pH: A major player in degenerative intervertebral disks

Abstract Chronic lower back pain is the leading cause of disability worldwide, generating a socioeconomic cost of over $100 billion annually in the United States. Among the prominent causes of low back pain (LBP) is degeneration of the intervertebral disk (IVD), a condition known as degenerative dis...

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Main Authors: Matthew A. R. Trone, Joshua D. Stover, Alejandro Almarza, Robert D. Bowles
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:JOR Spine
Subjects:
Online Access:https://doi.org/10.1002/jsp2.70025
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author Matthew A. R. Trone
Joshua D. Stover
Alejandro Almarza
Robert D. Bowles
author_facet Matthew A. R. Trone
Joshua D. Stover
Alejandro Almarza
Robert D. Bowles
author_sort Matthew A. R. Trone
collection DOAJ
description Abstract Chronic lower back pain is the leading cause of disability worldwide, generating a socioeconomic cost of over $100 billion annually in the United States. Among the prominent causes of low back pain (LBP) is degeneration of the intervertebral disk (IVD), a condition known as degenerative disk disease (DDD). Despite the prevalence of DDD and multiple studies demonstrating its relationship with LBP, the mechanisms by which it contributes to pain remain unknown. Previous studies have identified potential causes for this pain, such as extracellular matrix (ECM) breakdown, changes in biomechanics, and pro‐inflammatory signals. Possible pain treatments targeting these factors have been developed but with limited effects. However, low pH in DDD is a potential pain generator whose role has largely been unexplored and underappreciated. This review highlights hyperacidity's effects on the IVD, such as catabolism of disk cells and ECM, neoinnervation, altered mechanical signaling, and expression of pro‐inflammatory cytokines and ion channels. This review aims to discuss what is known about the contributions of acidity to DDD pain, identify the knowledge gaps on this topic, and propose what research can be conducted to fill these gaps. We must better understand the underlying mechanisms of DDD and the interaction between hyperacidity and nociception to develop better therapeutics for this disease.
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spelling doaj-art-62847dfb7c9e46048e0dbb6cd45893132025-08-20T01:57:45ZengWileyJOR Spine2572-11432024-12-0174n/an/a10.1002/jsp2.70025pH: A major player in degenerative intervertebral disksMatthew A. R. Trone0Joshua D. Stover1Alejandro Almarza2Robert D. Bowles3Department of Biomedical Engineering University of Utah Salt Lake City Utah USADepartment of Biomedical Engineering University of Utah Salt Lake City Utah USADepartment of Oral and Craniofacial Sciences University of Pittsburgh Pittsburgh Pennsylvania USADepartment of Biomedical Engineering University of Utah Salt Lake City Utah USAAbstract Chronic lower back pain is the leading cause of disability worldwide, generating a socioeconomic cost of over $100 billion annually in the United States. Among the prominent causes of low back pain (LBP) is degeneration of the intervertebral disk (IVD), a condition known as degenerative disk disease (DDD). Despite the prevalence of DDD and multiple studies demonstrating its relationship with LBP, the mechanisms by which it contributes to pain remain unknown. Previous studies have identified potential causes for this pain, such as extracellular matrix (ECM) breakdown, changes in biomechanics, and pro‐inflammatory signals. Possible pain treatments targeting these factors have been developed but with limited effects. However, low pH in DDD is a potential pain generator whose role has largely been unexplored and underappreciated. This review highlights hyperacidity's effects on the IVD, such as catabolism of disk cells and ECM, neoinnervation, altered mechanical signaling, and expression of pro‐inflammatory cytokines and ion channels. This review aims to discuss what is known about the contributions of acidity to DDD pain, identify the knowledge gaps on this topic, and propose what research can be conducted to fill these gaps. We must better understand the underlying mechanisms of DDD and the interaction between hyperacidity and nociception to develop better therapeutics for this disease.https://doi.org/10.1002/jsp2.70025acidicdegenerative disk diseaselow pHpain
spellingShingle Matthew A. R. Trone
Joshua D. Stover
Alejandro Almarza
Robert D. Bowles
pH: A major player in degenerative intervertebral disks
JOR Spine
acidic
degenerative disk disease
low pH
pain
title pH: A major player in degenerative intervertebral disks
title_full pH: A major player in degenerative intervertebral disks
title_fullStr pH: A major player in degenerative intervertebral disks
title_full_unstemmed pH: A major player in degenerative intervertebral disks
title_short pH: A major player in degenerative intervertebral disks
title_sort ph a major player in degenerative intervertebral disks
topic acidic
degenerative disk disease
low pH
pain
url https://doi.org/10.1002/jsp2.70025
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AT joshuadstover phamajorplayerindegenerativeintervertebraldisks
AT alejandroalmarza phamajorplayerindegenerativeintervertebraldisks
AT robertdbowles phamajorplayerindegenerativeintervertebraldisks