Inflammatory mediators and signalling pathways controlling intervertebral disc degeneration
Stefania Elena Navone1*, Giovanni Marfia1*, Amedeo Giannoni1, Matteo Beretta1, Laura Guarnaccia1, Roberta Gualtierotti2, Daniele Nicoli1, Paolo Rampini1 and Rolando Campanella1
1Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Neurosurgery Unit, Laboratory of Experimental Neurosurgery and Cell Therapy, University of Milan and 2Division of Rheumatology, Istituto Gaetano Pini and Department of Clinical Science and Community Health, University of Milan, Milan, Italy
*co-first authors
Offprint requests to: Dr. Giovanni Marfia, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, University of Milan, Neurosurgery Unit, Laboratory of Experimental Neurosurgery and Cell Therapy. via F. Sforza, 35 20122 Milan, Italy. e-mail: giovanni.marfia@unimi.it
Summary. Intervertebral disc (IVD) degeneration (IDD) is one of the major causes of back pain, a condition that represents a serious socio-economic burden. Deeper knowledge of the complex and fine relationship between IVD degeneration, tissue inflammation and pain, appears to be critical to improve the current therapies, which have so far proven themselves ineffective. Upon degeneration, IVD tissues become inflamed, and this inflammatory microenvironment is associated with a cascade of degenerative events that may eventually cause discogenic pain. In particular, several studies have highlighted the major role of a number of pro-inflammatory mediators not only in the onset of the inflammatory condition, but also in the development of IDD in general. In this review, we will present the main pathological events that occur during disc degeneration, focusing on the relationship between the abnormal inflammatory milieu of the degenerating IVD, IDD and the generation of pain. Finally, we will present the current therapies for the treatment of IDD and low back pain, and the perspectives of future, more effective therapies. Histol Histopathol 32, 523-542 (2017)
Key words: Intervertebral disc degeneration, Inflammatory mediators, Low back pain, Neuro-inflammation
DOI: 10.14670/HH-11-846