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Song C, Hu P, Peng R, Li F, Fang Z, Xu Y. Bioenergetic dysfunction in the pathogenesis of intervertebral disc degeneration. Pharmacol Res 2024; 202:107119. [PMID: 38417775 DOI: 10.1016/j.phrs.2024.107119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/16/2024] [Accepted: 02/24/2024] [Indexed: 03/01/2024]
Abstract
Intervertebral disc (IVD) degeneration is a frequent cause of low back pain and is the most common cause of disability. Treatments for symptomatic IVD degeneration, including conservative treatments such as analgesics, physical therapy, anti-inflammatories and surgeries, are aimed at alleviating neurological symptoms. However, there are no effective treatments to prevent or delay IVD degeneration. Previous studies have identified risk factors for IVD degeneration such as aging, inflammation, genetic factors, mechanical overload, nutrient deprivation and smoking, but metabolic dysfunction has not been highlighted. IVDs are the largest avascular structures in the human body and determine the hypoxic and glycolytic features of nucleus pulposus (NP) cells. Accumulating evidence has demonstrated that intracellular metabolic dysfunction is associated with IVD degeneration, but a comprehensive review is lacking. Here, by reviewing the physiological features of IVDs, pathological processes and metabolic changes associated with IVD degeneration and the functions of metabolic genes in IVDs, we highlight that glycolytic pathway and intact mitochondrial function are essential for IVD homeostasis. In degenerated NPs, glycolysis and mitochondrial function are downregulated. Boosting glycolysis such as HIF1α overexpression protects against IVD degeneration. Moreover, the correlations between metabolic diseases such as diabetes, obesity and IVD degeneration and their underlying molecular mechanisms are discussed. Hyperglycemia in diabetic diseases leads to cell senescence, the senescence-associated phenotype (SASP), apoptosis and catabolism of extracellualr matrix in IVDs. Correcting the global metabolic disorders such as insulin or GLP-1 receptor agonist administration is beneficial for diabetes associated IVD degeneration. Overall, we summarized the recent progress of investigations on metabolic contributions to IVD degeneration and provide a new perspective that correcting metabolic dysfunction may be beneficial for treating IVD degeneration.
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Affiliation(s)
- Chao Song
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Peixuan Hu
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Renpeng Peng
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China
| | - Feng Li
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
| | - Zhong Fang
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
| | - Yong Xu
- Department of Orthopaedic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
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Lower Prevalence and Severity of Degenerative Changes in the Lumbar Spine in Elderly Hong Kong Chinese Compared With Age-Matched Italian Caucasian Women. Spine (Phila Pa 1976) 2022; 47:1710-1718. [PMID: 35943213 DOI: 10.1097/brs.0000000000004445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional observational study. OBJECTIVE The aim was to compare the prevalence and severity of radiographic lumbar spine degeneration between elderly Hong Kong Chinese and elderly Italian Caucasian women. SUMMARY OF BACKGROUND DATA Rates of symptomatic low back pain and osteoporotic vertebral fracture have been shown to be lower in Asian and Chinese populations compared with Caucasians, but ethnic differences in spinal degeneration are less established. METHODS Lumbar spine lateral radiographs of 566 age-matched (mean: 73.6 yr; range: 65-87 yr) female subjects from two population-based epidemiological studies from Hong Kong (n=283) and Rome, Italy (n=283) were reviewed. Grading of degeneration categories: disk height loss (none, <30%, 30%-60%, >60%), osteophyte formation (not present, minimal, small, large), endplate sclerosis (none, mild, moderate, severe), and antero/retrolisthesis (none, <25%, 25%-50%, >50%) was performed for vertebral levels from L1/2 to L5/S1 (five levels). Each category was assigned a score (0, 1, 2, 3) at individual vertebral level according to severity. The total degeneration score was obtained by adding scores for all categories across the vertebral levels. RESULTS Italian subjects [total score (mean±SD): 7.0±5.5] had a higher severity of overall degenerative changes compared with Hong Kong subjects (5.7±4.4), P <0.01. Italian subjects had higher scores for individual findings of disk height loss (Italian, 3.6±2.8 vs. Hong Kong 2.5±2.1, P <0.01); antero/retrolisthesis (Italian 0.3±0.7 vs. Hong Kong 0.2±0.4, P =0.01); and endplate sclerosis (Italian 1.0±1.2 vs. Hong Kong 0.6±1.0, P <0.01). At each individual level from L1/2 to L5/S1, total degeneration scores were higher in Italian than Hong Kong subjects ( P <0.01-0.04). CONCLUSION Degenerative changes in the lumbar spine are less prevalent and less severe in elderly Hong Kong Chinese women than in age-matched Italian Caucasian women. The observed differences may reflect a foundational background influence of genetic predisposition that requires further studies.
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Bahar ME, Hwang JS, Ahmed M, Lai TH, Pham TM, Elashkar O, Akter KM, Kim DH, Yang J, Kim DR. Targeting Autophagy for Developing New Therapeutic Strategy in Intervertebral Disc Degeneration. Antioxidants (Basel) 2022; 11:antiox11081571. [PMID: 36009290 PMCID: PMC9405341 DOI: 10.3390/antiox11081571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 12/25/2022] Open
Abstract
Intervertebral disc degeneration (IVDD) is a prevalent cause of low back pain. IVDD is characterized by abnormal expression of extracellular matrix components such as collagen and aggrecan. In addition, it results in dysfunctional growth, senescence, and death of intervertebral cells. The biological pathways involved in the development and progression of IVDD are not fully understood. Therefore, a better understanding of the molecular mechanisms underlying IVDD could aid in the development of strategies for prevention and treatment. Autophagy is a cellular process that removes damaged proteins and dysfunctional organelles, and its dysfunction is linked to a variety of diseases, including IVDD and osteoarthritis. In this review, we describe recent research findings on the role of autophagy in IVDD pathogenesis and highlight autophagy-targeting molecules which can be exploited to treat IVDD. Many studies exhibit that autophagy protects against and postpones disc degeneration. Further research is needed to determine whether autophagy is required for cell integrity in intervertebral discs and to establish autophagy as a viable therapeutic target for IVDD.
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Affiliation(s)
- Md Entaz Bahar
- Department of Biochemistry and Convergence Medical Science, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, GyeongNam, Korea
| | - Jin Seok Hwang
- Department of Biochemistry and Convergence Medical Science, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, GyeongNam, Korea
| | - Mahmoud Ahmed
- Department of Biochemistry and Convergence Medical Science, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, GyeongNam, Korea
| | - Trang Huyen Lai
- Department of Biochemistry and Convergence Medical Science, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, GyeongNam, Korea
| | - Trang Minh Pham
- Department of Biochemistry and Convergence Medical Science, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, GyeongNam, Korea
| | - Omar Elashkar
- Department of Biochemistry and Convergence Medical Science, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, GyeongNam, Korea
| | - Kazi-Marjahan Akter
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Gyeongsang National University, Jinju 52828, GyeongNam, Korea
| | - Dong-Hee Kim
- Department of Orthopaedic Surgery, Institute of Health Sciences, Gyeongsang National University Hospital and Gyeongsang National University College of Medicine, Jinju 52727, GyeongNam, Korea
| | - Jinsung Yang
- Department of Biochemistry and Convergence Medical Science, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, GyeongNam, Korea
| | - Deok Ryong Kim
- Department of Biochemistry and Convergence Medical Science, Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, GyeongNam, Korea
- Correspondence: ; Tel.: +82-55-772-8054
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Zhang H, Chen L, Wang Z, Wang F, Shan Y, Qi L, Chen Y. Association of Single Nucleotide Polymorphism rs2228570 with Lumbar Disc Degeneration: A Case-Control Study and Meta-Analysis. J Pain Res 2021; 14:2001-2012. [PMID: 34234546 PMCID: PMC8257063 DOI: 10.2147/jpr.s313790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To examine the association between single nucleotide polymorphisms (SNPs) rs2228570, rs731236, rs7975232, and rs1544410 and lumbar disc degeneration (LDD) predisposition. Methods A search strategy was carried out, and the data were extracted after being chosen by the inclusion and exclusion criteria. Pooled odds ratios and 95% confidence intervals were calculated to assess the association between the aforementioned SNPs and LDD under allelic, dominant, recessive, heterozygous, and homozygous genetic models. In addition, a case–control study involving 46 LDD cases and 45 controls was also performed in the analysis to verify the result. Results A total of 17 studies were included in this meta-analysis. The pooled results did not show any association between vitamin D receptor (VDR) gene polymorphisms and LDD. But, interestingly, in subgroup analysis, the rs2228570 polymorphism was associated with LDD under the allelic (OR = 0.70, 95% CI = 0.56–0.87, p = 0.002), recessive (OR = 0.60, 95% CI = 0.43–0.84, p = 0.003), and homozygous (OR = 0.47, 95% CI= 0.28–0.79, p = 0.004) genetic models in the Asian population. SNPs rs731236 and rs7975232 still did not show any obvious association. We obtained a similar result from the case–control study: rs2228570 had an obvious relationship with LDD under allelic and homozygous genetic models. At the same time, we found that rs2228570 was also associated with the degree of low back pain (visual analogue scale, VAS score) in LDD population. Conclusion SNP rs2228570 was significantly associated with LDD predisposition and the degree of low back pain in the Asian population.
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Affiliation(s)
- Hengshuo Zhang
- Department of Spine Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Lu Chen
- Department of Spine Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Ziyu Wang
- Department of Spine Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Fuan Wang
- Department of Spine Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yu Shan
- Department of Spine Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Linzeng Qi
- Department of Spine Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
| | - Yunzhen Chen
- Department of Spine Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China
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Panda AK, Padhi S. Comment on: Vitamin D receptor gene polymorphisms and osteoarthritis: a meta-analysis. Rheumatology (Oxford) 2021; 60:e215. [PMID: 33493318 DOI: 10.1093/rheumatology/keab063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Aditya K Panda
- Department of Bioscience and Bioinformatics, Khallikote University, Berhampur, Odisha, India
| | - Sunali Padhi
- Department of Bioscience and Bioinformatics, Khallikote University, Berhampur, Odisha, India
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Azharuddin A, Ilmawan M, Fajar JK, Fahriani M, Mamada SS, Maliga HA, Nainu F, Dhama K, Harapan H, Magetsari R. The role of single nucleotide polymorphisms of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) on susceptibility to herniated nucleus pulposus: a systematic review and meta-analysis. F1000Res 2021; 10:419. [PMID: 34504685 PMCID: PMC8406444 DOI: 10.12688/f1000research.53235.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The pathogenesis of herniated nucleus pulposus (HNP) is complex and may involve the wide variety of gene polymorphism. However, the reports from the existing studies are inconclusive. The objective of this study was to determine the role of single nucleotide polymorphisms (SNPs) in interleukin 1 alpha ( IL-1A), tumor necrosis factor-alpha ( TNF-A), and vitamin D receptor ( VDR) genes on the susceptibility to herniated nucleus pulposus (HNP). Methods: Four databases (PubMed, Embase, Cochrane, and Web of Science) were searched as of April 1 st, 2021. Authors, publication year, targeted genes, genotype and allele frequency in each case and control groups were collected. Newcastle-Ottawa scale was used to evaluate the publication quality. The pooled estimates of association of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) and susceptibility to HNP were assessed using Z test. Results: We screened 3,067 unique studies for eligibility and three, two and nine case-control studies on IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI were included, respectively, in our meta-analysis. The studies consisting 369 HNP cases and 433 controls for IL-1A -889C>T, 252 cases and 259 controls for TNF-A -238G>A and 1130 cases and 2096 controls for VDR TaqI. Our pooled estimates indicated that there was no significant association of those SNPs with the susceptibility to HNP in any genotype, dominant model, recessive model, or allele comparations. Conclusion: Although individual studies suggested the important role of gene expression dysregulation associated with SNPs in IL-1A, TNF-A, and VDR, our data indicated that IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI had weak association with HNP susceptibility in both genotypes and allele distributions. However, since heterogeneity was identified among studies included in this meta-analysis, further meta-analysis with a larger population and subgroup analysis on specific population are warranted to support this finding.
