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A Cross-Tissue Transcriptome-Wide Association Study Identified Susceptibility Genes for Intervertebral Disc Degeneration 一项跨组织转录组关联研究确定了椎间盘退变的易感基因
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-09-07 DOI: 10.1002/jsp2.70109
Li Zhang, Wen Zhao, Hongsheng Yang, Tingting Deng, Yugang Li

Background

Intervertebral disc degeneration (IDD) is a prevalent spinal condition frequently associated with pain and motor impairment, imposing a substantial burden on quality of life. Despite extensive investigations into the genetic predisposition to IDD, the precise pathogenic genes and molecular pathways involved remain inadequately characterized, underscoring the need for continued research to clarify its genetic underpinnings.

Methods

This study leveraged IDD data from the FinnGen R12 cohort and integrated expression quantitative trait loci data across 49 tissues from the Genotype-Tissue Expression version 8 database to perform a cross-tissue transcriptome-wide association study (TWAS). The analytical framework incorporated functional summary-based imputation (FUSION), unified test for molecular signatures (UTMOST), and gene-level analysis via multi-marker genome annotation (MAGMA). To substantiate the findings, Mendelian randomization (MR) and colocalization analyses were subsequently conducted.

Results

Through TWAS and MAGMA analyses, 33 susceptibility genes associated with IDD were identified. Subsequent MR and colocalization analyses refined this list to six candidate genes—ADD1, GFPT1, MAPRE3, MSANTD1, SLC30A6, and XBP1—which may contribute to the initiation and progression of IDD by modulating pathways implicated in the endoplasmic reticulum stress response.

Conclusion

Six susceptibility genes associated with the risk of IDD were identified in this study, offering novel insights into the genetic architecture and potential pathogenic pathways underpinning the development of IDD.

椎间盘退变(IDD)是一种常见的脊柱疾病,通常与疼痛和运动障碍有关,对生活质量造成重大负担。尽管对IDD的遗传易感性进行了广泛的调查,但所涉及的确切致病基因和分子途径仍然没有得到充分的表征,这强调了继续研究以阐明其遗传基础的必要性。方法本研究利用FinnGen R12队列的IDD数据和基因型-组织表达版本8数据库中49个组织的表达数量性状位点数据进行跨组织转录组关联研究(TWAS)。分析框架包括基于功能摘要的归算(FUSION)、分子特征统一检测(most)和通过多标记基因组注释的基因水平分析(MAGMA)。为了证实研究结果,随后进行了孟德尔随机化(MR)和共定位分析。结果通过TWAS和MAGMA分析,鉴定出33个与IDD相关的易感基因。随后的MR和共定位分析将这一列表细化为六个候选基因——add1、GFPT1、MAPRE3、MSANTD1、SLC30A6和xbp1,它们可能通过调节内质网应激反应相关途径参与IDD的发生和进展。结论本研究确定了6个与IDD风险相关的易感基因,为IDD发展的遗传结构和潜在致病途径提供了新的见解。
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引用次数: 0
TRIM25-Mediated Ubiquitination and Degradation of SOX8 Promotes Ligament Fibroblast Osteogenic Differentiation and Regulates OPLL Progression by Inhibiting OSR2 Transcription trim25介导的泛素化和SOX8降解通过抑制OSR2转录促进韧带成纤维细胞成骨分化并调节OPLL进展
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-09-05 DOI: 10.1002/jsp2.70112
Zhenqiang Wang, Yifan Tang, Changjiang Gu, Minming Lu, Ziheng Wei, Quanwei Zhou, Shengyuan Zhou, Xiongsheng Chen

Background

Ossification of the posterior longitudinal ligament (OPLL) is a pathological condition characterized by ectopic ossification of spinal ligaments, primarily driven by abnormal osteogenic differentiation of ligament fibroblasts with stem cell-like properties. The SOX transcription factor family is crucial in regulating cell stemness and differentiation. Among them, SOX8 is known to influence osteoblast differentiation, but its role in OPLL remains unclear.

Methods

SOX8 expression was analyzed in non-OPLL and OPLL ligament tissues and cells. Its role in osteogenic differentiation was assessed using ALP/Alizarin Red staining, qPCR, Western blotting, and subcutaneous ectopic ossification models in nude mice. Mass spectrometry and co-immunoprecipitation identified SOX8-interacting E3 ubiquitin ligases, with ubiquitination assays assessing their effects on SOX8 stability. RNA-seq, GTRD analysis, and dual-luciferase reporter assays revealed SOX8 target genes. Functional recovery experiments were conducted to explore the role of these interactions in the osteogenic differentiation of ligament fibroblasts.

Results

SOX8 expression was downregulated in OPLL ligament tissues and cells. Functional analyses showed that SOX8 inhibits osteogenic differentiation of ligament fibroblasts both in vitro and in vivo. Mechanistically, TRIM25, an E3 ubiquitin ligase, was found to interact with SOX8, promoting its ubiquitination and degradation. Rescue experiments showed that SOX8 knockdown or overexpression reversed the osteogenic effects of TRIM25 knockdown or overexpression in ligament fibroblasts. Additionally, OSR2 was identified as a transcriptional target of SOX8, with SOX8 promoting OSR2 transcription. OSR2 knockdown negated the inhibitory effects of SOX8 overexpression on osteogenic differentiation.

Conclusions

SOX8 serves as a critical negative regulator of osteogenic differentiation in ligament fibroblasts. TRIM25 promotes ectopic ossification in OPLL by enhancing SOX8 ubiquitination and degradation, while SOX8 inhibits osteogenic differentiation through transcriptional activation of OSR2. These findings highlight the TRIM25/SOX8/OSR2 axis as a key regulator in OPLL ectopic ossification, suggesting it to be a potential target for non-surgical treatment.

