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Purpose: To investigate the molecular responses of various genes and proteins relatedto disc degeneration upon treatment with cytokines that affect disc-cell proliferationand phenotype in living human intervertebral discs (IVDs). Responsivenessto these cytokines according to the degree of disc degeneration was also evaluated. Materials and Methods: The disc specimens were classified into two groups: group 1 (6 patients) showed mild degeneration of IVDs and group 2 (6 patients)exhibited severe degeneration of IVDs. Gene expression was analyzed after treatment with four cytokines: recombinant human bone morphogenic protein (rhBMP-2), transforming growth factor-β (TGF-β), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α). Molecular responses were assessed after exposure of cells from the IVD specimens to these cytokines via real-time polymerase chain reaction and immunofluorescence staining. Results: mRNA gene expression was significantly greater for aggrecan, type I collagen, type II collagen, alkaline phosphatase,osteocalcin, and Sox9 in group 1 than mRNA gene expression in group 2, when the samples were not treated with cytokines. Analysis of mRNA levels for these molecules after morphogen treatment revealed significant increases in both groups, which were much higher in group 1 than in group 2. The average number of IVD cells that were immunofluorescence stained positive for alkaline phosphataseincreased after treatment with rhBMP-2 and TGF-β in group 1. Conclusion: The biologic responsiveness to treatment of rhBMP-2, TGF-β, TNF-α, and IL-1β in the degenerative living human IVD can be different according to the degree of degenerationof the IVD.
