Disc degeneration under the microscope
Degeneration of the intervertebral disc may give rise to disorders that often present an enormous clinical and financial burden. Targeted treatments and prevention measures cannot be realised in the absence of clear diagnostic criteria. The GENODISC project stepped in to develop relevant novel biomarkers and diagnostics. The overall project goal was to examine the relationship between back pain and disc degeneration in patients with disc-degeneration–related disorders, instead of the general population. Team members improved on the phenotyping of ailments linked to severe back pain. This will enable enhanced treatment, advanced understanding of degeneration, the development of prevention measures and investigation into possibilities for repair. Clinicians involved with the project hailed from five large specialist spine centres across different EU countries. They defined the major clinical phenotypes and characterised the clinical phenotypes of 2 573 patients with chronic back pain. The gathered information was uploaded to a central database and made available for association studies. DNA was also collected from all patients, and scientists identified new genes associated with disc herniation. Investigation into other areas generated useful knowledge for outlining prevention measures. For example, data produced on structural macromolecules provided information on the stability of the matrix (in relation to degradation effects): this is a critical factor in the development of tissue repair strategies. In addition, a project-developed exercise programme for young people targets the early prevention of degenerative spinal disorders. With regard to repair, scientists developed a computational model that can predict how, throughout the disc, levels of infection-targeting antibiotics vary with time. Maintaining drug levels above critical levels is important for successful prophylaxis and treatment. Contributing to clarification of back pain phenotypes and advances in diagnostics, GENODISC efforts and outcomes have significant implications for future research. Project work will inform subsequent studies on cell therapy, appropriate imaging techniques, new biomechanics approaches for degraded disc stabilisation, and a better understanding of degeneration pathways. GENODISC results were disseminated through presentations and official publications targeting the scientific community. Posters in hospitals, leaflets and workshops communicated relevant information to back pain patients, while workshops, newspaper articles and lectures at schools were used to reach the public. The project website contains more information.