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Affiliation(s)
- Azharuddin Azharuddin
- Department of Orthopedic and Traumatology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Department of Orthopedic and Traumatology, Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, 24415, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65117, Indonesia
| | - Jonny Karunia Fajar
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Marhami Fahriani
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Sukamto S. Mamada
- Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar, South Sulawesi, 90245, Indonesia
| | | | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar, South Sulawesi, 90245, Indonesia
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Rahadyan Magetsari
- Orthopaedic and Traumatology Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, DKI Yogyakarta, 55281, Indonesia
- Orthopaedic and Traumatology Division, Department of Surgery, Dr. Sardjito Hospital, Yogyakarta, DKI Yogyakarta, 55281, Indonesia
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Azharuddin A, Ilmawan M, Fajar JK, Fahriani M, Mamada SS, Maliga HA, Nainu F, Dhama K, Harapan H, Magetsari R. The role of single nucleotide polymorphisms of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) on susceptibility to herniated nucleus pulposus. F1000Res 2021; 10:419. [PMID: 34504685 PMCID: PMC8406444 DOI: 10.12688/f1000research.53235.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2021] [Indexed: 11/08/2023] Open
Abstract
Background: The pathogenesis of herniated nucleus pulposus (HNP) is complex and may involve the wide variety of gene polymorphism. However, the reports from the existing studies are inconclusive. The objective of this study was to determine the role of single nucleotide polymorphisms (SNPs) in interleukin 1 alpha ( IL-1A), tumor necrosis factor-alpha ( TNF-A), and vitamin D receptor ( VDR) genes on the susceptibility to herniated nucleus pulposus (HNP). Methods: Four databases (PubMed, Embase, Cochrane, and Web of Science) were searched as of April 1 st, 2021. Authors, publication year, targeted genes, genotype and allele frequency in each case and control groups were collected. Newcastle-Ottawa scale was used to evaluate the publication quality. The pooled estimates of association of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) and susceptibility to HNP were assessed using Z test. Results: We screened 3,067 unique studies for eligibility and three, two and nine case-control studies on IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI were included, respectively, in our meta-analysis. The studies consisting 369 HNP cases and 433 controls for IL-1A -889C>T, 252 cases and 259 controls for TNF-A -238G>A and 1130 cases and 2096 controls for VDR TaqI. Our pooled estimates indicated that there was no significant association of those SNPs with the susceptibility to HNP in any genotype, dominant model, recessive model, or allele comparations. Conclusion: Although individual studies suggested the important role of gene expression dysregulation associated with SNPs in IL-1A, TNF-A, and VDR, our data indicated that IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI had weak association with HNP susceptibility in both genotypes and allele distributions. However, since heterogeneity was identified among studies included in this meta-analysis, further meta-analysis with a larger population and subgroup analysis on specific population are warranted to support this finding.
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Affiliation(s)
- Azharuddin Azharuddin
- Department of Orthopedic and Traumatology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Department of Orthopedic and Traumatology, Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, 24415, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65117, Indonesia
| | - Jonny Karunia Fajar
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Marhami Fahriani
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Sukamto S. Mamada
- Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar, South Sulawesi, 90245, Indonesia
| | | | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar, South Sulawesi, 90245, Indonesia
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Rahadyan Magetsari
- Orthopaedic and Traumatology Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, DKI Yogyakarta, 55281, Indonesia
- Orthopaedic and Traumatology Division, Department of Surgery, Dr. Sardjito Hospital, Yogyakarta, DKI Yogyakarta, 55281, Indonesia
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Azharuddin A, Ilmawan M, Fajar JK, Fahriani M, Mamada SS, Maliga HA, Nainu F, Dhama K, Harapan H, Magetsari R. The role of single nucleotide polymorphisms of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) on susceptibility to herniated nucleus pulposus. F1000Res 2021; 10:419. [PMID: 34504685 PMCID: PMC8406444 DOI: 10.12688/f1000research.53235.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 11/08/2023] Open
Abstract
Background: The objective of this study was to determine the role of single nucleotide polymorphisms (SNPs) in interleukin 1 alpha ( IL-1A), tumor necrosis factor-alpha ( TNF-A), and vitamin D receptor ( VDR) genes on the susceptibility to herniated nucleus pulposus (HNP). Methods: Four databases (PubMed, Embase, Cochrane, and Web of Science) were searched as of April 1 st, 2021. Authors, publication year, targeted genes, genotype and allele frequency in each case and control groups were collected. Newcastle-Ottawa scale was used to evaluate the publication quality. The pooled estimates of association of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) and susceptibility to HNP were assessed using Z test and presented as odd ratio (OR) and 95% confidence intervals (95%CI). Results: We screened 3,067 unique studies for eligibility and three, two and nine studies on IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI were included, respectively, in our meta-analysis. The studies consisting 369 HNP cases and 433 controls for IL-1A -889C>T, 252 cases and 259 controls for TNF-A -238G>A and 1130 cases and 2096 controls for VDR TaqI. Our pooled estimates indicated that there was no significant association of those SNPs with the susceptibility to HNP in any genotype, dominant model, recessive model, or allele comparations. Conclusion: Although individual studies suggested the important role of gene expression dysregulation associated with SNPs in IL-1A, TNF-A, and VDR, our data indicated that IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI had weak association with HNP susceptibility in both genotypes and allele distributions. However, since heterogeneity was identified among studies included in this meta-analysis, further meta-analysis with a larger population and subgroup analysis on specific population are warranted to support this finding.
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Affiliation(s)
- Azharuddin Azharuddin
- Department of Orthopedic and Traumatology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Department of Orthopedic and Traumatology, Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, 24415, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65117, Indonesia
| | - Jonny Karunia Fajar
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, 65145, Indonesia
| | - Marhami Fahriani
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Sukamto S. Mamada
- Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar, South Sulawesi, 90245, Indonesia
| | | | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar, South Sulawesi, 90245, Indonesia
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, 243122, India
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, 23111, Indonesia
| | - Rahadyan Magetsari
- Orthopaedic and Traumatology Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, DKI Yogyakarta, 55281, Indonesia
- Orthopaedic and Traumatology Division, Department of Surgery, Dr. Sardjito Hospital, Yogyakarta, DKI Yogyakarta, 55281, Indonesia
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Xue J, Song Y, Liu H, Liu L, Li T, Gong Q. Vitamin D receptor gene polymorphisms and risk of intervertebral disc degeneration: An updated meta-analysis based on 23 studies. Medicine (Baltimore) 2021; 100:e25922. [PMID: 34011063 PMCID: PMC8136998 DOI: 10.1097/md.0000000000025922] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 04/19/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Numerous studies have investigated the associations between Vitamin D receptor (VDR) gene polymorphisms and risk of intervertebral disc degeneration but the results remain controversial. This study aimed to drive a more precise estimation of association between VDR gene polymorphisms and risk of intervertebral disc degeneration. METHODS PubMed, EMBASE, Cochrane library, Web of Science and China Knowledge Resource Integrated Database for papers on VDR gene polymorphisms and risk of intervertebral disc degeneration were searched. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of association in the homozygote model, heterozygote model, dominant model, recessive model and an additive model. RESULTS Overall, 23 articles were included in the final meta-analysis. The subgroup analyses by ethnicity showed a significant association of VDR FokI mutation with disc degeneration risk in Caucasians (recessive model, OR with 95%CI 1.301, [1.041, 1.626]; additive model, OR with 95%CI 1.119, [1.006, 1.245]). The results of subgroup analyses by ethnicity showed a significant association of VDR TaqI mutation with disc degeneration risk in Asians but not in Caucasians. There was a significant association between VDR ApaI mutation and risk of disc degeneration and subgroup analyses by ethnicity showed a significant association in Caucasians and in Asians. CONCLUSIONS In summary, VDR FokI polymorphisms was associated with disc degeneration risk among Caucasians but not Asians, VDR TaqI polymorphisms was associated with disc degeneration risk among Asians but not Caucasians, while VDR ApaI polymorphism was associated with disc degeneration risk among Asians and Caucasians.
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Li HM, Liu Y, Zhang RJ, Ding JY, Shen CL. Vitamin D receptor gene polymorphisms and osteoarthritis: a meta-analysis. Rheumatology (Oxford) 2021; 60:538-548. [PMID: 33147632 DOI: 10.1093/rheumatology/keaa644] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/31/2020] [Accepted: 07/31/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the association of vitamin D receptor (VDR) gene polymorphisms with OA susceptibility. METHODS Meta-analyses were performed using allelic contrast, contrast of homozygotes, and recessive and dominant models to clarify the association between OA and VDR ApaI, BsmI, TaqI and FokI polymorphisms. Odds ratio (OR) and the corresponding 95% CI were obtained, and subgroup analyses were performed based on the ethnicity and OA sites. RESULTS A total of 18 studies with 2983 OA patients and 4177 controls were included in this meta-analysis. There were statistically significant associations in the spine between OA susceptibility and the VDR BsmI (B vs b: OR = 1.25, 95% CI: 1.03, 1.53, P = 0.026; BB vs bb: OR = 1.56, 95% CI: 1.02, 2.37, P = 0.038) and TaqI (T vs t: OR = 0.73, 95% CI: 0.54, 0.99, P = 0.044; TT vs Tt + tt: OR = 0.63, 95% CI: 0.42, 0.95, P = 0.028) polymorphisms, but not for the other polymorphisms. A statistically significant association was found between the VDR FokI polymorphism and OA susceptibility in the knee in the recessive model contrast (FF vs Ff + ff: OR = 0.63, 95% CI: 0.42, 0.95, P = 0.028), but this result was only pooled from one study. However, no significant associations were found between the VDR ApaI polymorphism and OA. Besides, ethnic stratification also indicated that there was no significant association between VDR gene polymorphism and OA in Caucasians or Asians. CONCLUSION Our meta-analysis suggests that the VDR BsmI and TaqI polymorphisms are associated with OA susceptibility in the spine. However, the VDR ApaI polymorphism is not a significant genetic risk factor for OA.
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Affiliation(s)
- Hui-Min Li
- Department of Orthopedics & Spine Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yi Liu
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ren-Jie Zhang
- Department of Orthopedics & Spine Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jing-Yu Ding
- Department of Orthopedics & Spine Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Cai-Liang Shen
- Department of Orthopedics & Spine Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, China
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11
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Al-Zoubi MS, Otoum O, Alsmadi M, Muhaidat R, Albdour A, Mohaidat Z, Abu Alarjah MI, Al-Zoubi RM, Al-Batayneh KM. Elevated BMI is considerably associated with IDD rather than polymorphic variations in interleukin-1 and vitamin D receptor genes: A case-control study. J Med Biochem 2021; 40:129-137. [PMID: 33776562 PMCID: PMC7982293 DOI: 10.5937/jomb0-26367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 09/01/2020] [Indexed: 11/06/2022] Open
Abstract
Background Intervertebral disc degeneration (IDD) is a musculoskeletal disorder and one of the major causes of low back pain leading to the disability with high economic repercussions worldwide. This study applied the candidategene approach to investigate the potential association of selected polymorphisms with IDD development in a Jordanian population. Methods MRI-diagnosed IDD patients (N=155) and asymptomatic individuals as a control group (N=55). Whole blood samples for four variants in three genes (rs1800587 of IL-1α, rs1143634 of IL-1β and rs2228570 and rs731236 of VDR) were genotyped by PCR-RFLP. Results There was no significant association between the studied polymorphisms or their allelic frequency and the occurrence of IDD. However, the cohort presented a significant reverse association between rs1143634 C > T of the IL-1β gene and the occurrence of IDD (p<0.0001). In addition, BMI showed a significant association with the IDD in the study population (p<0.005). The current study was conceptualized based on the candidate-gene approach to investigate the role of inflammatory and metabolic genes, IL and VDR, respectively, in the occurrence of IDD. Conclusions While the data presented in this study showed that polymorphisms in these genes were not associated with IDD of the cohort investigated, elevated BMI, as a measure of obesity, is strongly associated with IDD. Investigating potential roles of other structural genes, such as col-IX and aggrecan (ACAN), in IDD and considering a GWAS to elucidate a genomically global look at the basis of IDD development would be of considerable impact on our understanding of IDD.
