Hypotonicity differentially affects inflammatory marker production by nucleus pulposus tissue in simulated disc degeneration versus herniation

Vivian H.M. Mouser (Corresponding author), Irene T.M. Arkesteijn, Bart G.M. van Dijk, Karin Wuertz-Kozak, Keita Ito

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Inflammatory cytokines play an important role in intervertebral disc degeneration. Although largely produced by immune cells, nucleus pulposus (NP) cells can also secrete them under various conditions, for example, under free swelling. Thus, tissue hypotonicity may be an inflammatory trigger for NP cells. The aim of this study was to investigate whether decreased tonicity under restricted swelling conditions (as occurring in early disc degeneration) could initiate an inflammatory cascade that mediates further degeneration. Healthy bovine NP tissue was balanced against different PEG concentrations (0–30%) to obtain various tissue tonicities. Samples were then placed in an artificial annulus (fixed volume) and were cultured for 3, 7, or 21 days, with free swelling NP as control. Tissue content (water, glycosaminoglycan, collagen) was analyzed, and both the tissue and medium were screened for tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), prostaglandin-E 2 (PGE 2 ), and nitric oxide (NO). A range of tonicities (isotonic to hypotonic) was present at day 3 in the PEG-treated samples. However, during culture, the tonicity range narrowed as GAGs leached from the tissue. TNF-α and IL-1β were below detection limits in all conditions, while mid- and downstream inflammatory cytokines were detected. This may suggest that the extracellular environment directly affects NP cells instead of inducing a classical inflammatory cascade. Furthermore, IL-8 increased in swelling restricted samples, while IL-6 and PGE 2 were elevated in free swelling controls. These findings may suggest the involvement of different mechanisms in disc degeneration with intact AF compared to herniation, and encourage further investigation.

Original languageEnglish
Pages (from-to)1110-1116
Number of pages7
JournalJournal of Orthopaedic Research
Issue number5
Publication statusPublished - 1 May 2019


  • (hypo)tonicity
  • inflammation
  • intervertebral disc degeneration
  • nucleus pulposus


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