# The Role of Disc Nutrition in the Etiology and Clinical Treatment of Disc Degeneration

> **NIH VA IK2** · PHILADELPHIA VA MEDICAL CENTER · 2021 · —

## Abstract

Low back pain, most commonly caused by degeneration of the intervertebral disc,
places a significant social and economic burden on the general public, active duty
military and veterans alike. The intervertebral discs of the spine are the largest avascular
structures in the body, and the cells within the disc therefore rely on the transport of
nutrients and waste products across the vertebral endplate to maintain disc
homeostasis. A compromise in transport across the vertebral endplate interface is
therefore implicated in the initiation and progression of disc degeneration. The
overarching goal of this proposal is twofold: (1) Elucidate the properties of the boney and
cartilage endplates that affect trans-endplate transport and how alterations in transport
contribute to disc degeneration, and (2) investigate alterations to trans-endplate
transport and disc health during non-operative treatment of patients with back pain and
their correlation with pain relief and functional outcomes. These goals will be
accomplished via the following specific aims: Aim 1: Determine the structural,
mechanical and compositional properties of the vertebral endplates affecting diffusion
and convection into healthy and degenerative human intervertebral discs. A custom
MRI-compatible device will be constructed to quantify the transport properties of
cadaveric human endplate samples under both diffusion and convection (fluid flow).
Transport properties will then be correlated with boney endplate compositional and local
mechanical properties, as assayed via µCT, histology, Fourier transform infrared
spectroscopy (FTIR), local strain tracking analysis, and atomic force microscopy (AFM).
Aim 2: Establish correlations between intervertebral disc degeneration, trans-endplate
small molecule diffusion, and vertebral endplate structure, composition and mechanics in
an in vivo rabbit model. Intervertebral disc degeneration will be induced in vivo in a rabbit
model via puncture of the disc with a 16G or 21G needle. Animals will be euthanized at
4, 8, and 16 weeks post-puncture to generate a spectrum of degeneration from mild
(21G puncture) to severe (16G puncture). Small molecule trans-endplate diffusion into
the disc will be quantified via post-contrast enhanced MRI T1-mapping. The boney and
cartilage endplates will be assayed via microFil enhanced µCT to determine bone and
vascular density. Composition and mechanics of the endplates will be assayed via FTIR
and AFM, respectively. Degeneration of the intervertebral disc will be assessed via MRI
T2-mapping, histology, biochemistry and gene expression assays. Aim 3: Determine the
feasibility and preliminary outcomes of quantifying the effect of physical therapy on
trans-endplate diffusion into the degenerative disc in patients with back pain. Human
patients with back pain concomitant with disc degeneration will be subjected to MRI T2-
mapping and post-contrast enhanced T1-mapping at time points prior to and 6 weeks
after physical th...

## Key facts

- **NIH application ID:** 10075137
- **Project number:** 5IK2RX003118-02
- **Recipient organization:** PHILADELPHIA VA MEDICAL CENTER
- **Principal Investigator:** SARAH E GULLBRAND
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-01-01 → 2024-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10075137

## Citation

> US National Institutes of Health, RePORTER application 10075137, The Role of Disc Nutrition in the Etiology and Clinical Treatment of Disc Degeneration (5IK2RX003118-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10075137. Licensed CC0.

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