后纵韧带骨化(OPLL)是一种以脊髓韧带异位骨化为特征的病理状况,主要是由具有干细胞样特性的韧带成纤维细胞异常成骨分化引起的。SOX转录因子家族在调节细胞干细胞和分化中起着至关重要的作用。其中,已知SOX8影响成骨细胞分化,但其在OPLL中的作用尚不清楚。方法分析SOX8在非OPLL和OPLL韧带组织和细胞中的表达。采用ALP/茜素红染色、qPCR、Western blotting和裸鼠皮下异位骨化模型评估其在成骨分化中的作用。质谱和共免疫沉淀鉴定了SOX8相互作用的E3泛素连接酶,泛素化分析评估了它们对SOX8稳定性的影响。RNA-seq、GTRD分析和双荧光素酶报告基因检测显示SOX8靶基因。通过功能恢复实验探讨这些相互作用在韧带成纤维细胞成骨分化中的作用。结果OPLL韧带组织和细胞中SOX8表达下调。功能分析表明,SOX8在体外和体内均能抑制韧带成纤维细胞的成骨分化。机制上,TRIM25,一个E3泛素连接酶,被发现与SOX8相互作用,促进其泛素化和降解。救援实验表明,SOX8敲低或过表达逆转了TRIM25敲低或过表达在韧带成纤维细胞中的成骨作用。此外,OSR2被鉴定为SOX8的转录靶点,SOX8促进OSR2的转录。OSR2敲低可使SOX8过表达对成骨分化的抑制作用消失。结论SOX8是韧带成纤维细胞成骨分化的关键负调控因子。TRIM25通过增强SOX8的泛素化和降解促进OPLL的异位骨化,而SOX8通过转录激活OSR2抑制成骨分化。这些发现强调TRIM25/SOX8/OSR2轴是OPLL异位骨化的关键调节因子,表明它是非手术治疗的潜在靶点。
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引用次数: 0
Wharton's Jelly Mesenchymal Stromal Cell-Derived Extracellular Vesicles Attenuate Intervertebral Disc Degeneration Under Inflammatory Stress in an In Vitro 3D Culture System 沃顿果冻间充质基质细胞衍生的细胞外囊泡在体外三维培养系统中减轻炎症应激下的椎间盘退变
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-08-20 DOI: 10.1002/jsp2.70106
Veronica Tilotta, Gianluca Vadalà, Giuseppina Di Giacomo, Luca Ambrosio, Claudia Cicione, Fabrizio Russo, Adas Darinskas, Rocco Papalia, Vincenzo Denaro

This study explores the therapeutic potential of extracellular vesicles (EVs) derived from Wharton's Jelly mesenchymal stem cells in an in vitro 3D model of intervertebral disc degeneration under inflammatory stress. The treatment with WJ-MSC-EVs enhanced nucleus pulposus cell proliferation, viability, and extracellular matrix synthesis while reducing oxidative stress and catabolic gene expression. These results support the promise of WJ-MSC-EVs as a novel, cell-free strategy for disc regeneration in inflammatory conditions.

本研究在炎症应激下椎间盘退变的体外3D模型中探讨了来自Wharton’s Jelly间充质干细胞的细胞外囊泡(EVs)的治疗潜力。wj - msc - ev增强了髓核细胞的增殖、活力和细胞外基质的合成,同时减少了氧化应激和分解代谢基因的表达。这些结果支持wj - msc - ev作为炎症条件下椎间盘再生的一种新的无细胞策略。
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引用次数: 0
Quantitative Sensory Testing in an Observational Cohort of Adults With Chronic Low Back Pain 慢性腰痛成人观察队列的定量感觉测试
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-08-19 DOI: 10.1002/jsp2.70103
Michael J. Schneider, Carol M. Greco, Amanda M. Acevedo, Kevin M. Bell, Jessa Darwin, Anthony Delitto, Nathan E. Dodds, John M. Jakicic, Gina P. McKernan, Charity G. Patterson, Paul A. Pilkonis, Sara R. Piva, Gwendolyn A. Sowa, Nam V. Vo, Lan Yu, Ajay D. Wasan

Background

Quantitative Sensory Testing (QST), also known as psychophysical testing, includes standardized methods for assessing humans' perceptions of different types of sensory stimuli and their associated pain thresholds. QST results can be used to estimate altered or atypical sensory processing and thus can be useful for determining pain mechanisms such as nociplastic or central nervous system-mediated pain. The University of Pittsburgh Mechanistic Research Center, entitled, “Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes (LB3P),” is part of the National Institutes of Health's Helping to End Addiction Long-term Initiative. LB3P conducted a prospective, observational cohort study to identify phenotypes of over 1000 participants with cLBP. QST was conducted on these participants as part of comprehensive data collection. This article reports on the results of the QST procedures performed at the initial in-person enrollment visit.

Methods

Four QST procedures were administered to participants of the LB3P study at their enrollment visit: (1) Pressure Pain Thresholds (PPT) over the participant-reported site of lumbar pain (paraspinals) and a control site (trapezius) using an analog algometer; (2) Temporal Summation (TS) over the lumbar pain and control sites (forearm) using a Neuropen with a 40-g monofilament; (3) Conditioned Pain Modulation (CPM) using a cold water (5°C) immersion tank; and (4) Cold Water Tolerance time. A subset of LB3P participants was excluded from the CPM and cold-water immersion procedures due to medical comorbidities such as cardiovascular disease and diabetic neuropathy. Means and standard deviations (SDs) were calculated from three trials of PPT and TS, two trials of CPM, and one trial of cold-water immersion time. TS was calculated by subtracting the numeric pain scores (0–10 scale) of the first from the 10th pinpricks. CPM was calculated by subtracting the mean trapezius algometer readings during the PPT procedure from those of the trapezius PPT during cold-water immersion.

Results

The final cohort of QST participants was 999 adults. The mean/SD of lumbar and trapezius PPTs was 4.6 (2.4) and 4.4 (1.9) kg/cm2, respectively. The mean/SD of lumbar and forearm TS was 1.6 (2.0) and 1.2 (1.8). Lingering pain after the 10th pinprick (after-sensations) was reported by 19.3% and 15.6% of participants after a series of 10 pinpricks was applied to the lumbar pain site and control site, respectively. The mean/SD CPM was 0.9 (1.2) with a wide range of CPM values

