Fakultäten » Medizinische Fakultät » Universitätsklinik Balgrist und Schweizerisches Paraplegikerzentrum » Orthopädie » Prof. Dr. Christian Gerber » Boos
| Title / Titel | Aktivation and Inhibition of Matrix degrading enzymes during disc degeneration | ||
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| Abstract (PDF, 14 KB) | |||
| Summary / Zusammenfassung | Objective: Recent own studies provide circumstantial evidence that the degeneration of intervertebral discs is associated with an upregulation of major MMPs indicating enhanced disc proteolysis. Despite these intriguing data, the mechanisms of activation and potential inhibition of the proteolytic systems remain unclear. The investigation of these mechanisms, however, are necessary in order to provide any progress in diagnosis and management of low-back pain. Our present understanding of the underlying mechanisms is still incomplete and requires further analysis. Research Plan: Complete motion segments of cadaveric lumbar spines and surgical disc material will be analyzed immunohistochemically for the occurence and distribution of natural MMP-inhibitors (TIMP-1, -2) and activators for MMPs (MT-MMP-1, EMMPRIN). The resulting pattern of tissue distribution will be correlated with the already known pattern for the major interstitial collagen types, MMPs and markers for particular cellular functions. Additionally, the expression of transcripts for the TIMPs (TIMP-1 and ¡V2) and activators of MMP-synthesis (MT-MMP-1, EMMPRIN) will be analyzed by non-radioactive in situ-hybridization. In addition, a set of markers recently identified as indicators for oxidative stress will be analyzed, since oxidative reaction products are assumed to play a potential role in the induction of MMP-synthesis via activation of specific cellular signalling cascades. We will examine carboxy-methyllysin (CML, marker for oxidative stress), 3-hydroxy-nonenal (HNE, marker for lipidperoxidation), the RAGE-receptor (marker for cellular activation by CML), activated NFƒÛB (marker for intracellular signalling following RAGE-receptor activation) and TGF-ƒÒ (marker for matrix disarrangement) by immunohistochemistry. The analysis of this ¡§cascade¡¨ offers not only a highly interesting insight into the potential induction of matrix disarrangement, but provides a possible therapeutic option. The blockade of oxidative stress and/or this cascade within the disc tissue may provide a significant protection for disc degeneration. Clinical Relevance: The basic knowledge on the mechanisms of disc degradation will help us better understand how we could prevent damage and may promote repair of disc tissue. In addition, it is conceivable that the proteolytic liberation of metabolic products may significantly contribute to the pain generation. Thus, the blocking of proteolysis may lead to new treatment options for patients with low-back pain and sciatica both to prevent herniation and possibly to block pain induction by metabolic irritation of peridiscal nerves. |
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| Publications / Publikationen | Nerlich AG, Bachmeier BE, Boos N. Expression of fibronectin and TGF-b1 mRNA and protein suggest altered regulation of extracellular matrix in degenerated disc tissue. Eur Spine J 2004.We studied the distribution of fibronectin (a marker for "active" reparative connective tissue processes) and TGF-beta1 (a cytokine controlling the connective tissue metabolism) in intervertebral disc tissue from individuals of different age and various histomorphological evidence for tissue degeneration. The protein deposition was determined by immunohistochemistry on 30 complete cross-sections of lumbar spine obtained at autopsy (0-86 years) and 12 surgically removed disc samples. The mRNA expression was detected by non-radioactive in situ hybridization in the surgical material. All control experiments (blank and isotype controls in immunohistochemistry/sense controls in in situ hybridization) were negative. Immunohistochemically, we detected enhanced staining for fibronectin in both nuclear and anular tissues in areas with histological signs of mild-to-severe tissue degeneration (e.g., cleft formation and cell clustering) beginning with 16 years of age. Anular tissue showed less fibronectin staining than did nuclear areas. Fibronectin mRNA was detected mainly in nuclear cells by in situ hybridization corresponding to the protein staining indicating de novo synthesis. In parallel, TGF-beta1 was expressed by nuclear and occasional anular cells spatially associated with the fibronectin synthesizing cells. This was seen by both immunohistochemistry and in situ hybridization. This preliminary study provides evidence for a significant ongoing rearrangement of the extracellular matrix during disc degeneration, as monitored by enhanced fibronectin deposition that is produced by local disc cells. These cells also synthesize TGF-beta1, as shown by protein and mRNA expression. Since it is known that TGF-beta1 induces matrix alterations (by auto and paracrine stimulation of matrix synthesis), these observations suggest that the recently described disturbance of the matrix during disc degeneration may be induced by TGF-beta. This may offer new approaches to interfere with disc matrix alterations. | ||
| Keywords / Suchbegriffe | Disc degeneration, MMP, extracellular matrix | ||
| Project leadership and contacts / Projektleitung und Kontakte |
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| Funding source(s) / Unterstützt durch |
Foundation |
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| Duration of Project / Projektdauer | Mar 2003 to Feb 2005 |