29/12/2025
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๐ง๐ต๐ฒ ๐๐๐-๐๐ถ๐๐ฐ ๐๐
๐ถ๐: ๐๐ผ๐ ๐ฌ๐ผ๐๐ฟ ๐ ๐ถ๐ฐ๐ฟ๐ผ๐ฏ๐ถ๐ผ๐บ๐ฒ ๐ ๐ฎ๐ ๐๐ฒ ๐๐ฎ๐๐๐ถ๐ป๐ด ๐ฌ๐ผ๐๐ฟ ๐๐ฎ๐ฐ๐ธ ๐ฃ๐ฎ๐ถ๐ป
โฌ ๐๐ซ๐๐ง๐ซ๐๐๐ฌ
๐น Low back pain (LBP) is a leading cause of disability worldwide, with Intervertebral Disc Degeneration (IDD) widely regarded as its primary driver
๐น While mechanical stress, age, and genetics are traditional suspects, recent research has unveiled a surprising culprit: the trillions of microorganisms living in your digestive tract
๐น This connection is now known as the gut-disc axis
๐น The following post details how the gut microbiome influences spinal health, challenging the long-held belief that intervertebral discs are sterile environments
โฌ ๐๐๐ ๐๐๐ง๐๐๐๐๐ข ๐๐๐๐๐ฉ: ๐๐๐ ๐ฟ๐๐จ๐ ๐๐จ ๐๐ค๐ฉ ๐๐ฉ๐๐ง๐๐ก๐
๐งซ Historically, the medical community viewed the intervertebral disc (IVD) as a sterile organ
๐งซ Recent studies using advanced sequencing have identified bacteria within these discs
๐งซ There is a significant overlap in bacterial species found in the gut and those found in the IVD, suggesting that the two environments "talk" to one another
โฌ ๐๐๐๐ง๐ค๐๐๐ค๐ฉ๐ ๐๐ง๐ค๐๐๐ก๐๐จ
๐ข Healthy Discs โช Tend to contain an abundance of Firmicutes, Actinobacteria, and Saccharopolyspora
โช These are associated with strong intestinal barriers and antibacterial protection
๐ด Degenerated/Herniated Discs โช Show higher levels of pathogenic bacteria such as Pseudomonas veronii, Streptococcus anginosus, and notably Propionibacterium acnes (P. acnes)
โช P. acnes is a bacteria strongly associated with bone and joint infections
โฌ ๐๐ค๐ฌ ๐ฉ๐๐ ๐๐ช๐ฉ ๐ฟ๐๐จ๐ฉ๐ง๐ค๐ฎ๐จ ๐ฉ๐๐ ๐ฟ๐๐จ๐: ๐๐๐ง๐๐ ๐๐๐๐๐๐ฃ๐๐จ๐ข๐จ
1. Bacterial Translocation (The "Leaky" Barrier) ๐ง When the gut microbiome is unbalanced, the intestinal epithelial barrier becomes permeable
โช Invasion:
โซ Bacteria escape the gut, enter the bloodstream, and reach the IVD
โช The Perfect Hiding Spot:
โซ Because the interior of a disc lacks oxygen (anaerobic) and has limited immune surveillance (it is "immune-privileged"), it becomes an ideal breeding ground for anaerobic bacteria like P. acnes
โช Destruction:
โซ Once established, these bacteria release toxins and trigger inflammation
โซ This leads to the ingrowth of blood vessels and nerves into the disc, destroying its structure and amplifying pain signals sent to the brain
2. Immune System Regulation ๐ก The gut microbiome acts as a "training ground" for the body's immune system
โช Systemic Inflammation:
โซ Dysbiosis weakens the gut lining, causing immune cells to release pro-inflammatory cytokines (such as IL-6 and TNF-ฮฑ) into the circulation
โช Remote Damage:
โซ These inflammatory molecules migrate to the spine
โซ They stimulate disc cells to degrade their own structural matrix (collagen and aggrecan), leading to herniation and degeneration
โช Pain Sensitization:
โซ The influx of immune cells stimulates the production of nerve growth factor (NGF)
โซ This causes pain-sensing nerve fibers to grow into the disc, causing chronic back pain
3. Metabolite and Nutrient Regulation ๐งช
Gut bacteria are responsible for metabolizing food into chemical signals, including Short-Chain Fatty Acids (SCFAs) like propionate and butyrate
โช Bone Remodeling:
โซ While SCFAs generally support bone health by regulating osteoclasts, their diffusion into the IVD can have mixed effects
โซ In degenerated discs, the presence of these metabolites and specific receptors may contribute to calcification of the disc and cartilage endplates
โช Barrier Maintenance:
โซ A healthy mucus layer in the gut, maintained by specific bacteria and mucins (like MUC2), is essential to prevent toxic metabolites from entering the bloodstream and reaching the spine
โฌ ๐๐๐ก๐๐ฉ๐๐ ๐ฝ๐๐ค๐ก๐ค๐๐๐๐๐ก ๐ผ๐ญ๐๐จ
๐ Gut-Bone Marrow Axis
โช Gut dysbiosis can damage the bone marrow niche
โช Since the spine consists of vertebral bodies containing marrow, inflammation here can lead to aberrant immune cell formation within the spine itself, contributing to systemic inflammation and pain
๐ Gut-Bone Axis
โช Hormones secreted by the gut after eating (like GIP and GLP-1) regulate bone remodeling
โช If the gut environment is compromised, it can lead to decreased bone mineral density in the vertebrae, which correlates with low back pain
โฌ ๐๐ช๐ฉ๐ช๐ง๐ ๐ฟ๐๐ง๐๐๐ฉ๐๐ค๐ฃ๐จ ๐๐ฃ ๐ฟ๐๐๐๐ฃ๐ค๐จ๐๐จ ๐๐ฃ๐ ๐๐ง๐๐๐ฉ๐ข๐๐ฃ๐ฉ
๐งฌ Diagnostics
โช Physicians may eventually use stool or blood samples to analyze microbiome diversity using 16S rRNA sequencing
โช This may help detect biomarkers for disc degeneration
๐ Therapeutics
โช Treatments could shift from purely mechanical interventions (like surgery) to biological ones
โช Targeting the gut microbiome may inhibit the cascade of inflammation that destroys the disc
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โ ๏ธDisclaimer: Sharing a study or a part of it is NOT an endorsement. Please read the original article and evaluate critically.โ ๏ธ
Link to Article ๐