定量感觉测试(QST),也被称为心理物理测试,包括评估人类对不同类型的感觉刺激及其相关疼痛阈值的感知的标准化方法。QST结果可用于估计改变或非典型的感觉加工,因此可用于确定疼痛机制,如伤害性或中枢神经系统介导的疼痛。匹兹堡大学机械研究中心,题为“腰痛:生物学,生物力学,行为表型(LB3P)”,是美国国立卫生研究院帮助结束成瘾长期倡议的一部分。LB3P进行了一项前瞻性、观察性队列研究,以确定1000多名cLBP患者的表型。作为全面数据收集的一部分,对这些参与者进行了QST。本文报告了在最初的亲自登记访问中执行的QST程序的结果。方法对LB3P研究的参与者在入组时进行四种QST程序:(1)使用模拟算法在参与者报告的腰痛部位(脊柱旁)和对照部位(斜方肌)上进行压力疼痛阈值(PPT)测量;(2)使用带40g单丝的Neuropen在腰痛和控制部位(前臂)进行颞叶累加(TS);(3)条件疼痛调节(CPM),使用冷水(5°C)浸泡池;(4)耐冷水时间。一部分LB3P参与者由于心血管疾病和糖尿病性神经病变等医疗合共病而被排除在CPM和冷水浸泡程序之外。计算PPT和TS的3个试验、CPM的2个试验和冷水浸泡时间的1个试验的均值和标准差(SDs)。从第10次针刺中减去第1次针刺的数值疼痛评分(0-10分)计算TS。CPM的计算方法是用冷水浸泡时斜方肌PPT的读数减去PPT过程中斜方肌algometer的平均值。结果QST参与者的最终队列为999名成年人。腰椎和斜方肌PPTs的平均/SD分别为4.6(2.4)和4.4 (1.9)kg/cm2。腰椎和前臂TS的平均/SD分别为1.6(2.0)和1.2(1.8)。在连续10次针刺腰痛部位和对照部位后,分别有19.3%和15.6%的参与者报告了第10次针刺后的持续疼痛(后感)。平均/SD CPM为0.9 (1.2),CPM值的范围从−2.9到5.9。冷水耐受性测试结果呈双峰分布,83%的参与者平均浸泡时间为30秒,其余17%的参与者达到180秒的最大浸泡时间。QST数据来自参加LB3P观察性研究的cLBP患者的大队列。QST结果为cLBP患者提供参考价值。
{"title":"Quantitative Sensory Testing in an Observational Cohort of Adults With Chronic Low Back Pain","authors":"Michael J. Schneider,&nbsp;Carol M. Greco,&nbsp;Amanda M. Acevedo,&nbsp;Kevin M. Bell,&nbsp;Jessa Darwin,&nbsp;Anthony Delitto,&nbsp;Nathan E. Dodds,&nbsp;John M. Jakicic,&nbsp;Gina P. McKernan,&nbsp;Charity G. Patterson,&nbsp;Paul A. Pilkonis,&nbsp;Sara R. Piva,&nbsp;Gwendolyn A. Sowa,&nbsp;Nam V. Vo,&nbsp;Lan Yu,&nbsp;Ajay D. Wasan","doi":"10.1002/jsp2.70103","DOIUrl":"https://doi.org/10.1002/jsp2.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Quantitative Sensory Testing (QST), also known as psychophysical testing, includes standardized methods for assessing humans' perceptions of different types of sensory stimuli and their associated pain thresholds. QST results can be used to estimate altered or atypical sensory processing and thus can be useful for determining pain mechanisms such as nociplastic or central nervous system-mediated pain. The University of Pittsburgh Mechanistic Research Center, entitled, “Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes (LB<sup>3</sup>P),” is part of the National Institutes of Health's Helping to End Addiction Long-term Initiative. LB<sup>3</sup>P conducted a prospective, observational cohort study to identify phenotypes of over 1000 participants with cLBP. QST was conducted on these participants as part of comprehensive data collection. This article reports on the results of the QST procedures performed at the initial in-person enrollment visit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four QST procedures were administered to participants of the LB<sup>3</sup>P study at their enrollment visit: (1) Pressure Pain Thresholds (PPT) over the participant-reported site of lumbar pain (paraspinals) and a control site (trapezius) using an analog algometer; (2) Temporal Summation (TS) over the lumbar pain and control sites (forearm) using a Neuropen with a 40-g monofilament; (3) Conditioned Pain Modulation (CPM) using a cold water (5°C) immersion tank; and (4) Cold Water Tolerance time. A subset of LB<sup>3</sup>P participants was excluded from the CPM and cold-water immersion procedures due to medical comorbidities such as cardiovascular disease and diabetic neuropathy. Means and standard deviations (SDs) were calculated from three trials of PPT and TS, two trials of CPM, and one trial of cold-water immersion time. TS was calculated by subtracting the numeric pain scores (0–10 scale) of the first from the 10th pinpricks. CPM was calculated by subtracting the mean trapezius algometer readings during the PPT procedure from those of the trapezius PPT during cold-water immersion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final cohort of QST participants was 999 adults. The mean/SD of lumbar and trapezius PPTs was 4.6 (2.4) and 4.4 (1.9) kg/cm<sup>2</sup>, respectively. The mean/SD of lumbar and forearm TS was 1.6 (2.0) and 1.2 (1.8). Lingering pain after the 10th pinprick (after-sensations) was reported by 19.3% and 15.6% of participants after a series of 10 pinpricks was applied to the lumbar pain site and control site, respectively. The mean/SD CPM was 0.9 (1.2) with a wide range of CPM values ","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Biological Sex Is Under-Reported in Cartilage-Related Preclinical Research: A Cross-Sectional Analysis 生物学性别在软骨相关的临床前研究中被低估:一项横断面分析
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-08-18 DOI: 10.1002/jsp2.70104
Daniele Zuncheddu, Paola Buedo, Martin J. Stoddart, Laura B. Creemers, Sibylle Grad, Marcin Waligora

Background

Intervertebral disc degeneration (IDD) and osteoarthritis (OA) share many similarities in the molecular processes involved in the onset and progression of these musculoskeletal pathologies. Biological sex is a risk factor for both conditions. Sex bias in orthopedic preclinical research affects knowledge, reproducibility, and translational aspects of basic research. This article aims to provide a comprehensive overview of how donor sex is reported in IDD and OA preclinical research using human or animal samples and in vivo models.

Methods

We performed a cross-sectional study, searching original articles from journals with the highest impact factor in the field, to determine: (i) whether they report donor sex, and if so, whether they include this data in the analysis; and (ii) whether journals have requirements for sex reporting.

Results

Our research has four main outcomes. First, donor sex was reported in only 61.9% of the 284 cases examined. Second, among the studies where sex was reported (176), samples were predominantly from only male donors or animals (56%). Moreover, sex was rarely incorporated as a variable in outcome analysis (3.4% of cases). Finally, although 14 out of 23 journals stipulated sex reporting requirements, 37.7% of papers published in these journals failed to report donor sex.

Conclusions

Our results provide evidence for the under-reporting of sample donor sex in OA and IDD research, which may contribute to the poor translation to clinical efficacy and the replication crisis. Our findings could guide journal policies, institutional guidelines for preclinical research, and funder requirements.