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Affiliation(s)
- Mazhar Salim Al-Zoubi
- Yarmouk University, Faculty of Medicine, Department of Basic Medical Sciences, Irbid, Jordan
| | - Osama Otoum
- Yarmouk University, Faculty of Science, Department of Biological Sciences, Irbid, Jordan
| | - Mohammed Alsmadi
- King Hussein Medical Centre, Royal Medical Services, Amman, Jordan
| | - Riyadh Muhaidat
- Yarmouk University, Faculty of Science, Department of Biological Sciences, Irbid, Jordan
| | - Ahmed Albdour
- King Hussein Medical Centre, Royal Medical Services, Amman, Jordan
| | - Ziyad Mohaidat
- Jordan University of Science and Technology, Faculty of Medicine, Irbid, Jordan
| | - Manal Issam Abu Alarjah
- Yarmouk University, Faculty of Medicine, Department of Basic Medical Sciences, Irbid, Jordan
| | - Raed M Al-Zoubi
- Jordan University of Science & Technology, Department of Chemistry, Irbid, Jordan
| | - Khalid M Al-Batayneh
- Yarmouk University, Faculty of Science, Department of Biological Sciences, Irbid, Jordan
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12
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Associations between vitamin D receptor gene polymorphisms and spinal degenerative disease: evidence from a meta-analysis based on 35 case-control studies. Clin Neurol Neurosurg 2020; 200:106325. [PMID: 33160714 DOI: 10.1016/j.clineuro.2020.106325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/01/2020] [Accepted: 10/20/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Dozens of reports on the associations of vitamin D receptor (VDR) gene polymorphisms and susceptibility to spinal degenerative disease (SDD) were conducted with inconsistent findings. This study aimed to elucidate the associations through a meta-analysis approach. METHODS Databases of PubMed, EMBASE, Web of Science, CNKI, and Wanfang were searched until July 10, 2020. Study quality was evaluated by using Newcastle-Ottawa Scale (NOS). Odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated to evaluate the associations under allelic model (1 vs. 2), homozygous model (11 vs. 22), heterozygous model (12 vs. 22), dominant model (11 + 12 vs. 22), and recessive model (11 vs. 12 + 22). RESULTS A total of 5021 cases and 5746 controls from 35 studies were eligible to this meta-analysis. According to NOS, the included studies were in excellent quality. In the overall population, the pooled data indicated that ApaI was associated with a reduced SDD susceptibility (AA vs. Aa + aa, OR = 0.83, 95%CI 0.71 - 0.96, P = 0.010). But the association was not observed in FokI, TaqI, and BsmI polymorphisms. Subgroup analysis suggested that TaqI polymorphism was correlated to an elevated SDD risk in Asians (TT + Tt vs. tt, OR = 2.55, 95%CI 1.90 - 3.44, P < 0.001). CONCLUSION The present study indicates that ApaI polymorphism may contribute to a reduced risk to SDD in the overall population, and TaqI polymorphism confers an elevated susceptibility to SDD in Asians. While, BsmI and FokI polymorphisms appear to have no significant association with SDD.
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Wang B, Shi Y, Chen B, Shao Z, Chen L, Lin J, Huang C, Yan Y, Wang X. No evidence of a correlation between lumbar spinal subtypes and intervertebral disc degeneration among asymptomatic middle-aged and aged patients. Exp Ther Med 2020; 20:2993-3000. [PMID: 32855665 PMCID: PMC7444345 DOI: 10.3892/etm.2020.9055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 02/18/2020] [Indexed: 11/25/2022] Open
Abstract
The aim of the present study was to identify whether lumbar spinal subtypes (LSS) were associated with lumbar disc degeneration (LDD) among asymptomatic middle-aged and aged subjects. A cohort of 158 asymptomatic Chinese adults aged >40 years was recruited and 97 volunteers that met the inclusion criteria with complete information available were selected for inclusion. According to spinal morphology, volunteers were divided into four subtypes based on the classification of Roussouly. After baseline information was collected and spinopelvic parameters were measured, the data were compared among the four groups. According to the Pfirrmann classification, the degree of LDD was evaluated at each level on the MRI. For grades I-V, LDD at each level was effectively compared. Each of the four LSS from I to IV according to Roussouly classification from types I to IV were comprised of 25 (25.8%), 19 (19.6%), 38 (39.2%) and 15 (15.5%) of volunteers, respectively. Lumbar lordosis, sacral slope and pelvic incidence were significantly different among the four sub-types (P<0.001 for each), but no difference in pelvic tilt was observed (P=0.21). From types I to IV LSS, the proportion of disc degeneration was found to be 44, 52, 50 and 48%, respectively, which exhibited no statistically significant difference among LSS. No correlation between LSS and intervertebral disc degeneration was obtained among the asymptomatic middle-aged and aged subjects. The present study provides a reference for spinal surgery and indicated that additional risk factors should be assessed in the asymptomatic population of this age group, particularly in terms of differentially expressed genes.
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Affiliation(s)
- Ben Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang 325027, P.R. China
| | - Yifeng Shi
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang 325027, P.R. China
| | - Boda Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang 325027, P.R. China
| | - Zhenxuan Shao
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang 325027, P.R. China
| | - Lijie Chen
- Department of Surgical Oncology, Taizhou Hospital of Wenzhou Medical University, Taizhou, Zhejiang 317000, P.R. China
| | - Jialiang Lin
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang 325027, P.R. China
| | - Chongan Huang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang 325027, P.R. China
| | - Yingzhao Yan
- Department of Orthopaedics, Zhejiang Hospital, Hangzhou, Zhejiang 310012, P.R. China
| | - Xiangyang Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, P.R. China.,Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang 325027, P.R. China
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Doraisamy R, Ramaswami K, Shanmugam J, Subramanian R, Sivashankaran B. Genetic risk factors for lumbar disc disease. Clin Anat 2020; 34:51-56. [PMID: 32583875 DOI: 10.1002/ca.23641] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 06/18/2020] [Indexed: 01/08/2023]
Abstract
AIM AND BACKGROUND Lumbar disc degeneration (LDD) is thought to be multifactorial in origin. Very recently the focus has shifted to the involvement of a family of candidate genes in the pathogenesis of LDD. There is particular emphasis on the vitamin D receptor gene (VDR gene). The VDR polymorphisms FOK1, TAQ1, and APO1 have been variably associated with LDD. OBJECTIVE To evaluate the association between the FOK1/Taq1 genes and LDD. MATERIALS AND METHODS One hundred unrelated healthy (asymptomatic) individuals who presented for routine health checkup and 93 consecutive patients (43 males and 50 females) with no history of low back pain were enrolled in the study after informed consent was obtained. The MRI images of cases and controls were graded and peripheral blood samples were collected from all participants and sent for genetic analysis. RESULTS Individuals with the dominant genotype for Taq1 had a significantly higher association with LDD than those without it. There was no association between LDD and the Fok1 genotype. CONCLUSION Genetic predisposition is an important risk factor for LDD.
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Affiliation(s)
- Ravichandran Doraisamy
- Department of Anatomy, KMCH Institute of Health Sciences and Research (KMCH IHSR), Coimbatore, India
| | - Karthikeyan Ramaswami
- Department of Orthopaedics, Karpagam Faculty of Medical Sciences and Research (KFMSR), Coimbatore, India
| | - Jeevithan Shanmugam
- Department of Community Medicine, KMCH Institute of Health Sciences and Research (KMCH IHSR), Coimbatore, India
| | - Rashmi Subramanian
- Central Research Laboratory, Karpagam Faculty of Medical Sciences and Research (KFMSR), Coimbatore, India
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15
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Biczo A, Szita J, McCall I, Varga PP, Lazary A. Association of vitamin D receptor gene polymorphisms with disc degeneration. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2019; 29:596-604. [PMID: 31768839 DOI: 10.1007/s00586-019-06215-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 09/23/2019] [Accepted: 11/07/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Numerous candidate genes and single-nucleotide polymorphisms (SNPs) have been identified in the background of lumbar disc degeneration (LDD). However, in most of these underpowered studies, definitions of LDD are inconsistent; moreover, many of the findings have not been replicated and are contradictory. Our aim was to characterize LDD by well-defined phenotypes and possible endophenotypes and analyse the association between these and candidate vitamin D receptor (VDR) gene polymorphisms on a large (N = 1426) dataset. METHODS Seven candidate VDR SNPs were genotyped. Individual association, haplotype and gene-gene interaction analyses were performed. All degenerative endophenotypes were significantly associated with one or more candidate VDR gene variants. RESULTS Haplotype analyses confirmed the association between the 3'-end VDR variants (BsmI, ApaI, TaqI) and Modic changes as well as the relationship of 5'-end variants (Cdx2, A1012G) with endplate defects. We also found significant interactions between the 3'- and 5'-end regulatory regions and endplate defects. Based on our results, VDR and its gene variants are highly associated with specific degenerative LDD endophenotypes. CONCLUSION Understanding relationships between phenotype and gene variants is crucial for describing the pathways leading to the multifactorial, polygenic degeneration process and LDD-related conditions. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- Adam Biczo
- National Center for Spinal Disorders, Kiralyhago Street 1, Budapest, 1126, Hungary.,Semmelweis University School of Ph.D. Studies, Ulloi Street 26, Budapest, 1086, Hungary
| | - Julia Szita
- National Center for Spinal Disorders, Kiralyhago Street 1, Budapest, 1126, Hungary.,Semmelweis University School of Ph.D. Studies, Ulloi Street 26, Budapest, 1086, Hungary
| | - Iain McCall
- Department of Diagnostic Imaging, The Robert Jones & Agnes Hunt Orthopaedic and District Hospital, Gobowen, Oswestry, SY10 7AG, UK
| | - Peter Pal Varga
- National Center for Spinal Disorders, Kiralyhago Street 1, Budapest, 1126, Hungary
| | | | - Aron Lazary
- National Center for Spinal Disorders, Kiralyhago Street 1, Budapest, 1126, Hungary.
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16
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Tong T, Liu Z, Zhang H, Sun J, Zhang D, Wang F, Miao D, Shen Y. Age-dependent expression of the vitamin D receptor and the protective effect of vitamin D receptor activation on H 2O 2-induced apoptosis in rat intervertebral disc cells. J Steroid Biochem Mol Biol 2019; 190:126-138. [PMID: 30905826 DOI: 10.1016/j.jsbmb.2019.03.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/13/2019] [Accepted: 03/19/2019] [Indexed: 11/17/2022]
Abstract
Accumulating evidence shows that genetic polymorphism of the vitamin D receptor (VDR) gene is associated with intervertebral disc degeneration (IDD), implying that VDR may be involved in the pathogenesis of IDD. However, the exact relationship between VDR and IDD remains unknown. The aim of this study was to investigate the age-dependent expression of VDR in rat intervertebral discs and to determine the effect of VDR on oxidative stress-induced cell apoptosis of the annulus fibrosus (AF) and the underlying mechanism. Sprague-Dawley rats were subjected to magnetic resonance imaging (MRI) and CT scans at young (2-3 months), adult (6-7 months), and old (14-15 months) ages. The images revealed age-related degeneration of the lumbar intervertebral discs and endplates. Immunohistochemistry demonstrated positive expression of VDR in the AF. The expression level of VDR in aged rats was significantly reduced compared with that in the young and adult animals and exhibited a negative correlation to IDD severity. Western blot analysis further demonstrated that the amount of VDR protein was significantly decreased in severe degenerative discs. AF cells were also isolated from young rat lumbar discs and subjected to different concentrations of hydrogen peroxide (H2O2) for various amounts of time. The results revealed that H2O2 inhibited the viability of AF cells and induced mitochondrial pathway apoptosis. However, pretreatment of AF cells with 10-7 and 10-8 M 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] effectively increased cell viability, increased mitochondrial membrane potential, decreased the level of reactive oxygen species, increased mitochondrial ATP content, reserved the activity of key enzymes in the oxidative respiratory chain, and thus protected the mitochondria from H2O2-induced damage. Whereas, siRNA knock-down of VDR abolished the protective effects of 1,25(OH)2D3. Moreover, 1,25(OH)2D3 inhibited H2O2-induced autophagy of AF cells through inhibition of the mTOR/p70S6K signal pathway. Our study demonstrated that decreased expression of VDR may play a role in age-related intervertebral disc degeneration in rats and that activation of VDR ameliorates oxidative stress-induced apoptosis in AF cells by preserving mitochondrial functions.
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Affiliation(s)
- Tong Tong
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Zhihui Liu
- Department of Endocrinology and Metabolism, First Hospital of Shijiazhuang City, Shijiazhuang, 050051, China
| | - Hua Zhang
- Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050051, China
| | - Jinglei Sun
- Department of Pharmacology, Hebei Medical University, Shijiazhuang, 050051, China
| | - Dongxia Zhang
- Department of Cardiovascular Medicine, Fourth Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Feng Wang
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Dechao Miao
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China
| | - Yong Shen
- Department of Spine Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
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Yang Q, Liu Y, Guan Y, Zhan X, Xiao Z, Jiang H, Wei Q. Vitamin D Receptor gene polymorphisms and plasma levels are associated with lumbar disc degeneration. Sci Rep 2019; 9:7829. [PMID: 31127184 PMCID: PMC6534588 DOI: 10.1038/s41598-019-44373-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 05/15/2019] [Indexed: 12/19/2022] Open
Abstract
The purpose of this study was to investigate the association of Vitamin D Receptor (VDR) gene polymorphisms and VDR levels with lumbar disc degeneration (LDD). TaqMan SNP Genotyping Assay was utilized to probe VDR gene polymorphisms including the FokI (rs2228570), ApaI (rs7975232) and TaqI (rs731236) in 454 patients with LDD and 485 controls. Enzyme-Linked Immunosorbent Assay (ELISA) was used to detect plasma VDR levels. The patients with LDD were divided into three subgroups (subgroup 1: lumbar disc herniation; subgroup 2: lumbar spinal stenosis; subgroup 3: lumbar spondylolisthesis) to further probe the association of plasma VDR levels and VDR gene polymorphisms and LDD. Moreover, immunohistochemistry (IHC) was implemented to evaluate VDR expression in lumbar degenerated disc and normal disc. Allele and genotype frequency of TaqI (rs731236) were significantly different in patients with LDD and controls (all P < 0.05). For TaqI polymorphism, the frequencies of T allele were significantly higher in the LDD patients compared with controls (OR = 1.319; 95%CI 1.091 to 1.595; P = 0.004, adjusted (OR = 1.319; 95%CI 1.091 to 1.595; P = 0.004, adjusted OR = 1.383; 95%CI 1.135 to 1.684; P = 0.016). Furthermore, the allele distribution showed a higher frequency of the T allele in the patients with lumbar disc herniation in subgroup 1 (OR = 1.384; 95% CI 1.105 to 1.732; P = 0.004, adjusted OR = 1.319; 95%CI 1.091 to 1.595; P = 0.016). Plasma VDR levels and VDR expression were significantly lower in patients with LDD compared with controls (all P < 0.05). Moreover, the TT genotype of TaqI polymorphism was significantly associated with lower plasma VDR levels in patients with LDD (P = 0.002). TaqI (rs731236) polymorphism was associated with a predisposition to LDD. Plasma VDR and VDR expression levels may be the marker for the occurrence and development of LDD.
