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Chen E, Li M, Liao Z, Yao D, Li Y, Huang L. Phillyrin reduces ROS production to alleviate the progression of intervertebral disc degeneration by inhibiting NF-κB pathway. J Orthop Surg Res 2024; 19:308. [PMID: 38773639 PMCID: PMC11110443 DOI: 10.1186/s13018-024-04695-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/22/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Intervertebral disc degeneration (IDD) is an increasingly important cause of low back pain (LBP) that results in substantial health and economic burdens. Inflammatory pathway activation and the production of reactive oxygen species (ROS) play vital roles in the progression of IDD. Several studies have suggested that phillyrin has a protective role and inhibits inflammation and the production of ROS. However, the role of phillyrin in IDD has not been confirmed. PURPOSE The purpose of this study was to investigate the role of phillyrin in IDD and its mechanisms. STUDY DESIGN To establish IDD models in vivo, ex-vivo, and in vitro to verify the function of phillyrin in IDD. METHOD The effects of phillyrin on extracellular matrix (ECM) degeneration, inflammation, and oxidation in nucleus pulposus (NP) cells were assessed using immunoblotting and immunofluorescence analysis. Additionally, the impact of phillyrin administration on acupuncture-mediated intervertebral disc degeneration (IDD) in rats was evaluated using various techniques such as MRI, HE staining, S-O staining, and immunohistochemistry (IHC). RESULT Pretreatment with phillyrin significantly inhibited the IL-1β-mediated reduction in the degeneration of ECM and apoptosis by alleviating activation of the NF-κB inflammatory pathway and the generation of ROS. In addition, in vivo and ex-vivo experiments verified the protective effect of phillyrin against IDD. CONCLUSION Phillyrin can attenuate the progression of IDD by reducing ROS production and activating inflammatory pathways.
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Affiliation(s)
- Enming Chen
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Ming Li
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Zhuangyao Liao
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Dengbo Yao
- Department of Orthopedics, the Eighth Affiliated Hospital of Sun Yat-sen University, Sun Yat- sen University, Shenzhen, China
| | - Yuxi Li
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Lin Huang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China.
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Mallow GM, Siyaji ZK, Galbusera F, Espinoza-Orías AA, Giers M, Lundberg H, Ames C, Karppinen J, Louie PK, Phillips FM, Pourzal R, Schwab J, Sciubba DM, Wang JC, Wilke HJ, Williams FMK, Mohiuddin SA, Makhni MC, Shepard NA, An HS, Samartzis D. Intelligence-Based Spine Care Model: A New Era of Research and Clinical Decision-Making. Global Spine J 2021; 11:135-145. [PMID: 33251858 PMCID: PMC7882816 DOI: 10.1177/2192568220973984] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- G. Michael Mallow
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Zakariah K. Siyaji
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | | | - Alejandro A. Espinoza-Orías
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Morgan Giers
- School of Chemical, Biological, and Environmental Engineering, Oregon State University, Corvallis, OR, USA
| | - Hannah Lundberg
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Christopher Ames
- Department of Neurosurgery, University of California San Francisco, CA, USA
| | - Jaro Karppinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | | | - Frank M. Phillips
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Robin Pourzal
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Joseph Schwab
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Daniel M. Sciubba
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | - Jeffrey C. Wang
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA
| | - Hans-Joachim Wilke
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Ulm, Germany
| | - Frances M. K. Williams
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | | | - Melvin C. Makhni
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Nicholas A. Shepard
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Howard S. An
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Dino Samartzis
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
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Järvinen J, Niinimäki J, Karppinen J, Takalo R, Haapea M, Tervonen O. Does bone scintigraphy show Modic changes associated with increased bone turnover? Eur J Radiol Open 2020; 7:100222. [PMID: 32071952 PMCID: PMC7013126 DOI: 10.1016/j.ejro.2020.100222] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/30/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose Our purpose was to evaluate whether Modic changes (MC) revealed in lumbar MRI are associated with increased tracer uptake shown in bone scintigraphy. To our knowledge, this has not previously been studied. Methods We included patients with MC shown in lumbar MRI and bone scintigraphy performed within six months before or after MRI. Exclusion criteria included metastasis and other specific lesions in the area of interest such as discitis, tumors or fractures. We compared the level and type of MC to the degree of tracer uptake shown in bone scintigraphy. Tracer uptake was assessed both visually and quantitatively. We calculated the lesion-to-normal-bone ratios between the MC area with increased tracer uptake and the vertebra with normal tracer uptake. We used linear mixed models in statistical analyses. Results Our study sample consisted of 93 patients (aged 37-86) with 299 MC (28 Type 1 (M1), 50 mixed Type 1/2 (M1/2), 3 mixed Type 1/3 (M1/3), 211 Type 2 (M2), 6 mixed Type 2/3 (M2/3), and 1 Type 3 (M3)). Of all the MC, 26 (93 %) M1, 34 (64 %) in the combined M1/2 and M1/3 group, and 11 (5 %) in the combined M2, M2/3 and M3 group showed increased tracer uptake. The mean lesion-to-normal-bone ratio was higher for lesions with a Type 1 component (M1, M1/2 and M1/3) than for other types, at 1.55 (SD 0.16) for M1; 1.44 (SD 0.21) for combined M1/2 and M1/3; and 1.28 (SD 0.11) for combined M2, M2/3 and M3; p = 0.001). Conclusion In most cases, MC with a Type 1 component showed increased tracer uptake in bone scintigraphy. This indicates that bone turnover is accelerated in the M1 area.
