Modern views on the pathogenesis of intervertebral disc degeneration

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Abstract

Introduction. Intervertebral disc (IVD) degeneration is defined as a multifactorial degenerative disease of the spine, starting from the structures of the nucleus pulposus of the IVD, spreading to the fibrous ring and other elements of the spinal motion segment. Unlike natural aging, a pathological degenerative process that occurs in IVDs as a result of the additive effect of genetic predisposition and external environmental factors leads to the formation of chronic back pain and reduces the patient’s quality of life. Despite many years of studying the problem of the pathogenesis of IVD degeneration, it is far from being resolved, which encourages us to further study the pathogenetic mechanisms of the development of this pathology.

Aim. To update the knowledge of practicing neurologists about the results of modern studies of the leading mechanisms of development of IVD degeneration in humans and their role in the development of promising biomarkers of this pathology and new strategies for pathogenetic therapy.

Materials and methods. A search and analysis of publications was carried out in Russian-language (e-Library) and Englishlanguage databases (PubMed, Oxford Press, Clinical Keys, Springer, Elsevier, Google Scholar). Search depth – 5 years (2018–2023).

Results. The analyzed and generalized results of studies of the molecular mechanisms influencing the development and progression of this pathology are presented. The leading pathogenetic mechanisms for the development of IVD degeneration, such as oxidative stress and the NO system, cytokine imbalance, increased activity of matrix metalloproteinases, dysfunction of fibrillar collagens and proteoglycan, as well as their relationship with each other, were considered.

Conclusion. The review provides a broader look at the pathogenetic mechanisms of IVD degeneration, which makes it possible to set new goals for future development of promising therapeutic strategies.

About the authors

N. A. Shnayder

V.M. Bekhterev National Medical Research Center of Psychiatry and Neurology, Ministry of Health of Russia;
Prof. V.F. Voino­-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia

Author for correspondence.
Email: naschnaider@yandex.ru
ORCID iD: 0000-0002-2840-837X

Natalia Alekseevna Shnayder 

3 Bekhtereva St., Saint Petersburg 192019; 
1 Partizanа Zheleznyakа St., Krasnoyarsk 660022

Russian Federation

V. V. Trefilova

V.M. Bekhterev National Medical Research Center of Psychiatry and Neurology, Ministry of Health of Russia

ORCID iD: 0000-0002-4378-1308

3 Bekhtereva St., Saint Petersburg 192019

Russian Federation

A. V. Ashkhotov

V.M. Bekhterev National Medical Research Center of Psychiatry and Neurology, Ministry of Health of Russia

ORCID iD: 0000-0003-3565-8657

3 Bekhtereva St., Saint Petersburg 192019

Russian Federation

O. A. Ovdienko

Hospital for War Veterans

ORCID iD: 0000-0002-1557-327X

2 Build., 21 Narodnaya St., Saint Petersburg 193079

Russian Federation

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