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Affiliation(s)
- Qinghua Yang
- The First Affiliated Hospital of Guangxi Medical University, Division of Spine Surgery, Nanning, 530021, China
| | - Yang Liu
- The First Affiliated Hospital of Guangxi Medical University, Division of Spine Surgery, Nanning, 530021, China
| | - Yewen Guan
- The First Affiliated Hospital of Guangxi Medical University, Division of Spine Surgery, Nanning, 530021, China
| | - Xinli Zhan
- The First Affiliated Hospital of Guangxi Medical University, Division of Spine Surgery, Nanning, 530021, China
| | - Zengming Xiao
- The First Affiliated Hospital of Guangxi Medical University, Division of Spine Surgery, Nanning, 530021, China
| | - Hua Jiang
- The First Affiliated Hospital of Guangxi Medical University, Division of Spine Surgery, Nanning, 530021, China.
| | - Qingjun Wei
- The First Affiliated Hospital of Guangxi Medical University, Department of Orthopedic Surgery, Nanning, 530021, China
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Withanage ND, Perera S, Peiris H, Athiththan LV. Serum 25-hydroxyvitamin D, serum calcium and vitamin D receptor (VDR) polymorphisms in a selected population with lumbar disc herniation-A case control study. PLoS One 2018; 13:e0205841. [PMID: 30356314 PMCID: PMC6200232 DOI: 10.1371/journal.pone.0205841] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/02/2018] [Indexed: 12/03/2022] Open
Abstract
Background Association of Vitamin D receptor (VDR) polymorphisms with lumbar disc herniation (LDH) have been identified in several ethnic groups globally. Despite abundant sunlight, vitamin D deficiency is reported in many tropical countries. As vitamin D is a key modulator for intestinal calcium absorption, low vitamin D could contribute to low serum calcium leading to abnormalities of skeletal homeostasis. Therefore, present study was aimed to study the association of serum 25-hydroxyvitamin D (25(OH)D), serum calcium and VDR polymorphisms in a selected Sri Lankan population. Materials & methods A case control study was conducted in 119 participants (cases = 51: controls = 68). Serum 25(OH)D levels were measured using ELISA. The VDR polymorphisms (Fok I and Taq I) were detected by polymerase chain reaction followed by restriction fragment length polymorphism. Results Findings indicated a significantly low (p = 0.000) 25(OH)D levels in cases (18.7±3.7 ng/mL) compared to controls(25.5±9.8 ng/mL) while 25(OH)D in both groups were below the reference range. Mean serum calcium levels in both groups were within normal reference range and was not significantly different among groups. Statistically significant association was not observed between VDR Fok I polymorphisms among cases and controls. Although Fok I polymorphism genotypes were in Hardy-Weinberg equilibrium (HWE), Taq I genotypes in controls violated HWE. Conclusion Present study confirms that insufficient serum 25(OH)D levels in cases have major contribution to LDH. VDR Fok I polymorphisms did not have any significant association with LDH in Sri Lankan ethnicity.
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Affiliation(s)
- Niroshima Dedunu Withanage
- Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugogoda, Sri Lanka
- * E-mail:
| | | | - Hemantha Peiris
- Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Kawaguchi Y. Genetic background of degenerative disc disease in the lumbar spine. Spine Surg Relat Res 2018; 2:98-112. [PMID: 31440655 PMCID: PMC6698496 DOI: 10.22603/ssrr.2017-0007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 02/28/2017] [Indexed: 02/07/2023] Open
Abstract
This is a review paper on the topic of genetic background of degenerative disc diseases in the lumbar spine. Lumbar disc diseases (LDDs), such as lumbar disc degeneration and lumbar disc herniation, are the main cause of low back pain. There are a lot of studies that tried to identify the causes of LDDs. The causes have been categorized into environmental factors and genetic factors. Recent studies revealed that LDDs are mainly caused by genetic factors. Numerous studies have been carried out using the genetic approach for LDDs. The history of these studies is divided into three periods: (1) era of epidemiological research using familial background and twins, (2) era of genomic research using DNA polymorphisms to identify susceptible genes for LDDs, and (3) era of functional research to determine how the genes cause LDDs. This review article was undertaken to present the history of genetic approach to LDDs and to discuss the current issues and future perspectives.
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Dharmajaya R, Sari DK, Ganie RA. A Comparison of the Quality of Sleep between Pre and Post-Surgery Cervical Herniated Nucleus Pulposus Patients Utilizing the Anterior Discectomy Method. Open Access Maced J Med Sci 2017; 5:948-954. [PMID: 29362625 PMCID: PMC5771301 DOI: 10.3889/oamjms.2017.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/24/2017] [Accepted: 09/29/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Herniated Nucleus Pulposus (HNP) is the prolapse of the intervertebral disk through a tear in the annulus fibrosus. This causes nerve root compression with clinical pain manifestation and affects the quality of sleep. AIM The aim of this study was find out the comparison in the quality of sleep between before (pre) and after (post) surgery cervical HNP patients. METHODS This study was a retrospective cohort study. Ninety patients were asked to complete the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All data which has been computed were analysed with the McNemar test. RESULT The outcome reveals that from 90 patient`s cervical HNP, 81 (90%) were 40 years old age group and 66 (73.3%) of them were women. The result showed that 66 (73.3%) patients have a bad sleep quality before surgery. Surgery has increased the quality of sleep after surgery 66 (73.3%) patients had good sleep quality. There was a significant difference in the quality of sleep pre and post operation (p = 0.001). CONCLUSION There was a significant difference in the quality of sleep between pre and post operation cervical HNP patient utilising anterior discectomy methods.
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Prevalence, Patterns, and Genetic Association Analysis of Modic Vertebral Endplate Changes. Asian Spine J 2017; 11:594-600. [PMID: 28874978 PMCID: PMC5573854 DOI: 10.4184/asj.2017.11.4.594] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 12/26/2016] [Accepted: 01/08/2017] [Indexed: 11/08/2022] Open
Abstract
STUDY DESIGN A prospective genetic association study. PURPOSE The etiology of Modic changes (MCs) is unclear. Recently, the role of genetic factors in the etiology of MCs has been evaluated. However, studies with a larger patient subset are lacking, and candidate genes involved in other disc degeneration phenotypes have not been evaluated. We studied the prevalence of MCs and genetic association of 41 candidate genes in a large Indian cohort. OVERVIEW OF LITERATURE MCs are vertebral endplate signal changes predominantly observed in the lumbar spine. A significant association between MCs and lumbar disc degeneration and nonspecific low back pain has been described, with the etiopathogenesis implicating various mechanical, infective, and biochemical factors. METHODS We studied 809 patients using 1.5-T magnetic resonance imaging to determine the prevalence, patterns, distribution, and type of lumbar MCs. Genetic association analysis of 71 single nucleotide polymorphisms (SNPs) of 41 candidate genes was performed based on the presence or absence of MCs. SNPs were genotyped using the Sequenome platform, and an association test was performed using PLINK software. RESULTS The mean age of the study population (n=809) was 36.7±10.8 years. Based on the presence of MCs, the cohort was divided into 702 controls and 107 cases (prevalence, 13%). MCs were more commonly present in the lower (149/251, 59.4%) than in the upper (102/251, 40.6%) endplates. L4-5 endplates were the most commonly affected levels (30.7%). Type 2 MCs were the most commonly observed pattern (n=206, 82%). The rs2228570 SNP of VDR (p=0.02) and rs17099008 SNP of MMP20 (p=0.03) were significantly associated with MCs. CONCLUSIONS Genetic polymorphisms of SNPs of VDR and MMP20 were significantly associated with MCs. Understanding the etiopathogenetic mechanisms of MCs is important for planning preventive and therapeutic strategies.
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Makino H, Kawaguchi Y, Seki S, Nakano M, Yasuda T, Suzuki K, Ikegawa S, Kimura T. Lumbar disc degeneration progression in young women in their 20's: A prospective ten-year follow up. J Orthop Sci 2017; 22:635-640. [PMID: 28431805 DOI: 10.1016/j.jos.2017.03.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 03/15/2017] [Accepted: 04/05/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Lumbar disc degeneration (LDD) is known to be the main cause of low back pain, although it is unclear how or when LDD progresses. The purpose of this study was to clarify the process and features of LDD progression in young women. METHODS We enrolled 480 nursing students and carried out a prospective cohort study in 84 nursing students. MRI of the lumbar spine was taken once during their time as a student and again at 9.8 years (7-14) after the first MRI when they were working as nurses. The grade of LDD was determined according to Schneiderman's grade. The progression of disc degeneration was evaluated by the change in the degenerative disc disease (DDD) score (the summation of DDD score at each disc level). The subjects were divided into two groups based on MRI findings: Group A, those without disc degeneration at the first MRI (n = 58) and Group B, those showing disc degeneration on the first MRI (n = 26). We evaluated the change in DDD score and assessed the particular disc levels that showed Schneiderman's grade worsening in each group. RESULTS At the time of the 2nd MRI, the DDD score increased from 5.6 (5-9) to 6.3 (5-11). The L5/S disc was the most frequent level showing the progression of LDD. In Group A, 18 subjects (31.0%) and in Group B, 15 subjects (57.7%) had degeneration progression (p = 0.02). CONCLUSIONS This study revealed that 31% of the young adult subjects already had disc degeneration in 20's (time of first MRI) and the disc degeneration rapidly progressed in these subjects.
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Affiliation(s)
- Hiroto Makino
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yoshiharu Kawaguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan.
| | - Shoji Seki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Masato Nakano
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Taketoshi Yasuda
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kayo Suzuki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Tomoatsu Kimura
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan
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Chen L, Zhao S, Niu F, Bi GB. Association between vitamin D receptor gene polymorphisms and intervertebral disc degeneration: A meta-analysis. J Orthop Sci 2017; 22:184-189. [PMID: 27939971 DOI: 10.1016/j.jos.2016.11.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 10/18/2016] [Accepted: 11/14/2016] [Indexed: 02/09/2023]
Abstract
BACKGROUND Studies that have investigated the association between vitamin D receptor (VDR) gene polymorphisms and intervertebral disc degeneration (IDD) have yielded inconsistent results. METHODS To investigate the association between VDR gene polymorphisms and IDD, a systematic literature search for relevant published studies was performed on PubMed, Embase, Web of Science, Cochrane library, Wan-Fang, and CNKI databases. A random effects model was used for heterogeneous data; while a fixed effect model was used for homogenous data. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to evaluate the strength of the association. RESULTS We observed no association between VDR FokI, TaqI-ApaI polymorphisms and IDD. However, on subgroup analysis by ethnicity, VDR FokI mutation was associated with a significantly lower risk for IDD [dominant model: OR = 0.78, 95% CI = 0.65-0.93; heterozygote model: OR = 0.76, 95% CI = 0.63-0.92; allele model: OR = 0.86, 95% CI = 0.75-0.98] among Caucasians. CONCLUSION These results suggest that the VDR FokI polymorphism may be associated with IDD among Caucasians. However, the association between VDR TaqI-ApaI polymorphisms and IDD in Asians is still not clear. Further well-designed studies are needed to arrive at a definitive conclusion.
