Natural products targeting programmed cell death: a novel therapeutic strategy for intervertebral disc degeneration.

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Intervertebral disc degeneration (IVDD) serves as a central pathological mechanism in the development of spinal degenerative disorders. Its progression is closely associated with the dysregulated activation of various programmed cell death (PCD) pathways, including apoptosis, pyroptosis, necroptosis, ferroptosis, and autophagy. Recent investigations have highlighted the potential of natural products to modulate these cell death processes through multitarget mechanisms, making them promising candidates for IVDD intervention. In this study, a comprehensive literature search was conducted using the PubMed database (up to 2025), applying a dual search strategy to systematically identify relevant publications. Following the screening of titles and abstracts and the removal of non-original publications, a total of 194 eligible studies were retained, covering 134 distinct natural products. The analysis revealed that these products are capable of targeting multiple PCD pathways in intervertebral disc cells and exhibit considerable therapeutic potential. These findings offer a theoretical framework and methodological reference for the development of novel treatments for IVDD. Nevertheless, limitations remain regarding natural products, particularly in terms of bioavailability and safety. Future efforts should focus on optimizing screening platforms and drug delivery strategies to enhance therapeutic efficacy while minimizing potential toxicity.

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