of disc macromolecules, and an imbalance between disc matrix proteinases and their inhibitors may be involved in the pathogenesis of disc degeneration. Along with degeneration, the primary avascular disc turns vascular. There is some evidence that disc degeneration of cigarette smokers is of more severe degree than that of non-smokers.Cigarette-smoking increases serum proteolytic activity by releasing proteolytic enzymes from neutrophils in alveolar capillaries, and by inhibiting the activity of alpha-1-antiprotease, the most potent protease inhibitor.We hypothesize that the high serum proteolytic activity of cigarette-smokers gets access to a previously degenerated neovascularized disc and speeds up the degerative process. The increased proteolytic activity may also weaken the spinal ligaments resulting in spinal instability. These processes may explain the increased risk of low back pain of cigarette smokers. (C) 2001 Harcourt Publishers Ltd.