Key Takeaways & Executive Findings
- ā¢ā¢ Cartilaginous endplate degeneration is a central link in intervertebral disc degeneration, characterized by extracellular matrix degradation and increased collagen types I and X. ā¢ The biomechanical properties of the cartilaginous endplate are determined by its extracellular matrix composition, and its degeneration is a cascade reaction triggered by mechanical environment changes. ā¢ Restoring and maintaining a healthy extracellular matrix microenvironment is the main therapeutic direction for intervertebral disc degeneration. ā¢ Multidisciplinary collaboration, including biomechanics and molecular biology, is essential for developing effective treatments such as controlled fixation-traction.
Abstract
BACKGROUND: The cartilaginous endplate is the bridge connecting the intervertebral disc to the vertebral body. Degeneration of the cartilaginous endplate is a central link in various degenerative spinal disorders. OBJECTIVE: To conduct an in-depth analysis of the biological mechanisms of cartilaginous endplate degeneration and to reveal the key role of cartilaginous endplate degeneration in intervertebral disc degeneration. METHODS: Computerized searches were conducted in Web of Science, PubMed, CNKI, WanFang, and VIP databases. The search terms included ācartilaginous endplate degeneration, inflammatory factors, biomechanics, extracellular matrixā in Chinese and English. The literature search spanned from the inception of each database to August 2024. Based on predefined inclusion and exclusion criteria, a total of 68 articles were ultimately selected for review. RESULTS AND CONCLUSION: Intervertebral disc degeneration is a cascade reaction triggered by changes in the mechanical environment, leading to cell-mediated biochemical, mechanical, and structural changes. The cartilaginous endplate, as a dynamic mechanical barrier of the intervertebral disc, has biomechanical properties determined by the components of the extracellular matrix. The degeneration of the cartilaginous endplate is characterized by changes in the extracellular matrix components, including the degradation of type II collagen and proteoglycans, and the increase in type I collagen and type X collagen. These changes directly impact the attachment, proliferation, and differentiation of cartilaginous endplate cells. Maintaining and restoring a healthy extracellular matrix is the main direction for the treatment of intervertebral disc degeneration. Cartilaginous endplate degeneration is a complex process involving multiple factors and mechanisms, spanning biomechanics, biochemistry, and cell biology. Through multidisciplinary collaboration, such as the combination of biomechanics and molecular biology, applying controlled fixation-traction under a comprehensive understanding of the mechanism of traction promoting intervertebral disc regeneration may provide more effective treatment for patients with intervertebral disc degeneration.
1. Introduction
The health of the intervertebral disc depends on a complex biomechanical and biochemical environment, in which the nucleus pulposus, annulus fibrosus, and cartilaginous endplate play crucial roles. The cartilaginous endplate, located between the nucleus pulposus and the vertebral body, plays an important role in the nutritional metabolism of the disc, regulating the exchange of nutrients and the removal of metabolites through osmosis. As a key component of the intervertebral disc, the integrity of the cartilaginous endplate is essential for maintaining the physiological function of the disc [1-2]. Degeneration of the cartilaginous endplate not only leads to early disc degeneration but is also a major cause of low back pain in middle-aged and elderly individuals, severely affecting patients' quality of life and imposing a heavy socioeconomic burden.
Although numerous studies have focused on the pathophysiology of the intervertebral disc (Figure 1), research on the cartilaginous endplate is relatively scarce. An in-depth exploration of the mechanisms of cartilaginous endplate degeneration remains an important gap in the field of disc research. Therefore, this article systematically reviews and comprehensively analyzes existing literature to reveal the molecular mechanisms of cartilaginous endplate degeneration and explore effective regulatory strategies, providing a scientific basis for the prevention and treatment of intervertebral disc degeneration.
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Jiang Chao, Che Yanjun (2026). Biological mechanisms and future research trends of cartilaginous endplate degeneration. Chinese Journal of Tissue Engineering Research. https://doi.org/10.12307/2026.21255
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Frequently Asked Questions
What is the cartilaginous endplate and why is it important?
The cartilaginous endplate is a key component of the intervertebral disc, located between the vertebral body and the nucleus pulposus. It acts as a bridge connecting the disc to the vertebra and is crucial for nutrient exchange and waste removal via osmosis. Its integrity is essential for disc health.
What are the main biological mechanisms of cartilaginous endplate degeneration?
The degeneration involves changes in the extracellular matrix, including degradation of type II collagen and proteoglycans, and an increase in type I and type X collagen. These changes affect cell attachment, proliferation, and differentiation, and are driven by biomechanical, inflammatory, and apoptotic processes.
How does cartilaginous endplate degeneration relate to intervertebral disc degeneration?
Cartilaginous endplate degeneration is a central link in intervertebral disc degeneration. It disrupts nutrient supply to the disc, leading to a cascade of biochemical and structural changes that contribute to disc degeneration and related disorders like lumbar disc herniation.
What are the future research trends in this field?
Future research focuses on restoring the extracellular matrix microenvironment, understanding the interplay between biomechanics and molecular biology, and developing multidisciplinary approaches such as controlled fixation-traction to promote disc regeneration.
What are the clinical implications of this research?
Understanding the mechanisms of cartilaginous endplate degeneration can lead to targeted therapies that prevent or reverse disc degeneration, potentially reducing the burden of low back pain and improving patient outcomes.
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