Abstract

Developing effective therapies for back pain associated with intervertebral disc (IVD) degeneration is a research priority since it is a major socioeconomic burden and current conservative and surgical treatments have limited success. Polyphenols are naturally occurring compounds in plant-derived foods and beverages, and evidence suggests dietary supplementation with select polyphenol preparations can modulate diverse neurological and painful disorders. This study tested whether supplementation with a select standardized Bioactive-Dietary-Polyphenol-Preparation (BDPP) may alleviate pain symptoms associated with IVD degeneration. Painful IVD degeneration was surgically induced in skeletally-mature rats by intradiscal saline injection into three consecutive lumbar IVDs. Injured rats were given normal or BDPP-supplemented drinking water. In-vivo hindpaw mechanical allodynia and IVD height were assessed weekly for 6 weeks following injury. Spinal column, dorsal-root-ganglion (DRG) and serum were collected at 1 and 6 weeks post-operative (post-op) for analyses of IVD-related mechanical and biological pathogenic processes. Dietary BDPP significantly alleviated the typical behavioral sensitivity associated with surgical procedures and IVD degeneration, but did not modulate IVD degeneration nor changes of pro-inflammatory cytokine levels in IVD. Gene expression analyses suggested BDPP might have an immunomodulatory effect in attenuating the expression of pro-inflammatory cytokines in DRGs. This study supports the idea that dietary supplementation with BDPP has potential to alleviate IVD degeneration-related pain, and further investigations are warranted to identify the mechanisms of action of dietary BDPP.

Highlights

  • Low back pain affects 70–85% of the population at some time in their life and is the leading cause of disability worldwide [1]

  • intervertebral disc (IVD) injury-induced weight loss was attenuated by dietary BDPP treatment, and Body weight (BW) of the BDPP animals were comparable to Sham animals throughout the 6 week study period (Fig 2B)

  • This study aimed to evaluate whether dietary supplementation with BDPP was able to alleviate painful IVD degeneration in a previously established rat model [22,23,24]

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Summary

Introduction

Low back pain affects 70–85% of the population at some time in their life and is the leading cause of disability worldwide [1]. IVDrelated pain can result from spinal cord or nerve compression arising from IVD height loss, foraminal stenosis, IVD bulging and herniation, spinal instability or chronic inflammation among other pathologic mechanisms [4]. Because of the complex etiology of axial, or discogenic, back pain, and challenges treating chronic conditions, there is little consensus on the best course of therapy [5]. Neither conservative therapies nor spinal fusion surgery result in significant improvement for IVD degeneration-related back pain [6,7,8]. While many challenges and opportunities exist for IVD repair there is much data to suggest that treatments for chronic back pain conditions might require interventions that promote resilience and influence other spinal structures [8, 9]. There remains an urgent need to develop safe, minimally invasive and effective treatments for alleviating discogenic back pain

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