背景椎间盘退变(IDD)和骨关节炎(OA)在这些肌肉骨骼病变的发生和进展的分子过程中有许多相似之处。生理性别是这两种情况的风险因素。骨科临床前研究中的性别偏见影响基础研究的知识、可重复性和转化方面。本文旨在全面概述如何在IDD和OA临床前研究中使用人类或动物样本和体内模型报告供体性别。我们进行了一项横断面研究,从该领域影响因子最高的期刊中检索原始文章,以确定:(i)他们是否报告了供体性别,如果有,他们是否将这些数据纳入分析;(ii)期刊是否对性报道有要求。我们的研究有四个主要结果。首先,在284例被检查的病例中,只有61.9%报告了供体性别。其次,在报告性别的研究中(176),样本主要来自男性捐赠者或动物(56%)。此外,性别很少被纳入结果分析的变量(3.4%的病例)。最后,尽管23种期刊中有14种规定了性别报告要求,但在这些期刊上发表的37.7%的论文没有报告捐赠者的性别。结论本研究结果为OA和IDD研究中供体性别的低报提供了证据,这可能导致临床疗效的不良转化和复制危机。我们的发现可以指导期刊政策、临床前研究的机构指南和资金要求。
{"title":"Biological Sex Is Under-Reported in Cartilage-Related Preclinical Research: A Cross-Sectional Analysis","authors":"Daniele Zuncheddu,&nbsp;Paola Buedo,&nbsp;Martin J. Stoddart,&nbsp;Laura B. Creemers,&nbsp;Sibylle Grad,&nbsp;Marcin Waligora","doi":"10.1002/jsp2.70104","DOIUrl":"https://doi.org/10.1002/jsp2.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intervertebral disc degeneration (IDD) and osteoarthritis (OA) share many similarities in the molecular processes involved in the onset and progression of these musculoskeletal pathologies. Biological sex is a risk factor for both conditions. Sex bias in orthopedic preclinical research affects knowledge, reproducibility, and translational aspects of basic research. This article aims to provide a comprehensive overview of how donor sex is reported in IDD and OA preclinical research using human or animal samples and in vivo models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a cross-sectional study, searching original articles from journals with the highest impact factor in the field, to determine: (i) whether they report donor sex, and if so, whether they include this data in the analysis; and (ii) whether journals have requirements for sex reporting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our research has four main outcomes. First, donor sex was reported in only 61.9% of the 284 cases examined. Second, among the studies where sex was reported (176), samples were predominantly from only male donors or animals (56%). Moreover, sex was rarely incorporated as a variable in outcome analysis (3.4% of cases). Finally, although 14 out of 23 journals stipulated sex reporting requirements, 37.7% of papers published in these journals failed to report donor sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results provide evidence for the under-reporting of sample donor sex in OA and IDD research, which may contribute to the poor translation to clinical efficacy and the replication crisis. Our findings could guide journal policies, institutional guidelines for preclinical research, and funder requirements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Conceptual Review of Naturally Occurring Toxins and Venoms as Peptide Blockers to Combat Chronic Low Back Pain 自然产生的毒素和毒液作为对抗慢性腰痛的肽阻滞剂的概念综述
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-08-15 DOI: 10.1002/jsp2.70107
James Melrose, Stone Sima, Neha Chopra, Ashish Diwan, Zi Gu
<div> <section> <h3> Background</h3> <p>One of the significant putative causes of low back pain (LBP) is degeneration of the intervertebral disc (IVD). Degenerated discs exhibit loss of proteoglycans, notably aggrecan, leading to mechanical dysfunction and aberrant nerve ingrowth. This pathological innervation results in the proliferation of nociceptive and mechanoreceptive neurons, significantly contributing to persistent pain. A critical therapeutic target is the dorsal root ganglion (DRG), which serves as a key neural hub for nociceptive signaling and neurogenic inflammation. Increased calcium influx through voltage-gated calcium channels within DRG neurons underpins heightened neuronal excitability, facilitating persistent pain transmission. Recent evidence highlights the promising role of bioactive peptides derived from reptilian and insect venoms as potent calcium channel blockers.</p> </section> <section> <h3> Methods</h3> <p>This conceptual review explores published evidence and mechanistic rationale on naturally occurring toxins and venoms as peptide calcium channel blockers for chronic LBP. We considered DRG targeted mechanisms and delivery approaches, including incorporation into biomimetic proteoglycans for localized, sustained intradiscal release, and their use along conventional nerve block procedures.</p> </section> <section> <h3> Results</h3> <p>Venom derived peptide families including ω-conotoxins from cone snail and Tx3-family spider peptides from Phoneutria nigriventer selectively block neuronal calcium channels (notably Ca<sub>v</sub>2.2), thereby reducing the release of neurotransmitters that propogate pain signals. Alongside these antinocicpetive effects, the targeted mechanism of action and directed modalities of these peptides offer a novel therapeutic approach with potential advantages over tradiitonal analgesics, which often present challenges related to tolerance and systemic side effects.</p> </section> <section> <h3> Conclusion</h3> <p>Naturally occurring bioactive peptide calcium channel blockers delivered either directly to the DRG or through a multifaceted therapeutic approach with biomimetic proteoglycans into the IVD or conventional nerve block procedures into the epidural space resents a promising future direction in managing chronic LBP. This approach warrants further pre-clinical and clinical evaluation to clarify clinical utility, potentially transforming pain management paradigms and significantly reducing healthcare burdens associated with chronic spinal disorders.</p> </section> </
背景腰椎间盘退变(IVD)是腰痛(LBP)的重要推定原因之一。椎间盘退行性变表现为蛋白聚糖的损失,尤其是聚集蛋白的损失,导致机械功能障碍和神经向内生长异常。这种病理性神经支配导致伤害性和机械感受性神经元的增殖,显著地促进了持续性疼痛。一个关键的治疗靶点是背根神经节(DRG),它是一个关键的神经中枢,负责伤害性信号和神经源性炎症。通过DRG神经元内电压门控钙通道增加的钙流入支持神经元兴奋性增强,促进持续疼痛传递。最近的证据强调了来自爬行动物和昆虫毒液的生物活性肽作为有效的钙通道阻滞剂的有希望的作用。方法对已发表的关于天然毒素和毒液作为肽钙通道阻滞剂治疗慢性腰痛的证据和机制进行综述。我们考虑了DRG靶向机制和给药方法,包括与仿生蛋白聚糖结合用于局部、持续的椎间盘内释放,以及在常规神经阻滞手术中使用。结果来自锥形蜗牛的ω-conotoxins和来自黑栉水母的tx3家族蜘蛛肽选择性地阻断神经元钙通道(特别是Cav2.2),从而减少传播疼痛信号的神经递质的释放。除了这些抗损伤作用外,这些肽的靶向作用机制和定向方式提供了一种新的治疗方法,与传统镇痛药相比具有潜在的优势,传统镇痛药通常存在与耐受性和全身副作用相关的挑战。结论天然生物活性肽钙通道阻滞剂直接给药于DRG或通过仿生蛋白多糖进入IVD或常规神经阻滞进入硬膜外间隙的多方面治疗方法是治疗慢性LBP的一个有希望的未来方向。这种方法需要进一步的临床前和临床评估,以明确临床效用,潜在地改变疼痛管理模式,并显著减少与慢性脊柱疾病相关的医疗负担。
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引用次数: 0
Relationship Between Quantitative MRI and Radiological, Histological, and Biochemical Measures of Intervertebral Disc Health in Client-Owned, Nonchondrodystrophic-Breed Dogs 定量MRI与客户拥有的非软骨营养不良犬椎间盘健康的放射学、组织学和生化指标之间的关系
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-08-13 DOI: 10.1002/jsp2.70105
Alaina L. Falck, Erick O. Buko, Kayla L. Chase, Diana Pendleton, Katie McDermott, Olivia Kim, Suhail P. Parvaze, Alexandra R. Armstrong, Susan A. Arnold, Elizabeth W. Bradley, Arin M. Ellingson, Christopher P. Ober, Aaron Rendahl, Casey P. Johnson

Background

Client-owned dogs presenting clinically with intervertebral disc disease (IVDD) are a potential comparative animal model to help advance the understanding of disc degeneration and its treatment. To utilize dog patients as a model, noninvasive imaging techniques are needed that can characterize subtle and progressive changes in disc health in longitudinal and treatment efficacy studies. The purpose of this study was to assess the sensitivity of quantitative MRI techniques in detecting disc degeneration in client-owned, nonchondrodystrophic-breed dogs.

