2021 Volume No 41 – pages 355-369
Title: For whom the disc tolls: intervertebral disc degeneration, back pain and toll-like receptors |
Authors: DG Bisson, M Mannarino, R Racine, L Haglund |
Address: The Orthopaedic Research
Laboratory, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Room C10.148.2, Montreal,
QC, H3G 1A4, Canada |
E-mail: lisbet.haglund at mcgill.ca |
Abstract: Intervertebral disc (IVD) degeneration is characterised by catabolic and inflammatory processes that contribute
largely to tissue degradation and chronic back pain. The disc cells are responsible for the pathological
production of pro-inflammatory cytokines and catabolic enzymes leading to degeneration. However, this
phenotypical change is poorly understood. Growing evidence in animal and human studies implicates Toll-like
receptors (TLR) and their activation through danger-associated alarmins, found increasingly in degenerating
IVDs. TLR signalling results in the release of pro-inflammatory cytokines and proteolytic enzymes that can
directly cause IVD degeneration and back pain. This review aims to summarise the current literature on
TLR activation in IVD degeneration and discuss potential treatment modalities to alleviate the inflammatory
phenotype of disc cells in order to arrest IVD degeneration and back pain. |
Key Words: Inflammation, proteases, catabolism, alarmins, pain, innervation. |
Publication date: March 19th 2021 |
Article download: Pages
355-369 (PDF file) |