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Affiliation(s)
- Lin Chen
- Department of Spine Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, PR China
| | - Song Zhao
- Department of Spine Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, PR China
| | - Feng Niu
- Department of Spine Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, PR China.
| | - Gui-Bin Bi
- Department of Spine Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, PR China
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Walker CT, Bonney PA, Martirosyan NL, Theodore N. Genetics Underlying an Individualized Approach to Adult Spinal Disorders. Front Surg 2016; 3:61. [PMID: 27921035 PMCID: PMC5118450 DOI: 10.3389/fsurg.2016.00061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 10/26/2016] [Indexed: 12/22/2022] Open
Abstract
Adult spinal disorders are a significant cause of morbidity across the world and carry significant health and economic burdens. Genetic predispositions are increasingly considered for these conditions and are becoming understood. Advances in molecular technologies since the mid-1990s have made possible genetic characterizations of these diseases in many populations, and recent findings have provided insight into the underlying pathophysiologic mechanisms. These studies have made clear the genetic heterogeneity producing clinical phenotypes and suggest that individualized treatments are possible in the future. We review the genetics and heritability of cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament and perform a systematic review of the genetics of adult lumbar degenerative scoliotic deformity, highlighting recent discoveries and the potential for personalized future therapeutics for these patients.
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Affiliation(s)
- Corey T Walker
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute , Phoenix, AZ , USA
| | - Phillip A Bonney
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute , Phoenix, AZ , USA
| | - Nikolay L Martirosyan
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute , Phoenix, AZ , USA
| | - Nicholas Theodore
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute , Phoenix, AZ , USA
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How Reliable Are the Reported Genetic Associations in Disc Degeneration?: The Influence of Phenotypes, Age, Population Size, and Inclusion Sequence in 809 Patients. Spine (Phila Pa 1976) 2016; 41:1649-1660. [PMID: 27513226 DOI: 10.1097/brs.0000000000001847] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Prospective genetic association study. OBJECTIVE The aim of this study was to document the variations in the genetic associations, when different magnetic resonance imaging (MRI) phenotypes, age stratification, cohort size, and sequence of cohort inclusion are varied in the same study population. SUMMARY OF BACKGROUND DATA Genetic associations with disc degeneration have shown high inconsistency, generally attributed to hereditary factors and ethnic variations. However, the effect of different phenotypes, size of the study population, age of the cohort, etc have not been documented clearly. METHODS Seventy-one single-nucleotide polymorphisms (SNPs) of 41 candidate genes were correlated to six MRI markers of disc degeneration (annular tears, Pfirmann grading, Schmorl nodes, Modic changes, Total Endplate Damage score, and disc bulge) in 809 patients with back pain and/or sciatica. In the same study group, the correlations were then retested for different age groups, different sample, size and sequence of subject inclusion (first 404 and the second 405) and the differences documented. RESULTS The mean age of population (M: 455, F: 354) was 36.7 ± 10.8 years. Different genetic associations were found with different phenotypes: disc bulge with three SNPs of CILP; annular tears with rs2249350 of ADAMTS5 and rs11247361 IGF1R; modic changes with VDR and MMP20; Pfirmann grading with three SNPs of MMP20 and Schmorl node with SNPs of CALM1 and FN1 and none with Total End Plate Score.Subgroup analysis based on three age groups and dividing the total population into two groups also completely changed the associations for all the six radiographic parameters. CONCLUSION In the same study population, SNP associations completely change with different phenotypes. Variations in age, inclusion sequence, and sample size resulted in change of genetic associations. Our study questions the validity of previous studies and necessitates the need for standardizing the description of disc degeneration, phenotype selection, study sample size, age, and other variables in future studies. LEVEL OF EVIDENCE 4.
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Vitamin D Receptor Gene, Matrix Metalloproteinase 3 Polymorphisms and the Risk of Intervertebral Disc Degeneration Susceptibility: Meta-Analysis. Asian Spine J 2016; 10:964-971. [PMID: 27790329 PMCID: PMC5081336 DOI: 10.4184/asj.2016.10.5.964] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 01/16/2016] [Accepted: 01/19/2016] [Indexed: 12/02/2022] Open
Abstract
Several studies have evaluated the association between vitamin D receptor, matrix metalloproteinase 3 (MMP-3) polymorphisms and the risk of intervertebral disc degeneration susceptibility. The findings were inconsistent. This meta-analysis aimed to systematically assess the association between vitamin D receptor, MMP-3 polymorphisms and the risk of intervertebral disc degeneration susceptibility. A search of various databases was done covering all papers published until December 31th, 2014. Eight, 4, 3 studies were finally included that addressed the risk of intervertebral disc degeneration susceptibility and vitamin D receptor FokI (rs2228570), ApaI (rs7975232), and MMP-3 (rs731236) polymorphisms, respectively. FokI (f vs. F: summary odds ratio [OR], 1.13; 95% confidence interval [CI], 0.76–1.69; ff vs. FF: OR, 1.02; 95% CI, 0.59–1.77; ff vs. Ff/FF: OR, 1.05; 95% CI, 0.70–1.58), ApaI (a vs. A: OR, 0.73; 95% CI, 0.45–1.19; aa vs. AA: OR, 0.53; 95% CI, 0.22–1.25 p=0.14; aa vs. AA/Aa: OR, 0.69; 95% CI, 0.53–0.89) in the vitamin D receptor gene and MMP3 polymorphisms (5A vs. 6A: OR, 1.92; 95% CI, 0.77–4.80; 5A5A vs. 6A6A: OR, 2.17; 95% CI, 0.75–6.24; 5A5A vs. 5A6A/6A6A: OR, 1.58; 95% CI, 0.72–3.44) were not obviously associated with risk of intervertebral disc degeneration susceptibility. FokI, ApaI polymorphisms in the vitamin D receptor gene and MMP-3 polymorphism are not obvious risk factors for intervertebral disc degeneration susceptibility.
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Samartzis D, Mok FPS, Karppinen J, Fong DYT, Luk KDK, Cheung KMC. Classification of Schmorl's nodes of the lumbar spine and association with disc degeneration: a large-scale population-based MRI study. Osteoarthritis Cartilage 2016; 24:1753-1760. [PMID: 27143364 DOI: 10.1016/j.joca.2016.04.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 04/25/2016] [Accepted: 04/25/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Schmorl's nodes (SN) are highly associated with lumbar disc degeneration (DD). However, SN present with different morphologies/topographies that may be associated with varying degrees of DD. This study proposed a classification of SN to determine their morphological/topographical prevalence and association with the severity of DD. METHODS Sagittal T2-weighted MRIs were assessed to identify SN and additional imaging findings from L1-S1 in 2,449 individuals. SN characteristics were classified by six criteria: disc level; endplate involvement; shape; size; location of endplate zone; and the presence of marrow changes. Hierarchical clustering was performed to identify distinct SN characteristics with endplate patterns. RESULTS Good to excellent observer classification reliability was noted. SN most commonly presented at the L1 and L2 disc levels, and entailed one-third of the endplate, predominantly the middle zone. Round shape (39.2%) was the most common SN shape. Four specific SN and endplate linkage patterns were identified. 8.3% of identified SN (n = 960) were "Atypical SN". Multivariable regression showed that "Typical SN" and "Atypical SN", depending on levels, were associated with an adjusted 2- to 4-fold and a 5- to 13-fold higher risk of increased severity of DD, respectively (p < 0.05). CONCLUSIONS This is the first large-scale magnetic resonance imaging (MRI) study to propose a novel SN classification. Specific SN-types were identified, which were associated with more severe DD. This study further broadens our understanding of the role of SN and degrees of DD, further expanding on the SN phenotyping that can be internationally adopted for utility assessment.
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Affiliation(s)
- D Samartzis
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - F P S Mok
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - J Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Finnish Institute of Occupational Health, Health and Work Ability, and Disability Prevention Centre, Oulu, Finland
| | - D Y T Fong
- Department of Nursing Studies, The University of Hong Kong, Hong Kong, China
| | - K D K Luk
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - K M C Cheung
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China.
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Jiang H, Qin Z, Zong S, He M, Zhan X, Xiao Z, Wei Q. Vitamin D receptor gene polymorphisms and lumbar disc degeneration: a systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 26:267-277. [PMID: 27613009 DOI: 10.1007/s00586-016-4771-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 08/06/2016] [Accepted: 09/03/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine the association between Vitamin D receptor (VDR) gene polymorphisms and lumbar disc degeneration (LDD) predisposition. METHODS A comprehensive literature search was conducted to identify all the relevant studies. The allele/genotype frequencies were extracted from each study. We calculated the pooled odds ratios (ORs) and 95 % confidence intervals (CI) to assess the strength of the association between the VDR gene polymorphisms and LDD risk. Statistical analysis was performed using RevMan 5.31 software. RESULTS A total of 23 case-control studies (1835 cases and 1923 controls) were included in this systematic review. For the TaqI (rs731236), FokI (rs2228570) and ApaI (rs7975232) polymorphisms of VDR gene, nine studies, seven studies, and five studies, were eventually included in the meta-analysis, respectively. There was no evidence that the VDR gene polymorphisms (TaqI, FokI, ApaI) had significant associations with LDD risk.(for TaqI allelic comparison, OR = 1.07, 95 % CI 0.81-1.40, p = 0.64; for FokI allelic comparison, OR = 1.23, 95 % CI 0.83-1.82, p = 0.31; for ApaI allelic comparison, OR = 0.79, 95 % CI 0.55-1.14, p = 0.20). For stratified analyses by ethnicity and study design, no significant associations were found in Caucasian population and Asian population, as well as the population-based studies and hospital-based studies under all genetic models. CONCLUSIONS TaqI, FokI, and ApaI polymorphisms of VDR gene were not significantly associated with the predisposition of LDD. Large-scale and well-designed international studies are needed to further analyze this field.
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Affiliation(s)
- Hua Jiang
- Division of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhilin Qin
- Division of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Shaohui Zong
- Division of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Maolin He
- Division of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xinli Zhan
- Division of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zengming Xiao
- Division of Spine Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qingjun Wei
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Guangxi Medical University, Shuangyong Road No. 6, Nanning, 530021, China.
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Hemanta D, Jiang XX, Feng ZZ, Chen ZX, Cao YW. Etiology for Degenerative Disc Disease. ACTA ACUST UNITED AC 2016; 31:185-191. [DOI: 10.1016/s1001-9294(16)30049-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hanaei S, Abdollahzade S, Khoshnevisan A, Kepler CK, Rezaei N. Genetic aspects of intervertebral disc degeneration. Rev Neurosci 2016; 26:581-606. [PMID: 25996483 DOI: 10.1515/revneuro-2014-0077] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 04/01/2015] [Indexed: 01/16/2023]
Abstract
Intervertebral disc degeneration (IVDD) is one of the common causes of low back pain. Similar to many other multifactorial diseases, it is affected by environmental and genetic factors. Although not completely understood, genetic factors include a wide spectrum of variations, such as single nucleotide polymorphisms, which could play a significant role in the etiology of this disease. Besides, the interactions with environmental factors could make the role of genetic factors more complicated. Genetic variations in disc components could participate in developing degenerative disc disease through altering the normal homeostasis of discs. Gene polymorphisms in disc proteins (collagens I, II, III, IX, and XI), proteoglycans (aggrecan), cytokines (interleukins I, VI, and X), enzymes (matrix metalloproteinases II, III, and IX), and vitamin D receptor seem to play considerable roles in the pathology of this disease. There are also many other investigated genes that could somehow take part in the process. However, it seems that more studies are needed to clarify the exact role of genetics in IVDD.
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Colombini A, Brayda-Bruno M, Lombardi G, Croiset SJ, Ceriani C, Buligan C, Barbina M, Banfi G, Cauci S. BsmI, ApaI and TaqI Polymorphisms in the Vitamin D Receptor Gene (VDR) and Association with Lumbar Spine Pathologies: An Italian Case-Control Study. PLoS One 2016; 11:e0155004. [PMID: 27149110 PMCID: PMC4858196 DOI: 10.1371/journal.pone.0155004] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/22/2016] [Indexed: 11/21/2022] Open
Abstract
Three adjacent single nucleotide polymorphisms of the vitamin D receptor gene (VDR) BsmI (rs1544410), ApaI (rs7975232), and TaqI (rs731236) are commonly studied in several pathologies. We aimed to evaluate the distribution of VDR BsmI, ApaI, and TaqI allele, genotype, and haplotype frequencies in an Italian cohort of 266 patients with lumbar spine disorders assessed by Magnetic Resonance Imaging and 252 asymptomatic controls. The exposure to putative risk factors was evaluated by a questionnaire. Polymorphisms were detected by PCR-RFLP and TaqMan® SNP Genotyping Assay. The results were statistically adjusted for the identified conventional risk factors. The three SNPs were in linkage disequilibrium. For all cases BbAaTT was a 3-fold risk factor OR = 3.38), whereas bbAATT (OR = 0.22), and bbaaTT (OR = 0.47) genotypes were found to be protective. Specifically, for patients affected by disc herniation only (n = 88) and all lumbar pathologies excluding stenosis and/or spondylolistesis (n = 215) B allele, Bb, Aa, and BbAaTT genotypes were risky, whereas b allele, bb, aa, and bbaaTT genotypes were protective. In patients affected by osteochondrosis with or without disc hernation (n = 50), T allele, Aa, and bbAaTT genotypes were risky, whereas t allele, AA, tt genotypes were protective. In patients affected by stenosis and/or spondylolistesis (n = 51) no significant associations were found. This is the first study showing an association of the three genetic VDR variants BsmI, ApaI, and TaqI and lumbar spine pathologies. Our study contributes to delineate genetic risk factors for specific subgroups of patients with lumbar spine pathologies highlighting the importance of haplotype analysis, and of detailed clinical evaluation of the patients for identification of genetic biomarkers.