Methods

Thoracolumbar vertebral columns from the donated bodies of 15 dogs without a history of IVDD were imaged at 3T MRI. Quantitative MRI maps (T2, T2*, T1ρ, adiabatic T1ρ, adiabatic T2ρ, and ADC) were acquired axially for 10 discs (T11-T12 to L7-S1), and median values were measured in the nucleus pulposus and annulus fibrosus. Four disc health measures (Pfirrmann grade, histology score, water content, and glycosaminoglycan content) were evaluated for each disc. The quantitative MRI and disc health measures were compared using linear models, and partial correlations (Rpartial) were calculated.

Results

Most dogs had both relatively healthy and degenerated discs as assessed by Pfirrmann grade and histology score. Quantitative MRI values in relatively healthy discs varied greatly between dogs but were similar across disc levels. In the nucleus pulposus, T2 relaxation times were moderately correlated with Pfirrmann grade (Rpartial = −0.62; p < 0.0001), histology score (Rpartial = −0.63; p < 0.0001), and water content (Rpartial = +0.45; p < 0.0001), and weakly correlated with glycosaminoglycan content (Rpartial = +0.31; p = 0.0047). T2, T2*, T1ρ, adiabatic T1ρ, and adiabatic T2ρ had similar relationships to the disc health measures in the nucleus pulposus. No notable relationships were observed with ADC or in the annulus fibrosus.

Conclusions

Quantitative T2, T2*, T1ρ, adiabatic T1ρ, and adiabatic T2ρ relaxation time mapping techniques are similarly related to radiological and histological measures of disc health and water and glycosaminoglycan content in nonchondrodystrophic-breed dogs.

临床表现为椎间盘疾病(IVDD)的客户拥有的狗是一个潜在的比较动物模型,有助于提高对椎间盘退变及其治疗的理解。为了利用狗患者作为模型,在纵向和治疗疗效研究中,需要无创成像技术来表征椎间盘健康的细微和进行性变化。本研究的目的是评估定量MRI技术在检测客户拥有的非软骨营养不良犬的椎间盘退变中的敏感性。方法对15只无IVDD病史的犬供体的胸腰椎进行3T MRI成像。对10个椎间盘(T11-T12至L7-S1)进行轴向定量MRI成像(T2、T2*、T1ρ、绝热T1ρ、绝热T2ρ和ADC),测量髓核和纤维环的中位值。评估每个椎间盘的四项健康指标(Pfirrmann分级、组织学评分、水分含量和糖胺聚糖含量)。定量MRI和椎间盘健康测量采用线性模型进行比较,并计算偏相关性(Rpartial)。结果通过Pfirrmann分级和组织学评分,大多数犬的椎间盘既相对健康,也有退变。相对健康椎间盘的定量MRI值在犬之间差异很大,但在椎间盘水平上相似。在髓核,T2弛豫时间与Pfirrmann分级中度相关(r偏= - 0.62;p < 0.0001),组织学评分(Rpartial = - 0.63;p < 0.0001),含水量(Rpartial = +0.45;p < 0.0001),且与糖胺聚糖含量呈弱相关(Rpartial = +0.31;p = 0.0047)。T2、T2*、T1ρ、绝热T1ρ和绝热T2ρ与髓核椎间盘健康指标有相似的关系。与ADC或纤维环无明显关系。结论定量T2、T2*、T1ρ、绝热T1ρ和绝热T2ρ松弛时间测图技术与非软骨营养不良犬的椎间盘健康、水和糖胺聚糖含量的放射学和组织学指标相似。
{"title":"Relationship Between Quantitative MRI and Radiological, Histological, and Biochemical Measures of Intervertebral Disc Health in Client-Owned, Nonchondrodystrophic-Breed Dogs","authors":"Alaina L. Falck,&nbsp;Erick O. Buko,&nbsp;Kayla L. Chase,&nbsp;Diana Pendleton,&nbsp;Katie McDermott,&nbsp;Olivia Kim,&nbsp;Suhail P. Parvaze,&nbsp;Alexandra R. Armstrong,&nbsp;Susan A. Arnold,&nbsp;Elizabeth W. Bradley,&nbsp;Arin M. Ellingson,&nbsp;Christopher P. Ober,&nbsp;Aaron Rendahl,&nbsp;Casey P. Johnson","doi":"10.1002/jsp2.70105","DOIUrl":"https://doi.org/10.1002/jsp2.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Client-owned dogs presenting clinically with intervertebral disc disease (IVDD) are a potential comparative animal model to help advance the understanding of disc degeneration and its treatment. To utilize dog patients as a model, noninvasive imaging techniques are needed that can characterize subtle and progressive changes in disc health in longitudinal and treatment efficacy studies. The purpose of this study was to assess the sensitivity of quantitative MRI techniques in detecting disc degeneration in client-owned, nonchondrodystrophic-breed dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thoracolumbar vertebral columns from the donated bodies of 15 dogs without a history of IVDD were imaged at 3T MRI. Quantitative MRI maps (T2, T2*, T1ρ, adiabatic T1ρ, adiabatic T2ρ, and ADC) were acquired axially for 10 discs (T11-T12 to L7-S1), and median values were measured in the nucleus pulposus and annulus fibrosus. Four disc health measures (Pfirrmann grade, histology score, water content, and glycosaminoglycan content) were evaluated for each disc. The quantitative MRI and disc health measures were compared using linear models, and partial correlations (<i>R</i><sub>partial</sub>) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most dogs had both relatively healthy and degenerated discs as assessed by Pfirrmann grade and histology score. Quantitative MRI values in relatively healthy discs varied greatly between dogs but were similar across disc levels. In the nucleus pulposus, T2 relaxation times were moderately correlated with Pfirrmann grade (<i>R</i><sub>partial</sub> = −0.62; <i>p</i> &lt; 0.0001), histology score (<i>R</i><sub>partial</sub> = −0.63; <i>p</i> &lt; 0.0001), and water content (<i>R</i><sub>partial</sub> = +0.45; <i>p</i> &lt; 0.0001), and weakly correlated with glycosaminoglycan content (<i>R</i><sub>partial</sub> = +0.31; <i>p</i> = 0.0047). T2, T2*, T1ρ, adiabatic T1ρ, and adiabatic T2ρ had similar relationships to the disc health measures in the nucleus pulposus. No notable relationships were observed with ADC or in the annulus fibrosus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Quantitative T2, T2*, T1ρ, adiabatic T1ρ, and adiabatic T2ρ relaxation time mapping techniques are similarly related to radiological and histological measures of disc health and water and glycosaminoglycan content in nonchondrodystrophic-breed dogs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient-Reported Outcomes Among an Observational Cohort of Individuals With Chronic Low Back Pain 慢性腰痛患者报告的观察性队列结果
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-08-13 DOI: 10.1002/jsp2.70097
Carol M. Greco, Nathan E. Dodds, Amanda M. Acevedo, William Anderst, Kevin M. Bell, Jessa Darwin, Anthony Delitto, John M. Jakicic, Gina P. McKernan, Charity G. Patterson, Paul A. Pilkonis, Sara R. Piva, Michael J. Schneider, Nam V. Vo, Ajay D. Wasan, Lan Yu, Gwendolyn A. Sowa

