• Sarit Sara Sivan, Anthony J Hayes, Ellen Wachtel, Bruce Caterson, Yulia Merkher, Alice Maroudas, Sharon Brown, and Sally Roberts.
• Department of Biomedical Engineering, Technion, Israel Institute of Technology, 32000, Haifa, Israel, sivan.sarit@gmail.com.
• Eur Spine J. 2014 Jun 1;23 Suppl 3:S344-53.

BackgroundThe intervertebral disc (IVD) is a complex cartilaginous structure which functions to resist biomechanical loads during spinal movement. It consists of the highly viscous cartilaginous nucleus pulposus, which is surrounded laterally by a thick outer ring of fibrous cartilage-the annulus fibrosus-and sandwiched inferiorly and superiorly by the cartilage end-plates. The main extracellular matrix molecules of the disc are collagens, proteoglycans, glycoproteins and elastin. The disc also contains appreciable amounts of water, matrix-degrading protease enzymes and their inhibitors, soluble signalling molecules and various metabolic breakdown products.MethodsThis review provides a comprehensive description of the biochemical composition of the extracellular matrix of the IVD and, specifically, the proteases involved in its molecular turnover. Quantitation of the turnover rates using racemization of aspartic acid as a molecular clock is also discussed.ConclusionsMolecular turnover rates of the major constituent matrix macromolecules of the IVD are found to be particularly slow, especially in the case of collagen. Over a normal human life span, this slow turnover may compromise the structural integrity of the IVD extracellular matrix essential for normal physiological functioning.

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