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Affiliation(s)
- Alessandra Colombini
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
- * E-mail:
| | - Marco Brayda-Bruno
- Scoliosis Unit, Department of Orthopedics and Traumatology – Spine surgery III, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - Samantha Jennifer Croiset
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - Cristina Ceriani
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
| | - Cinzia Buligan
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Mattia Barbina
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Giuseppe Banfi
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Sabina Cauci
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
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Abstract
Low back pain (LBP) is a major cause of disability and imposes huge economic burdens on human society worldwide. Among many factors responsible for LBP, intervertebral disc degeneration (IDD) is the most common disorder and is a target for intervention. The etiology of IDD is complex and its mechanism is still not completely understood. Many factors such as aging, spine deformities and diseases, spine injuries, and genetic factors are involved in the pathogenesis of IDD. In this review, we will focus on the recent advances in studies on the most promising and extensively examined genetic factors associated with IDD in humans. A number of genetic defects have been correlated with structural and functional changes within the intervertebral disc (IVD), which may compromise the disc's mechanical properties and metabolic activities. These genetic and proteomic studies have begun to shed light on the molecular basis of IDD, suggesting that genetic factors are important contributors to the onset and progression of IDD. By continuing to improve our understanding of the molecular mechanisms of IDD, specific early diagnosis and more effective treatments for this disabling disease will be possible in the future.
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Affiliation(s)
- Yi Feng
- Harrington Laboratory for Molecular Orthopedics, Department of Orthopedic Surgery
| | - Brian Egan
- Harrington Laboratory for Molecular Orthopedics, Department of Orthopedic Surgery
| | - Jinxi Wang
- Harrington Laboratory for Molecular Orthopedics, Department of Orthopedic Surgery; Department of Biochemistry & Molecular Biology, University of Kansas Medical Center, Kansas City, Kansas, USA
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Mok FPS, Samartzis D, Karppinen J, Fong DYT, Luk KDK, Cheung KMC. Modic changes of the lumbar spine: prevalence, risk factors, and association with disc degeneration and low back pain in a large-scale population-based cohort. Spine J 2016; 16:32-41. [PMID: 26456851 DOI: 10.1016/j.spinee.2015.09.060] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 08/18/2015] [Accepted: 09/29/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Modic changes (MC) are bone marrow lesions on magnetic resonance imaging (MRI), suggestive of being associated with low back pain (LBP). Data on determinants of MC and their association with disc degeneration and other spinal phenotypes, as well as that of LBP, rely mostly on small-scale patient populations and remain controversial. PURPOSE This study addressed the potential determinants of MC and their association with disc degeneration and LBP among Southern Chinese. STUDY DESIGN/SETTING A cross-sectional, population-based study was carried out. PATIENT SAMPLE This study consisted of 2,449 Southern Chinese volunteers. METHODS Sagittal T2-weighted MRIs of the lumbar spine were assessed for the presence of MC and other spinal phenotypes (eg, disc degeneration, disc displacement, Schmorl nodes) in all individuals. Subjects' demographics, occupation, lifestyle, and clinical profiles were assessed. RESULTS The overall prevalence of MC was 5.8% (n=141), which increased with advancing age. Modic changes predominantly occurred at the lowest two lumbar levels (83%). In the multivariate analyses, only the presence of disc displacement and a higher disc degeneration score were associated with MC at the upper lumbar levels (L1/L2-L3/L4) (p<.01). The presence of MC at the lowest two lumbar levels (L4/L5-L5/S1) were associated with age, the presence of Schmorl nodes, disc degeneration or displacement, and historical lumbar injury (p<.01). Subjects who were both smokers and overweight or obese had increased likelihood of MC in the lower spine (OR: 2.18; 95% CI: 1.10-4.30). The presence of MC at the lower lumbar levels were associated with historical LBP (OR: 1.93; 95% CI: 1.05-3.54) and with severity and duration of symptoms (p<.05). CONCLUSIONS Based on one of the largest MRI studies to assess lumbar MC, we noted that MC were associated with both disc degeneration and the presence and severity of LBP. Determinants and association of MC with disc degeneration and clinical symptoms in the upper versus the lower lumbar spine were different. Our study further stresses the significance of MC as important imaging phenotypes associated with LBP.
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Affiliation(s)
- Florence P S Mok
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China
| | - Dino Samartzis
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China.
| | - Jaro Karppinen
- Department of Physical and Rehabilitation Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Box 5000, 90014, Oulu, Finland; Finnish Institute of Occupational Health, Health and Work Ability, and Disability Prevention Centre, Aapistie 1, 90220, Oulu, Finland
| | - Daniel Y T Fong
- School of Nursing, The University of Hong Kong, William M.W. Mong Block, 4/F, 21 Sassoon Road, Pokfulam, Hong Kong, SAR, China
| | - Keith D K Luk
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China
| | - Kenneth M C Cheung
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China.
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Osman E, Al Anouti F, El Ghazali G, Haq A, Mirgani R, Al Safar H. Frequency of rs731236 (Taql), rs2228570 (Fok1) of Vitamin-D Receptor (VDR) gene in Emirati healthy population. Meta Gene 2015; 6:49-52. [PMID: 26504744 PMCID: PMC4576359 DOI: 10.1016/j.mgene.2015.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 08/16/2015] [Accepted: 09/02/2015] [Indexed: 11/29/2022] Open
Abstract
Vitamin D is getting more attention everyday due to its importance in maintaining bone and calcium homeostasis, cellular proliferation, differentiation and immune response. Vitamin D is derived from diet or elicited in the skin by the activation of 7-dehydrocholesterol, which is an inert molecule that must be activated by ultraviolet light to form pre-vitamin D3. Recent studies connected the gene encoding for vitamin D (VDR) to the genetic control of bone mass and other diseases. As VDR SNPs have been associated with several disorders and diseases, it's important to investigate the allelic and genotypic distribution among populations. The aim of this study is to determine the frequency of rs731236 (Taq1) and rs2228570 (Fok1) variants in healthy Emirati individuals and compare their genotype and allele distribution with other populations. In this study 282 (female, 187; male, 95) unrelated healthy UAE nationals were involved. Two hundreds and eight two DNA samples been collected to genotype rs731236 (Taq1) and rs2228570 (Fok1) VDR SNPs. Our results indicate that the distribution of the alleles and genotypes of rs731236 (Taq1) and rs2228570 (Fok1) vary considerably in different populations. In the Emirati population the distribution of rs731236 (Taq1) and rs2228570 (Fok1) were AA 38%, AG 42%, GG 20% and AA 27%, AG 42%, GG 31% respectively. The Emirati population genotype and allele distribution of rs731236 (Taq1) and rs2228570 (Fok1) had no difference with Caucasians from USA and France. However, there was significant difference with Asian populations.
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Affiliation(s)
- Enas Osman
- Khalifa University of Science, Technology & Research, Biomedical Department, Abu Dhabi, United Arab Emirates
| | | | - Gehad El Ghazali
- Institute of Laboratory Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Afrozul Haq
- VPS Healthcare, Abu Dhabi, United Arab Emirates
| | - Rajaa Mirgani
- Fatima College for Health Sciences, Abu Dhabi, United Arab Emirates
| | - Habiba Al Safar
- Khalifa University of Science, Technology & Research, Biomedical Department, Abu Dhabi, United Arab Emirates ; Khalifa University Center of Biotechnology, Abu Dhabi, United Arab Emirates
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Toktaş ZO, Ekşi MŞ, Yılmaz B, Demir MK, Özgen S, Kılıç T, Konya D. Association of collagen I, IX and vitamin D receptor gene polymorphisms with radiological severity of intervertebral disc degeneration in Southern European Ancestor. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 24:2432-41. [PMID: 26342701 DOI: 10.1007/s00586-015-4206-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 08/22/2015] [Accepted: 08/22/2015] [Indexed: 01/07/2023]
Abstract
PURPOSE Several genomic loci have been previously found to be associated with intervertebral disc degeneration, so far. Data are mostly derived from northern European countries whereas data derived from Southern European Ancestor are limited. This study aimed to evaluate the association between radiological disease severity of lumbar disc degeneration and certain genetic loci in a sample of participants from Southern Europe. METHODS Seventy-five patients with mild to severe lumbar disc degeneration and 25 healthy controls were enrolled into the study. In each subject, each lumbar intervertebral disc was separately examined to obtain a total radiological score for disease severity. In addition, single-nucleotide polymorphisms of predefined genetic samples were analyzed in all participants: COL1A1 Sp1, COL9a2 Trp2, COL9a3 Trp3, and VDR TaqI. RESULTS Degeneration scores were significantly worse in cases with COL1A1 Sp1, COL9a3 Trp3, and VDR TaqI mutations; however, COL9a2 Trp2 mutation was not associated with a difference in the severity of disc degeneration. In addition, subjects with mutation in more than one gene sample (n = 20) had significantly worse degeneration scores than the remaining study participants (n = 80) (17.70 ± 2.72 vs. 21.81 ± 1.81, p < 0.001). CONCLUSION Single-nucleotide polymorphisms occurring in COL1A1, COL9a3 and VDR genes seem to be associated with the development of lumbar disc degeneration in this cohort, possibly with even more pronounced association when multiple mutations are present in the same individual. By further prospective twin studies in associated genes and analyses of their relationship with environmental factors in an internationally sampled large cohort will make a more clear-minded conclusion about their association with disc degeneration, which would yield better appreciation and clinical planning of some predisposed people for these pathologies.
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Affiliation(s)
- Zafer Orkun Toktaş
- Department of Neurosurgery, Bahçeşehir University Medical Faculty, Çırağan Caddesi Osmanpaşa Mektebi Sokak No: 4-6, 34353, Beşiktaş, Istanbul, Turkey.
| | - Murat Şakir Ekşi
- Department of Orthopedic Surgery, University of California at San Francisco, San Francisco, CA, USA
| | - Baran Yılmaz
- Department of Neurosurgery, Bahçeşehir University Medical Faculty, Çırağan Caddesi Osmanpaşa Mektebi Sokak No: 4-6, 34353, Beşiktaş, Istanbul, Turkey
| | - Mustafa Kemal Demir
- Department of Radiology, Bahçeşehir University Medical Faculty, Istanbul, Turkey
| | - Serdar Özgen
- Department of Neurosurgery, Acıbadem University Medical Faculty, Istanbul, Turkey
| | - Türker Kılıç
- Department of Neurosurgery, Bahçeşehir University Medical Faculty, Çırağan Caddesi Osmanpaşa Mektebi Sokak No: 4-6, 34353, Beşiktaş, Istanbul, Turkey
| | - Deniz Konya
- Department of Neurosurgery, Bahçeşehir University Medical Faculty, Çırağan Caddesi Osmanpaşa Mektebi Sokak No: 4-6, 34353, Beşiktaş, Istanbul, Turkey
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Samartzis D, Borthakur A, Belfer I, Bow C, Lotz JC, Wang HQ, Cheung KMC, Carragee E, Karppinen J. Novel diagnostic and prognostic methods for disc degeneration and low back pain. Spine J 2015; 15:1919-32. [PMID: 26303178 PMCID: PMC5473425 DOI: 10.1016/j.spinee.2014.09.010] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 09/09/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Dino Samartzis
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China; The Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China.