Background

Chronic low back pain (cLBP) is complex, disabling, and costly to patients and to society. Patients' social circumstances, beliefs, and behaviors interact in a dynamic way with biomedical factors and have the potential to amplify or reduce suffering. It is important to assess the experience of pain via patient-reported outcomes (PROs). The University of Pittsburgh Mechanistic Research Center, entitled, “Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes (LB3P),” is part of the National Institutes of Health's Helping to End Addiction Long-term Initiative. LB3P conducted a prospective, observational cohort study to identify phenotypes of over 1000 participants with cLBP. This article reports key information from the PROs and selected demographic variables obtained at the in-person LB3P study enrollment visit.

Methods

The LB3P study participants completed numerous PROs, including the minimum data set assessments of the NIH Research Task Force on back pain and the NIH HEAL Initiative's Common Data Elements. PROs were organized into five conceptual domains: (1) Pain Characteristics and Qualities, (2) Pain-related Psychosocial Factors, (3) General Psychosocial Factors, (4) General Health and Lifestyle Factors, and (5) Social Determinants of Health (SDoH). Patient Acceptance of Symptom Status, which consists of yes/no responses to 10 questions about whether the level of each of the 10 symptoms is satisfactory, was also assessed.

Results

PRO measures were collected from 1007 LB3P participants with cLBP. The means and standard deviations, or medians and interquartile ranges, and percentages for the PRO variables collected at the in-person enrollment visit are presented for the overall group and stratified by sex at birth (females and males) and by age (< 60 years old and ≥ 60 years old). For the participants overall, and across sex and age groups, pain intensity and interference were moderate on average. Neuropathic pain, assessed via PainDETECT, was present in 18% of the overall sample, and in 22.5% of those younger than 60. On average, fatigue, depressive and anxiety symptoms, memory and concentration, self-efficacy, and positive outlook were within normal limits, as indicated by PROMIS T-scores. However, PROMIS Physical function was below normal, with T-scores in the mild to moderate range of impairment. When participants were asked to rate the acceptability of their symptom status in 10 areas of function, the most frequently reported areas of dissatisfacti

