Research advances on the role and relevance of vascular endothelial growth factor in intervertebral disc degeneration
Intervertebral disc degeneration(IVDD)is a common cause of chronic low back pain,while its specific underlying mechanisms remain unclear.Vascular endothelial growth factor(VEGF)is an important cellular factor involved in the process of angiogenesis,which has activities in promoting blood vessel formation,controlling vascular permeability,maintaining vascular function and integrity,participating in extracellular matrix remodeling,and regulating vascular bone and cartilage tissue.VEGF plays a significant role in promoting endothelial cell proliferation and is closely associated with IVDD.It participates in the degenerative process of intervertebral discs by promoting angiogenesis,matrix degradation,and prominent nucleus pulposus resorption.Intervertebral discs are avascular structures in the human body.Factors such as VEGF and hypoxia-inducible factor 1α(HIF-1α)are upregulated when disc degeneration occurs,leading to the invasion of blood vessels from the outer annulus fibrosus into the inner disc,promoting the expression of nerve growth factors(NGF),inducing the invasion of nerve endings into the nucleus pulposus,and causing sensitization of pain receptors,ultimately leading to discogenic low back pain.VEGF was considered as an important marker of IVDD by most studies.Its expression significantly increases during severe disc degeneration and,in conjunction with other factors,exacerbates the degenerative process.However,there are still a small number of scholars who believe that VEGF upregulates the protective mechanism of activating the body,promotes the absorption of protruding nucleus pulposus,and plays an important role in delaying IVDD.With the advancement of basic research,the use of adenoviral co-transfection techniques to explore the mechanism of action of VEGF in animal models of IVDD holds promise for uncovering the biological functions of VEGF.This article provides a comprehensive review of the research progress on VEGF and IVDD,analyzes their correlation,and discusses the feasibility of VEGF-based biological therapy in the treatment of IVDD.It aims to provide new targets and theoretical foundations for the prevention and treatment of IVDD and related discogenic low back pain.
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