| | - Ari Borthakur
- Center for Magnetic Resonance and Optical Imaging, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Mezzanine, Philadelphia, PA, 19104, USA
| | - Inna Belfer
- Department of Anesthesiology, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA
| | - Cora Bow
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China
| | - Jeffrey C Lotz
- Department of Orthopaedic Surgery, University of California at San Francisco, 500 Parnassus Ave, San Francisco, CA 94143, USA
| | - Hai-Qiang Wang
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, No. 169, Changle West Road, Xi'an, Shaanxi, 710032, P.R. China
| | - Kenneth M C Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Professorial Block, 5th Floor, 102 Pokfulam Road, Pokfulam, Hong Kong, SAR, China
| | - Eugene Carragee
- Department of Orthopaedic Surgery, Stanford University, 450 Serra Mall, Stanford, CA 94305, USA
| | - Jaro Karppinen
- Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Kajaanintie 50, 90220 Oulu, Finland
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Li Y, Zhu J, Gao C, Peng B. Vitamin D Receptor (VDR) Genetic Polymorphisms Associated with Intervertebral Disc Degeneration. J Genet Genomics 2015; 42:135-40. [PMID: 26153579 DOI: 10.1016/j.jgg.2015.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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The Influence of Lumbar Spinal Subtype on Lumbar Intervertebral Disc Degeneration in Young and Middle-Aged Adults. Spine Deform 2015; 3:172-179. [PMID: 27927309 DOI: 10.1016/j.jspd.2014.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 06/08/2014] [Accepted: 08/08/2014] [Indexed: 11/21/2022]
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVE To identify whether an in vivo correlation exists between lumbar spinal subtype (LSS) and lumbar disc degeneration (LDD) in young adults. SUMMARY OF BACKGROUND DATA Lumbar disc degeneration has largely been ascribed to biomechanical and structural alterations to the disc, which are attributed to aging and pathological physical loading. Sagittal alignment in the asymptomatic spine has also been considered. A biomechanical study by Roussouly and Pinheiro-Franco proposed level-specific patterns in LDD. To date, no in vivo correlation between the LSS and LDD has been established. METHODS The authors screened 608 consecutive patients over 5.3 years. Lumbar spinal subtype and pelvic parameters were collected from standing lumbar radiographs and were categorized using the classification of Roussouly and Pinheiro-Franco. Lumbar disc degeneration at all lumbar intervertebral levels was classified using criteria of Pfirrmann et al. A stratified disc degeneration score was derived for each patient. Lumbar disc degeneration in type I, II, and IV LSS was compared using chi-square test. Pelvic incidence was correlated with stratified disc degeneration score using Spearman R, to determine whether a high PI was protective against LDD. Statistical significance was accepted at p < .05. RESULTS A total of 139 patients were included, with 91 females and a mean age of 32.6 years (range, 13-49 years). For LSS grades I to IV, there were 10 (7.3%), 43 (30.9%), 50 (35.9%), and 36 (25.9%) patients, respectively. The proportion of high-grade (Pfirrmann grades IV and V) LDD increased distally toward the lower intervertebral levels, affecting 2.88%, 2.9%, 5%, 9.4%, 33.1%, and 54% of discs at each sequential lumbar level from T12-L1 to L5-S1, respectively. Age but not gender was statistically significant for higher-grade LDD (p < .0001 and p = .442, respectively). Pelvic incidence across all LSS grades was not significantly correlated with stratified disc degeneration score (Spearman R = 0.0933; p = .335). No LSS (type I-IV) reached statistical significance for a specific pattern of LDD. CONCLUSIONS In this study, LSS was not statistically significantly correlated with LDD, nor was a high pelvic incidence protective against LDD.
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Willems PC. Provocative diskography: safety and predictive value in the outcome of spinal fusion or pain intervention for chronic low-back pain. J Pain Res 2014; 7:699-705. [PMID: 25506242 PMCID: PMC4259559 DOI: 10.2147/jpr.s45615] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
There is still no clear definition of diskogenic low-back pain and no consensus on a generally agreed test, such as provocative diskography (PD), to diagnose painful disk degeneration, and probably more importantly, to predict the outcome of therapy intended to reduce pain that is presumed to be diskogenic in nature. Nevertheless, PD is the most specific procedure to diagnose diskogenic low-back pain. Its accuracy, however, is rather low or at best unknown. Although rare, the most prevalent complication, postdiskography diskitis, can be devastating for the individual patient, so all measures, like strict sterile conditions and antibiotic prophylaxis, should be taken to avoid this complication. It is advised to perform the procedure in a pressure-controlled way with a constant low flow, and optionally computed tomography imaging. PD should not be performed in morphologically normal disks. A standardized execution of the test should be established in order to perform high-quality studies to determine its accuracy to lead to meaningful interventions, and find best practices for diagnosis and treatment of diskogenic back pain. Possibly, PD may have detrimental effects on the disk, causing early degeneration, although it is unknown whether this will be related to clinical symptoms. Especially with these possible adverse side effects in mind, the risk-benefit ratio with the lack of clear benefits from treatments provided, and possible complications of disk puncture, the rationale for PD is questionable, which should be stressed to patients in the process of shared decision making. Diskography as a stand-alone test is not recommended in clinical decision making for patients with chronic low-back pain.
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Affiliation(s)
- Paul C Willems
- Department of Orthopedic Surgery, CAPHRI Research School, Maastricht University Medical Center, Maastricht, the Netherlands
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Falavigna A, Righesso O, Teles AR, Bossardi JB, Silva PGD. Preoperative motor deficit in lumbar disc herniation and its influence on quality of life. COLUNA/COLUMNA 2014. [DOI: 10.1590/s1808-18512014130400473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: Evaluate the impact of motor deficit (MD) on pain, disability, depression and quality of life measures of patients with LDH prior to a specific treatment. Methods: A total of 254 consecutively enrolled patients with LDH associated to neurological impairment and sciatica who have not responded to conservative treatment were evaluated. After reviewing the exclusion criteria, 168 were included. Validated instruments were used in the preoperative period to evaluate: pain, disability, quality of life, anxiety and depression. Results: Normal motor strength was observed in 57 (33.9%) patients and MD was observed in 111 (66.1%) cases. No statistically significant differences were observed between patients with and without MD regarding gender, age, level of herniation, lateralization and workers&apos; compensation. Regarding quality of life, no difference was detected in the eight domains of SF36 and between the PCS and MCS groups. The only difference observed was a higher disability rate in the MD group, with the mean ODI difference being 7.84 (CI 95%: 1.82â€"13.87; p=0.011). Motor weakness was observed in 35.1% (n=39/111) of patients who had abnormal results at the motor evaluation, being related to severity (X²: 46.058; p<0.0001). Conclusion: In patients with LDH without prior specific treatment, the presence of MD did not modify the pain, disability, depression measures and self-reported quality of life. The MD has no discriminative power for measures of quality of life in patients with LDH.
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Rajasekaran S, Kanna RM, Senthil N, Raveendran M, Ranjani V, Cheung KMC, Chan D, Kao PYP, Yee A, Shetty AP. Genetic susceptibility of lumbar degenerative disc disease in young Indian adults. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 24:1969-75. [PMID: 25416170 DOI: 10.1007/s00586-014-3687-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 11/07/2014] [Accepted: 11/13/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Although the exact mechanisms that lead to degenerative disc disease (DDD) are not well understood, a significant genetic influence has been found. Focusing on DDD that occurs in young adults can be valuable in determining the exact role of genetic predisposition to DDD. METHODS Patients (<40 years) with lumbar disc degeneration were evaluated with MRI imaging (1.5 Tesla) and genetic association analysis for 58 single nucleotide polymorphism (SNP) of 35 candidate genes was performed. Disc degeneration of individual discs of lumbar spine from L1 to S1 was graded by Pfirrmann's grading. The subjects were stratified into two groups based on Total Disc Degenerative Score (TDDS). Based on TDDS, the severity of DDD was classified as mild (Group A: TDDS <10) and severe (Group B: TDDS >10). RESULTS 695 Indian subjects including 308 with mild TDDS and 387 with severe TDDS were studied. The mean age of the patients was 29.6 ± 6.9 years in group A and 31.7 ± 6.1 in group B (p < 0.05). Five of the 35 candidate genes viz., rs1337185 of COL11A (p = 0.02), rs5275 (p = 0.03) and rs5277 (p = 0.05) of COX2, rs7575934 of IL1F5 (p = 0.04), rs3213718 of CALM1 (p = 0.04) and rs162509 of ADAMTS5 (p = 0.04) were found to be significantly associated with severe TDDS. CONCLUSION The study identifies specific SNP associations of five genes in young adults with severe lumbar disc degeneration. These five genes (COL11A1, ADAMTS5, CALM1, IL1F5 and COX2) have different functions in the matrix metabolism, intracellular signalling and inflammatory cascade. This shows that disc degeneration is a complex disease with an intricate interplay of multiple genetic polymorphisms.
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Affiliation(s)
- S Rajasekaran
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, Tamil Nadu, 641 011, India,
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Genetic polymorphisms of interleukin-1 alpha and the vitamin d receptor in mexican mestizo patients with intervertebral disc degeneration. Int J Genomics 2014; 2014:302568. [PMID: 25506053 PMCID: PMC4258367 DOI: 10.1155/2014/302568] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 11/12/2014] [Indexed: 01/08/2023] Open
Abstract
Intervertebral disc degeneration (IDD) is the most common diagnosis in patients with back pain, a leading cause of musculoskeletal disability worldwide. Several conditions, such as occupational activities, gender, age, and obesity, have been associated with IDD. However, the development of this disease has strong genetic determinants. In this study, we explore the possible association between rs1800587 (c.-949C>T) of interleukin-1 alpha (IL1A) and rs2228570 (c.2T>V) and rs731236 (c.1056T>C) of vitamin D receptor (VDR) gene polymorphisms and the development of IDD in northwestern Mexican Mestizo population. Gene polymorphisms were analyzed by polymerase chain reaction followed by restriction fragment length polymorphism, in two groups matched by age and gender: patients with symptomatic lumbar IDD (n = 100) and subjects with normal lumbar-spine MRI-scans (n = 100). Distribution of the mutated alleles in patients and controls was 27.0% versus 28.0% (P = 0.455) for T of rs1800587 (IL1A); 53.0% versus 58.0% (P = 0.183) for V of rs2228570 (VDR); and 18.0% versus 21.0% (P = 0.262) for C of rs731236 (VDR). Our results showed no association between the studied polymorphisms and IDD in this population. This is the first report on the contribution of gene polymorphisms on IDD in a Mexican population.
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Sedighi M, Haghnegahdar A. Role of vitamin D3 in treatment of lumbar disc herniation--pain and sensory aspects: study protocol for a randomized controlled trial. Trials 2014; 15:373. [PMID: 25257359 PMCID: PMC4190421 DOI: 10.1186/1745-6215-15-373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 09/04/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Vitamin D receptors have been identified in the spinal cord, nerve roots, dorsal root ganglia and glial cells, and its genetic polymorphism association with the development of lumbar disc degeneration and herniation has been documented. Metabolic effects of active vitamin D metabolites in the nucleus pulposus and annulus fibrosus cells have been studied. Lumbar disc herniation is a process that involves immune and inflammatory cells and processes that are targets for immune regulatory actions of vitamin D as a neurosteroid hormone. In addition to vitamin D's immune modulatory properties, its receptors have been identified in skeletal muscles. It also affects sensory neurons to modulate pain. In this study, we aim to study the role of vitamin D3 in discogenic pain and related sensory deficits. Additionally, we will address how post-treatment 25-hydroxy vitamin D3 level influences pain and sensory deficits severity. The cut-off value for serum 25-hydroxy vitamin D3 that would be efficacious in improving pain and sensory deficits in lumbar disc herniation will also be studied. METHODS/DESIGN We will conduct a randomized, placebo-controlled, double-blind clinical trial. Our study population will include 380 cases with one-level and unilateral lumbar disc herniation with duration of discogenic pain less than 8 weeks. Individuals who do not have any contraindications, will be divided into three groups based on serum 25-hydroxy vitamin D3 level, and each group will be randomized to receive either a single-dose 300,000-IU intramuscular injection of vitamin D3 or placebo. All patients will be under conservative treatment. Pre-treatment and post-treatment assessments will be performed with the McGill Pain Questionnaire and a visual analogue scale. For the 15-day duration of this study, questionnaires will be filled out during telephone interviews every 3 days (a total of five times). The initial and final interviews will be scheduled at our clinic. After 15 days, serum 25-hydroxy vitamin D3 levels will be measured for those who have received vitamin D3 (190 individuals). TRIAL REGISTRATION Iranian Registry for Clinical Trials ID: IRCT2014050317534N1 (trial registration: 5 June 2014).
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Affiliation(s)
- Mahsa Sedighi
- Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, PO Box 71345-1536, Shiraz, Iran.