慢性腰痛(cLBP)是一种复杂的、致残的、对患者和社会都昂贵的疾病。患者的社会环境、信仰和行为以动态的方式与生物医学因素相互作用,并有可能放大或减少痛苦。通过患者报告的结果(PROs)来评估疼痛体验是很重要的。匹兹堡大学机械研究中心,题为“腰痛:生物学,生物力学,行为表型(LB3P)”,是美国国立卫生研究院帮助结束成瘾长期倡议的一部分。LB3P进行了一项前瞻性、观察性队列研究,以确定1000多名cLBP患者的表型。本文报告了在LB3P研究登记访问中获得的PROs和选定的人口统计变量的关键信息。LB3P研究的参与者完成了许多PROs,包括NIH背痛研究工作组的最低数据集评估和NIH HEAL倡议的公共数据元素。研究将疼痛因素分为5个概念域:(1)疼痛特征和质量;(2)疼痛相关心理社会因素;(3)一般心理社会因素;(4)一般健康和生活方式因素;(5)健康社会决定因素。还评估了患者对症状状态的接受程度,包括对10个问题中的每一个症状的水平是否令人满意的回答是/否。结果收集1007例LB3P患者cLBP PRO测量数据。在亲自入组访问中收集的PRO变量的均值和标准差,或中位数和四分位数范围,以及百分比被呈现在整个组中,并按出生性别(女性和男性)和年龄(60岁和≥60岁)分层。对于所有参与者来说,不分性别和年龄,疼痛强度和干扰的平均程度是中等的。通过PainDETECT评估的神经性疼痛在整个样本中占18%,在60岁以下的人中占22.5%。平均而言,疲劳、抑郁和焦虑症状、记忆和注意力、自我效能感和积极前景在正常范围内,如PROMIS t评分所示。然而,PROMIS的身体功能低于正常,t评分在轻度到中度的损害范围内。当参与者被要求对10个功能领域的症状状态的可接受程度进行评分时,最常报告的不满意领域是:疼痛强度和干扰、身体功能、睡眠和疲劳。在SDoH领域,近一半(44%)的参与者报告有过创伤经历。在整个群体中,36%的人表示难以支付食物、医疗和取暖等基本需求,而60岁以上人群中有51%的人表示存在这种程度的经济压力。结论LB3P cLBP观察队列表现出中等水平的疼痛强度,疼痛干扰生活活动和疼痛相关残疾。参与者报告了轻度至中度与疼痛相关的社会心理因素,而抑郁和焦虑等一般心理健康挑战相对较少。许多参与者报告了创伤经历的历史,并面临着当前的经济挑战。LB3P PRO结果为社区cLBP患者样本提供了参考价值。
{"title":"Patient-Reported Outcomes Among an Observational Cohort of Individuals With Chronic Low Back Pain","authors":"Carol M. Greco,&nbsp;Nathan E. Dodds,&nbsp;Amanda M. Acevedo,&nbsp;William Anderst,&nbsp;Kevin M. Bell,&nbsp;Jessa Darwin,&nbsp;Anthony Delitto,&nbsp;John M. Jakicic,&nbsp;Gina P. McKernan,&nbsp;Charity G. Patterson,&nbsp;Paul A. Pilkonis,&nbsp;Sara R. Piva,&nbsp;Michael J. Schneider,&nbsp;Nam V. Vo,&nbsp;Ajay D. Wasan,&nbsp;Lan Yu,&nbsp;Gwendolyn A. Sowa","doi":"10.1002/jsp2.70097","DOIUrl":"https://doi.org/10.1002/jsp2.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic low back pain (cLBP) is complex, disabling, and costly to patients and to society. Patients' social circumstances, beliefs, and behaviors interact in a dynamic way with biomedical factors and have the potential to amplify or reduce suffering. It is important to assess the experience of pain via patient-reported outcomes (PROs). The University of Pittsburgh Mechanistic Research Center, entitled, “<i>Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes (LB</i><sup>3</sup><i>P),”</i> is part of the National Institutes of Health's Helping to End Addiction Long-term Initiative. LB<sup>3</sup>P conducted a prospective, observational cohort study to identify phenotypes of over 1000 participants with cLBP. This article reports key information from the PROs and selected demographic variables obtained at the in-person LB<sup>3</sup>P study enrollment visit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The LB<sup>3</sup>P study participants completed numerous PROs, including the minimum data set assessments of the NIH Research Task Force on back pain and the NIH HEAL Initiative's Common Data Elements. PROs were organized into five conceptual domains: (1) Pain Characteristics and Qualities, (2) Pain-related Psychosocial Factors, (3) General Psychosocial Factors, (4) General Health and Lifestyle Factors, and (5) Social Determinants of Health (SDoH). Patient Acceptance of Symptom Status, which consists of yes/no responses to 10 questions about whether the level of each of the 10 symptoms is satisfactory, was also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PRO measures were collected from 1007 LB<sup>3</sup>P participants with cLBP. The means and standard deviations, or medians and interquartile ranges, and percentages for the PRO variables collected at the in-person enrollment visit are presented for the overall group and stratified by sex at birth (females and males) and by age (&lt; 60 years old and ≥ 60 years old). For the participants overall, and across sex and age groups, pain intensity and interference were moderate on average. Neuropathic pain, assessed via PainDETECT, was present in 18% of the overall sample, and in 22.5% of those younger than 60. On average, fatigue, depressive and anxiety symptoms, memory and concentration, self-efficacy, and positive outlook were within normal limits, as indicated by PROMIS T-scores. However, PROMIS Physical function was below normal, with T-scores in the mild to moderate range of impairment. When participants were asked to rate the acceptability of their symptom status in 10 areas of function, the most frequently reported areas of dissatisfacti","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility of Physical Exam and Performance-Based Tests in Individuals With Chronic Low Back Pain: A Descriptive Study 慢性腰痛患者体格检查和性能测试的可行性:一项描述性研究
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-08-12 DOI: 10.1002/jsp2.70096
Sara R. Piva, Zakiy Alfikri, William Anderst, Kevin M. Bell, Cristiane Carlesso, Jessa Darwin, Anthony Delitto, Carol M. Greco, Marit E. Johnson, Gina P. McKernan, Rachel McLoughlin, Charity G. Patterson, Rachel E. Roos, Michael J. Schneider, Clair Smith, Gwendolyn A. Sowa, Nam V. Vo, Leming Zhou
<div> <section> <h3> Background</h3> <p>Despite the wide utilization of physical tests and pain assessments to evaluate individuals with chronic low back pain (cLBP), there is limited information about their feasibility in terms of test duration, the ability of individuals with cLBP to perform these tests, and associated adverse events. The literature also lacks reports on comprehensive characterization of physical tests to serve as a reference for clinicians and researchers. The objectives of the present work are to assess the feasibility of a comprehensive battery of physical tests and pain assessments germane to individuals with cLBP and characterize the tests' values in the context of a large cohort.</p> </section> <section> <h3> Methods</h3> <p>This cross-sectional analysis uses enrollment data from a large observational study conducted by the University of Pittsburgh Mechanistic Research Center—“Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes (LB<sup>3</sup>P).” LB<sup>3</sup>P is part of the National Institutes of Health's Helping to End Addiction Long-term Initiative. Individuals with cLBP were screened by trained clinicians who assessed their safety to partake in up to 37 physical tests based on pre-existing medical conditions. Testers could elect not to administer tests based on their clinical judgment and participants could refuse to partake in tests. The reasons for not performing tests were recorded. The feasibility of the tests was assessed by the time to complete each test, percentages and reasons for tests not done, and adverse events related to test performance. Descriptive statistics for the physical tests were computed for the sample overall, and for the subgroups (male/female and age < 60/≥ 60) to serve as reference values for individuals with cLBP.</p> </section> <section> <h3> Results</h3> <p>The testing protocol took on average 130 min. In total, 8.9% of tests were not done. About one third of tests not done were screened out due to medical conditions identified during the safety screening, and two-thirds due to the tester's clinical judgment or participant refusal. Only four adverse events occurred, and they resolved without sequelae. The tests most often omitted were those requiring maximal and submaximal physical effort or could elevate blood pressure in those with hypertension, such as muscle strength testing of the hip, abdomen, and thigh, or hand immersion in cold water. From the 1007 participants enrolled in the study, those who did not complete one or more tests tended to be older, obese, less educated, and experienced more disability and back pain for a longer time. The descriptive statistics of th
背景:尽管身体检查和疼痛评估被广泛用于评估慢性腰痛(cLBP)患者,但在测试持续时间、cLBP患者执行这些检查的能力以及相关不良事件方面,关于其可行性的信息有限。文献也缺乏全面表征的物理测试的报告,以作为临床医生和研究人员的参考。本研究的目的是评估与cLBP患者相关的一系列全面的身体测试和疼痛评估的可行性,并在一个大队列的背景下描述这些测试的价值。方法横断面分析使用匹兹堡大学机械研究中心进行的一项大型观察性研究的登记数据-“腰痛:生物学,生物力学,行为表型(LB3P)”。LB3P是美国国立卫生研究院帮助结束成瘾长期倡议的一部分。cLBP患者由训练有素的临床医生筛选,他们根据已有的医疗状况评估他们参加多达37项身体检查的安全性。测试人员可以根据他们的临床判断选择不进行测试,参与者可以拒绝参加测试。记录了不执行测试的原因。通过完成每项测试的时间、未完成测试的百分比和原因以及与测试性能相关的不良事件来评估测试的可行性。计算总体样本和亚组(男性/女性和年龄60岁/≥60岁)体格检查的描述性统计数据,作为cLBP患者的参考值。结果检测方案平均耗时130 min。总共有8.9%的测试没有完成。约三分之一未完成的测试是由于在安全筛选期间确定的医疗条件而被筛选掉的,三分之二是由于测试人员的临床判断或参与者的拒绝。仅发生4次不良事件,且均无后遗症。最常被忽略的测试是那些需要最大和次最大的体力努力或可能升高高血压患者血压的测试,如臀部、腹部和大腿的肌肉力量测试,或手浸在冷水中。从参与研究的1007名参与者中,那些没有完成一项或多项测试的人往往年龄更大,肥胖,受教育程度更低,经历更多残疾和背部疼痛的时间更长。37项试验的描述性统计数据按性别和年龄分层。结论:本研究结果支持对cLBP患者进行全面的身体检查和疼痛评估的安全性和可行性。本研究还提供了有关cLBP患者测试表现频率、未完成原因、持续时间和描述性结果的新信息。这一综合表征为今后的研究规划和临床实践提供了比较参考价值。
{"title":"Feasibility of Physical Exam and Performance-Based Tests in Individuals With Chronic Low Back Pain: A Descriptive Study","authors":"Sara R. Piva,&nbsp;Zakiy Alfikri,&nbsp;William Anderst,&nbsp;Kevin M. Bell,&nbsp;Cristiane Carlesso,&nbsp;Jessa Darwin,&nbsp;Anthony Delitto,&nbsp;Carol M. Greco,&nbsp;Marit E. Johnson,&nbsp;Gina P. McKernan,&nbsp;Rachel McLoughlin,&nbsp;Charity G. Patterson,&nbsp;Rachel E. Roos,&nbsp;Michael J. Schneider,&nbsp;Clair Smith,&nbsp;Gwendolyn A. Sowa,&nbsp;Nam V. Vo,&nbsp;Leming Zhou","doi":"10.1002/jsp2.70096","DOIUrl":"https://doi.org/10.1002/jsp2.70096","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Despite the wide utilization of physical tests and pain assessments to evaluate individuals with chronic low back pain (cLBP), there is limited information about their feasibility in terms of test duration, the ability of individuals with cLBP to perform these tests, and associated adverse events. The literature also lacks reports on comprehensive characterization of physical tests to serve as a reference for clinicians and researchers. The objectives of the present work are to assess the feasibility of a comprehensive battery of physical tests and pain assessments germane to individuals with cLBP and characterize the tests' values in the context of a large cohort.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This cross-sectional analysis uses enrollment data from a large observational study conducted by the University of Pittsburgh Mechanistic Research Center—“Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes (LB&lt;sup&gt;3&lt;/sup&gt;P).” LB&lt;sup&gt;3&lt;/sup&gt;P is part of the National Institutes of Health's Helping to End Addiction Long-term Initiative. Individuals with cLBP were screened by trained clinicians who assessed their safety to partake in up to 37 physical tests based on pre-existing medical conditions. Testers could elect not to administer tests based on their clinical judgment and participants could refuse to partake in tests. The reasons for not performing tests were recorded. The feasibility of the tests was assessed by the time to complete each test, percentages and reasons for tests not done, and adverse events related to test performance. Descriptive statistics for the physical tests were computed for the sample overall, and for the subgroups (male/female and age &lt; 60/≥ 60) to serve as reference values for individuals with cLBP.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The testing protocol took on average 130 min. In total, 8.9% of tests were not done. About one third of tests not done were screened out due to medical conditions identified during the safety screening, and two-thirds due to the tester's clinical judgment or participant refusal. Only four adverse events occurred, and they resolved without sequelae. The tests most often omitted were those requiring maximal and submaximal physical effort or could elevate blood pressure in those with hypertension, such as muscle strength testing of the hip, abdomen, and thigh, or hand immersion in cold water. From the 1007 participants enrolled in the study, those who did not complete one or more tests tended to be older, obese, less educated, and experienced more disability and back pain for a longer time. The descriptive statistics of th","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 3","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.70096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144814982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comments on “Exploring the Therapeutic Potential of Puerarin on Intervertebral Disc Degeneration by Regulating Apoptosis of Nucleus Pulposus Cells” 《探讨葛根素通过调节髓核细胞凋亡治疗椎间盘退变的潜力》一文评论
IF 3.9 3区 医学 Q1 ORTHOPEDICS Pub Date : 2025-08-12 DOI: 10.1002/jsp2.70099
Ji Jin, Miao Liu, Jiajie Guo, Hong Sun

