Current research on the role of HIF in intervertebral disc degeneration.

Abstract

Low back pain affects a large population globally, and intervertebral disc degeneration (IVDD) is one of its major causes. This review aims to summarize the roles and molecular mechanisms of hypoxia-inducible factors (HIFs) in IVDD progression, and provide theoretical support for developing precise treatment strategies for IVDD. We systematically retrieved, sorted and analyzed recent peer-reviewed studies concerning the association between HIF family members and IVDD. IVDD involves complex pathological changes including hypoxic microenvironment imbalance, inflammatory responses, extracellular matrix (ECM) dysfunction and altered autophagy. HIFs, key oxygen-sensing regulators, exert bidirectional effects on IVDD: they can either alleviate or accelerate disc degeneration under different conditions. HIFs play a central regulatory role in IVDD. Targeting HIF-related pathways holds great potential for clinical translation, and further research is still required to clarify unresolved mechanisms.