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Zhu ZH, Jin XZ, Zhang W, Chen M, Ye DQ, Zhai Y, Dong FL, Shen CL, Ding C. Associations between vitamin D receptor gene polymorphisms and osteoarthritis: an updated meta-analysis. Rheumatology (Oxford) 2014; 53:998-1008. [PMID: 24497541 DOI: 10.1093/rheumatology/ket418] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Vitamin D receptor (VDR) gene polymorphisms may be associated with the risk of OA, however, evidence for this is controversial. This meta-analysis aims to confirm whether VDR gene polymorphisms are associated with OA. METHODS Meta-analyses on the association between OA and VDR ApaI, BsmI, TaqI and FokI polymorphisms were conducted using allele and homozygote contrast and contrasts in the recessive and dominant models. Stratification analyses by different demographic regions (Europe vs Asian) were also performed and pooled odds ratios (ORs) were obtained using the random effects model if the results were heterogeneous. RESULTS A total of 13 relevant studies involving OA patients (n = 2104) and controls (n = 2939) were included in the analysis. There were significant associations between VDR ApaI polymorphisms and OA in the Asian population (A vs a: OR= 1.16, 95% CI 1.02, 1.32, P = 0.025; AA vs Aa/aa: OR= 1.36, 95% CI 1.04, 1.77, P = 0.025; AA vs aa: OR= 1.35, 95% CI 1.00, 1.80, P = 0.047), but not in the whole population. There was also a statistically significant association between FokI polymorphism and OA (FF vs Ff/ff: OR= 0.65, 95% CI 0.44, 0.95, P = 0.024); however, this result was derived from only two studies. No significant associations were found between VDR TaqI and BsmI polymorphisms and OA. CONCLUSION There are modest but statistically significant associations between VDR ApaI polymorphisms and the susceptibility of OA in the Asian population.
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Liu H, He H, Li S, Yang L, Wang P, Liu C, Wei X, Wu T, He C. Vitamin D receptor gene polymorphisms and risk of osteoarthritis: A meta-analysis. Exp Biol Med (Maywood) 2014; 239:559-67. [PMID: 24603077 DOI: 10.1177/1535370213514920] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The vitamin D receptor (VDR) gene polymorphisms have been reported to be involved in the development of many musculoskeletal disorders, including osteoarthritis (OA). However, results were inconsistent and there is no definite conclusion regarding the association between any VDR polymorphism and the risk of OA. In this study, we conducted a meta-analysis to determine whether BsmI, TaqI, and ApaI polymorphisms in the VDR gene are associated with OA susceptibility. Literature research was performed using PubMed and EMBASE databases. Studies illustrating the association between the three VDR polymorphisms and OA were included, and their qualities were assessed using Newcastle–Ottawa scale. Eight eligible studies, recruiting 1626 cases and 2024 controls were identified. Their methodological qualities were generally good, with scores ranging from 6 to 8 points. However, throughout all summary analyses, which were performed for multiple categories and on four contrasts (allele contrast, contrast of homozygotes, recessive and dominant models), none of the VDR BsmI, TaqI, and ApaI gene polymorphisms were found to be significantly associated with the risk of OA. On the other hand, there was no significant publication bias. Results from this meta-analysis suggested that the VDR BsmI, TaqI, and ApaI gene polymorphisms might not be important predictors of OA. More studies further investigating these associations, especially taking into account of gene–gene, gene–environment interactions, and other confounding factors are warranted.
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Affiliation(s)
- Huifang Liu
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Hongchen He
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Shasha Li
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Lin Yang
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Pu Wang
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Chuan Liu
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Xiaofei Wei
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Taixiang Wu
- Chinese Evidence-Based Medicine Centre/Cochrane Center, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Chengqi He
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
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Kanna RM, Shetty AP, Rajasekaran S. Patterns of lumbar disc degeneration are different in degenerative disc disease and disc prolapse magnetic resonance imaging analysis of 224 patients. Spine J 2014; 14:300-7. [PMID: 24231779 DOI: 10.1016/j.spinee.2013.10.042] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 10/21/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Existing research on lumbar disc degeneration has remained inconclusive regarding its etiology, pathogenesis, symptomatology, prevention, and management. Degenerative disc disease (DDD) and disc prolapse (DP) are common diseases affecting the lumbar discs. Although they manifest clinically differently, existing studies on disc degeneration have included patients with both these features, leading to wide variations in observations. The possible relationship or disaffect between DDD and DP is not fully evaluated. PURPOSE To analyze the patterns of lumbar disc degeneration in patients with chronic back pain and DDD and those with acute DP. STUDY DESIGN Prospective, magnetic resonance imaging-based radiological study. METHODS Two groups of patients (aged 20-50 years) were prospectively studied. Group 1 included patients requiring a single level microdiscectomy for acute DP. Group 2 included patients with chronic low back pain and DDD. Discs were assessed by magnetic resonance imaging through Pfirmann grading, Schmorl nodes, Modic changes, and the total end-plate damage score for all the five lumbar discs. RESULTS Group 1 (DP) had 91 patients and group 2 (DDD) had 133 patients. DP and DDD patients differed significantly in the number, extent, and severity of degeneration. DDD patients had a significantly higher number of degenerated discs than DP patients (p<.000). The incidence of multilevel and pan-lumbar degeneration was also significantly higher in DDD group. The pattern of degeneration also differed in both the groups. DDD patients had predominant upper lumbar involvement, whereas DP patients had mainly lower lumbar degeneration. Modic changes were more common in DP patients, especially at the prolapsed level. Modic changes were present in 37% of prolapsed levels compared with 9.9% of normal discs (p<.00). The total end-plate damage score had a positive correlation with disc degeneration in both the groups. Further the mean total end-plate damage score at prolapsed level was also significantly higher. CONCLUSION The results suggest that patients with disc prolapse, and those with back pain with DDD are clinically and radiologically different groups of patients with varying patterns, severity, and extent of disc degeneration. This is the first study in literature to compare and identify significant differences in these two commonly encountered patient groups. In patients with single-level DP, the majority of the other discs are nondegenerate, the lower lumbar spine is predominantly involved and the end-plate damage is higher. Patients with back pain and DDD have larger number of degenerate discs, early multilevel degeneration, and predominant upper lumbar degeneration. The knowledge that these two groups of patients are different clinically and radiologically is critical for our improved understanding of the disease and for future studies on disc degeneration and disc prolapse.
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Affiliation(s)
- Rishi M Kanna
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Rd, Coimbatore 641 011, Tamil Nadu, India
| | - Ajoy Prasad Shetty
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Rd, Coimbatore 641 011, Tamil Nadu, India
| | - S Rajasekaran
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Rd, Coimbatore 641 011, Tamil Nadu, India.
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Colombini A, Cauci S, Lombardi G, Lanteri P, Croiset S, Brayda-Bruno M, Banfi G. Relationship between vitamin D receptor gene (VDR) polymorphisms, vitamin D status, osteoarthritis and intervertebral disc degeneration. J Steroid Biochem Mol Biol 2013; 138:24-40. [PMID: 23500379 DOI: 10.1016/j.jsbmb.2013.03.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 02/26/2013] [Accepted: 03/01/2013] [Indexed: 02/07/2023]
Abstract
The vitamin D endocrine system is involved in bony and cartilaginous metabolisms and alterations in the homeostasis of this system could be associated to pathological conditions of cartilaginous tissue. In this context, the presence of polymorphisms in the vitamin D receptor gene (VDR), in association with the susceptibility to common osteochondral diseases, was largely investigated. The aim of this review was to summarize data present in literature, analyzing the association of the VDR polymorphisms, vitamin D status and knee cartilage and intervertebral disc pathologies, trying to suggest links between the different specific pathologies analyzed. Concerning the association between VDR polymorphisms and cartilaginous tissue diseases, we found controversial reports. However, the great majority of papers reported an association with lumbar disc degeneration, whereas about half of the studies found an association with osteoarthritis. A further association between VDR polymorphisms (in linkage disequilibrium) and the presence of specific characteristics of these diseases, in particular the formation of osteophytes, was evidenced. Finally, the influence of vitamin D status on these pathologies was evaluated, trying to evidence the relation between the presence of particular genetic variants in the VDR and vitamin D levels or to show whether a particular vitamin D status could predispose to the development or progression of such diseases, however, no significant associations were found. In the future, given the role of vitamin D system in the cartilaginous tissue metabolism, it could be interesting to perform functional and tissue specific studies to analyze the interplay between the different VDR variants and its ligand.
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Affiliation(s)
- Alessandra Colombini
- Laboratory of Experimental Biochemistry and Molecular Biology, I.R.C.C.S. Istituto Ortopedico Galeazzi, Milano, Italy.
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Rajasekaran S, Kanna RM, Senthil N, Raveendran M, Cheung KMC, Chan D, Subramaniam S, Shetty AP. Phenotype variations affect genetic association studies of degenerative disc disease: conclusions of analysis of genetic association of 58 single nucleotide polymorphisms with highly specific phenotypes for disc degeneration in 332 subjects. Spine J 2013; 13:1309-20. [PMID: 23792102 DOI: 10.1016/j.spinee.2013.05.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 11/30/2012] [Accepted: 05/04/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Although the influence of genetics on the process of disc degeneration is well recognized, in recently published studies, there is a wide variation in the race and selection criteria for such study populations. More importantly, the radiographic features of disc degeneration that are selected to represent the disc degeneration phenotype are variable in these studies. The study presented here evaluates the association between single nucleotide polymorphisms (SNPs) of candidate genes and three distinct radiographic features that can be defined as the degenerative disc disease (DDD) phenotype. PURPOSE The study objectives were to examine the allelic diversity of 58 SNPs related to 35 candidate genes related to lumbar DDD, to evaluate the association in a hitherto unevaluated ethnic Indian population that represents more than one-sixth of the world population, and to analyze how genetic associations can vary in the same study subjects with the choice of phenotype. STUDY DESIGN A cross-sectional, case-control study of an ethnic Indian population was carried out. METHODS Fifty-eight SNPs in 35 potential candidate genes were evaluated in 342 subjects and the associations were analyzed against three highly specific markers for DDD, namely disc degeneration by Pfirrmann grading, end-plate damage evaluated by total end-plate damage score, and annular tears evaluated by disc herniations and hyperintense zones. Genotyping of cases and controls was performed on a genome-wide SNP array to identify potential associated disease loci. The results from the genome-wide SNP array were then used to facilitate SNP selection and genotype validation was conducted using Sequenom-based genotyping. RESULTS Eleven of the 58 SNPs provided evidence of association with one of the phenotypes. For annular tears, rs1042631 SNP of AGC1 and rs467691 SNP of ADAMTS5 were highly significantly associated (p<.01) and SNPs in NGFB, IL1B, IL18RAP, and MMP10 were also significantly associated (p<.05). The rs4076018 SNP of NGFB was highly significant (p<.01) and rs2292657 SNP of GLI1 was significantly (p<.05) correlated to disc degeneration. For end-plate damage, the rs2252070 SNP of MMP 13 showed a significant association (p<.05). Previously associated genes such as COL 9, SKT, CHST 3, CILP, IGFR, SOXp, BMP, MMP 2-12, ADH2, IL1RN, and COX2 were not significantly associated and new associations (NGFB and GLI1) were identified. The validity of all the associations was found to be phenotype dependent. CONCLUSIONS For the first time, genetic associations with DDD have been performed in an Indian population. Apart from identifying new associations, the highlight of the study was that in the same study population with DDD, SNP associations completely changed when different radiographic features were used to define the DDD phenotype. Our study results therefore indicate that standardization of the phenotypes chosen to study the genetics of disc degeneration is essential and should be strongly considered before planning genetic association studies.
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Affiliation(s)
- S Rajasekaran
- Department of Orthopaedics and Spine Surgery, Ganga Hospital, 313, Mettupalayam Rd, Coimbatore 641 011, India.
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50
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Battié MC, Lazáry A, Fairbank J, Eisenstein S, Heywood C, Brayda-Bruno M, Varga PP, McCall I. Disc degeneration-related clinical phenotypes. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2013; 23 Suppl 3:S305-14. [PMID: 23884550 DOI: 10.1007/s00586-013-2903-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 06/24/2013] [Accepted: 07/08/2013] [Indexed: 10/26/2022]
Abstract
The phenotype, or observable trait of interest, is at the core of studies identifying associated genetic variants and their functional pathways, as well as diagnostics. Yet, despite remarkable technological developments in genotyping and progress in genetic research, relatively little attention has been paid to the equally important issue of phenotype. This is especially true for disc degeneration-related disorders, and the concept of degenerative disc disease, in particular, where there is little consensus or uniformity of definition. Greater attention and rigour are clearly needed in the development of disc degeneration-related clinical phenotypes if we are to see more rapid advancements in knowledge of this area. When selecting phenotypes, a basic decision is whether to focus directly on the complex clinical phenotype (e.g. the clinical syndrome of spinal stenosis), which is ultimately of interest, or an intermediate phenotype (e.g. dural sac cross-sectional area). While both have advantages, it cannot be assumed that associated gene variants will be similarly relevant to both. Among other considerations are factors influencing phenotype identification, comorbidities that are often present, and measurement issues. Genodisc, the European research consortium project on disc-related clinical pathologies has adopted a strategy that will allow for the careful characterisation and examination of both the complex clinical phenotypes of interest and their components.
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Affiliation(s)
- Michele C Battié
- Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G 2G4, Canada,
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