We read with interest the article by Xiaoqiang Wang et al. [1] titled “Exploring the Therapeutic Potential of Puerarin on Intervertebral Disc Degeneration by Regulating Apoptosis of Nucleus Pulposus Cells” published in JOR Spine on December 11, 2024. The study presents compelling findings on the role of puerarin in mitigating intervertebral disc degeneration (IDD). However, we would like to raise two critical points regarding the data analysis and interpretation that may affect the validity of the conclusions.

First, in Figure 1E, the intersection size of four different datasets is presented. However, the results appear counterintuitive: the intersection size increases as more datasets are included, while it decreases with fewer datasets. This observation contradicts mathematical principles, as the intersection of multiple datasets typically diminishes with the addition of more datasets due to increased variability and reduced common elements. We suggest that the authors revisit the methodology used to calculate these intersections and verify the data processing steps to ensure accuracy. Clarification on how the intersection sizes were derived would greatly enhance the reliability of this analysis.

Second, the authors did not explicitly state the log2FoldChange threshold used in their differential analysis. Based on Figure 2A, the absolute values appear to range between 0.2 and 0.3. Such a low threshold may result in an overly broad range of differentially expressed genes, potentially reducing the biological significance of the findings [2, 3]. We recommend that the authors justify their choice of threshold and consider applying a more stringent cutoff to improve the robustness of their results. Additionally, exploring the biological relevance of the identified genes through functional enrichment analysis could strengthen the study's conclusions [4].

We believe that addressing these issues would significantly enhance the clarity and impact of the study. We appreciate the authors' contributions to the field and hope that our comments will encourage further refinement of this important work. Thank you for considering our comments. We look forward to the authors' response and any potential follow-up studies.

我们饶有兴趣地阅读了2024年12月11日发表在《JOR Spine》杂志上的王晓强等人的文章《通过调节髓核细胞凋亡探索葛根素对椎间盘退变的治疗潜力》。该研究提出了葛根素在减轻椎间盘退变(IDD)中的作用的令人信服的发现。然而,关于数据分析和解释,我们想提出两个关键点,这可能会影响结论的有效性。首先,在图1E中,给出了四个不同数据集的交集大小。然而,结果似乎是违反直觉的:交集大小随着数据集的增加而增加,而随着数据集的减少而减少。这种观察结果与数学原理相矛盾,因为由于可变性增加和公共元素减少,多个数据集的交集通常会随着更多数据集的增加而减少。我们建议作者重新审视用于计算这些交叉点的方法,并验证数据处理步骤以确保准确性。澄清交点大小是如何推导出来的,将大大提高这一分析的可靠性。其次,作者没有明确说明差异分析中使用的log2FoldChange阈值。根据图2A,绝对值的范围在0.2到0.3之间。如此低的阈值可能导致差异表达基因的范围过宽,从而可能降低研究结果的生物学意义[2,3]。我们建议作者证明他们选择阈值的合理性,并考虑采用更严格的截止值来提高结果的稳健性。此外,通过功能富集分析探索鉴定基因的生物学相关性可以加强研究结论[4]。我们认为,解决这些问题将大大提高研究的清晰度和影响。我们感谢作者对该领域的贡献,并希望我们的评论将鼓励进一步完善这一重要工作。谢谢你考虑我们的意见。我们期待作者的回复和任何可能的后续研究。
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