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Key Words
- 99mTc, 99mTechnetium
- 99mTc-HDP, 99m Technetium-labeled hydroxymethylene diphosphonate
- Bone scintigraphy
- Bone turnover
- ICC, intraclass correlation coefficients
- LBP, low back pain
- M1, Type 1 Modic change
- M1/2, Type 1/2 mixed Modic change
- M1/3, Type 1/3 mixed Modic change
- M2, Type 2 Modic change
- M2/3, Type 2/3 mixed Modic change
- M3, Type 3 Modic change
- MC, Modic changes
- MRI, magnetic resonance imaging
- Magnetic resonance imaging
- Modic changes
- SPECT, single photon emission computed tomography
- κ, Cohen’s kappa
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Affiliation(s)
- Jyri Järvinen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jaakko Niinimäki
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Finnish Institute of Occupational Health, Oulu, Finland
| | - Reijo Takalo
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Marianne Haapea
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Osmo Tervonen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
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Kitab S, Lee BS, Benzel EC. Redefining lumbar spinal stenosis as a developmental syndrome: an MRI-based multivariate analysis of findings in 709 patients throughout the 16- to 82-year age spectrum. J Neurosurg Spine 2019; 29:654-660. [PMID: 30215592 DOI: 10.3171/2018.5.spine18100] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/22/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVEUsing an imaging-based prospective comparative study of 709 eligible patients that was designed to assess lumbar spinal stenosis (LSS) in the ages between 16 and 82 years, the authors aimed to determine whether they could formulate radiological structural differences between the developmental and degenerative types of LSS.METHODSMRI structural changes were prospectively reviewed from 2 age cohorts of patients: those who presented clinically before the age of 60 years and those who presented at 60 years or older. Categorical degeneration variables at L1-S1 segments were compared. A multivariate comparative analysis of global radiographic degenerative variables and spinal dimensions was conducted in both cohorts. The age at presentation was correlated as a covariable.RESULTSA multivariate analysis demonstrated no significant between-groups differences in spinal canal dimensions and stenosis grades in any segments after age was adjusted for. There were no significant variances between the 2 cohorts in global degenerative variables, except at the L4-5 and L5-S1 segments, but with only small effect sizes. Age-related degeneration was found in the upper lumbar segments (L1-4) more than the lower lumbar segments (L4-S1). These findings challenge the notion that stenosis at L4-5 and L5-S1 is mainly associated with degenerative LSS.CONCLUSIONSIntegration of all the morphometric and qualitative characteristics of the 2 LSS cohorts provides evidence for a developmental background for LSS. Based on these findings the authors propose the concept of LSS as a developmental syndrome with superimposed degenerative changes. Further studies can be conducted to clarify the clinical definition of LSS and appropriate management approaches.
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Affiliation(s)
- Sameer Kitab
- 1Scientific Council of Orthopedics, Baghdad, Iraq
| | - Bryan S Lee
- 2Department of Neurosurgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic; and.,3Center for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
| | - Edward C Benzel
- 2Department of Neurosurgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic; and.,3Center for Spine Health, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
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Freidin M, Kraatari M, Skarp S, Määttä J, Kettunen J, Niinimäki J, Karppinen J, Williams F, Männikkö M. Genome-wide meta-analysis identifies genetic locus on chromosome 9 associated with Modic changes. J Med Genet 2019; 56:420-426. [PMID: 30808802 DOI: 10.1136/jmedgenet-2018-105726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/18/2018] [Accepted: 01/11/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Low back pain (LBP) is a common disabling condition. Lumbar disc degeneration (LDD) may be a contributing factor for LBP. Modic change (MC), a distinct phenotype of LDD, is presented as a pathological bone marrow signal change adjacent to vertebral endplate on MRI. It is strongly associated with LBP and has heritability around 30%. Our objective was to identify genetic loci associated with MC using a genome-wide meta-analysis. METHODS Presence of MC was evaluated in lumbar MRI in the Northern Finland Birth Cohort 1966 (n=1182) and TwinsUK (n=647). Genome-wide association analyses were carried out using linear regression model. Inverse-variance weighting approach was used in the meta-analysis. RESULTS A locus associated with MC (p<5e-8) was found on chromosome 9 with the lead SNP rs1934268 in an intron of the PTPRD gene. It is located in the binding region of BCL11A, SPI1 and PBX3 transcription factors. The SNP was nominally associated with LBP in TwinsUK (p=0.001) but not associated in the UK Biobank (p=0.914). Suggestive signals (p<1e-5) were identified near XKR4, SCIN, MGMT, DLG2, ZNF184 and OPRK1. CONCLUSION PTPRD is a novel candidate gene for MC that may act via the development of cartilage or nervous system; further work is needed to define the mechanisms underlying the pathways leading to development of MC. This is the first genome-wide meta-analysis of MC, and the results pave the way for further studies on the genetic factors underlying the various features of spine degeneration and LBP.
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Affiliation(s)
- Maxim Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Minna Kraatari
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Sini Skarp
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Juhani Määttä
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johannes Kettunen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Computational Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu, Oulu, Finland.,National Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Health, Oulu, Finland
| | - Frances Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Minna Männikkö
- Northern Finland Birth Cohorts, Faculty of Medicine, University of Oulu, Oulu, Finland
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Abstract
Low back pain affects individuals of all ages and is a leading contributor to disease burden worldwide. Despite advancements in assessment and treatment methods, the management of low back pain remains a challenge for researchers and clinicians alike. One reason for the limited success in identifying effective treatments is the large variation in the manifestations, possible causes, precipitating and maintaining factors, course, prognosis and consequences in terms of activity interference and quality of life. However, despite these challenges, steady progress has been achieved in the understanding of back pain, and important steps in the understanding of the psychological and social risk factors, genetics and brain mechanisms of low back pain have been made. These new findings have given impetus to the development of new diagnostic procedures, evidence-based screening methods and more targeted interventions, which underscore the need for a multidisciplinary approach to the management of low back pain that integrates biological, psychological and social aspects.
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Skarp S, Kämäräinen OP, Wei GH, Jakkula E, Kiviranta I, Kröger H, Auvinen J, Lehenkari P, Ala-Kokko L, Männikkö M. Whole exome sequencing in Finnish families identifies new candidate genes for osteoarthritis. PLoS One 2018; 13:e0203313. [PMID: 30157244 PMCID: PMC6114922 DOI: 10.1371/journal.pone.0203313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/18/2018] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Osteoarthritis (OA) is the most common degenerative joint disease and one of the major causes of disability worldwide. It is a multifactorial disorder with a significant genetic component. The heritability of OA has been estimated to be 60% for hip OA and 39% for knee OA. Genetic factors behind OA are still largely unknown. Studying families with strong history of OA, facilitates examining the co-segregation of genetic variation and OA. The aim of this study was to identify new, rare genetic factors and novel candidate genes for OA. METHODS Eight patients from three Finnish families with hip and knee OA were studied using whole exome sequencing. We focused on rare exonic variants with predicted pathogenicity and variants located in active promoter or strong enhancer regions. Expression of identified candidate genes were studied in bone and cartilage tissues and the observed variants were investigated using bioinformatic analyses. RESULTS Two rare variants co-segregated with OA in two families. In Family 8 a missense variant (c.628C>G, p.Arg210Gly) was observed in the OLIG3 gene that encodes a transcription factor known to be associated with rheumatoid arthritis and inflammatory polyarthritis. The Arg210Gly variant was estimated to be pathogenic by Polyphen-2 and Mutation taster and the locus is conserved among mammals. In Family 12 the observed variant (c.-127G>T) was located in the transcription start site of the FIP1L1 gene. FIP1L1 participates in the regulation of polyadenylation. The c.-127G>T is located in the transcription start site and may alter the DNA-binding of transcription factors. Both, OLIG3 and FIP1L1 were observed in human bone and cartilage. CONCLUSION The identified variants revealed novel candidate genes for OA. OLIG3 and FIP1L1 have specific roles in transcription and may effect expression of other genes. Identified variants in these genes may thus have a role in the regulatory events leading to OA.
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Affiliation(s)
- Sini Skarp
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
- * E-mail:
| | | | - Gong-Hong Wei
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Eveliina Jakkula
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Ilkka Kiviranta
- Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Orthopaedics and Traumatology, Jyväskylä Central Hospital, Jyväskylä, Finland
| | - Heikki Kröger
- Department of Orthopaedics and Traumatology, Kuopio University Hospital and Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Petri Lehenkari
- Department of Anatomy and Cell biology and Surgery Clinic, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Leena Ala-Kokko
- Connective Tissue Gene Tests, Allentown, PA, United States of America
| | - Minna Männikkö
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
- Northern Finland Birth Cohort, Faculty of Medicine, University of Oulu, Oulu, Finland
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