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Blood and lymphatic vascular remodeling in intervertebral disc degeneration
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DOI：10.3389/fimmu.2026.1862921.png)
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Abstract
En 中文
A defining histological feature of the intervertebral disc (IVD) in healthy adults is its avascular and alymphatic status; which is closely related to its mode of nutrient supply and local immune homeostasis. Following the onset of intervertebral disc degeneration (IDD); blood vessels invade the interior of the degenerated IVD under the combined effects of anatomical barrier disruption; inflammatory responses; and aberrant activation of growth factor regulatory networks; thereby accelerating the degenerative process and being closely associated with discogenic pain. However; as another major component of the vascular system; there is still no consensus regarding the presence of lymphatic vessels in the adult IVD; their spatial distribution; and whether they serve functional drainage and immunoregulatory roles. In addition; differences among studies in species background; tissue sampling range; degeneration stage; and detection strategies have further increased the complexity of mechanistic interpretation. Against this background; this review first outlines the vascular anatomical and physiological basis of the normal IVD; summarizes vascular-related pathological changes and key regulatory networks during IDD; and synthesizes the principal findings; major controversies; and methodological limitations of lymphatic research. On this basis; it further discusses the potential links between remodeling of the vascular system; including both blood vessels and lymphatic vessels; and pain generation as well as degenerative outcomes; and outlines potential intervention strategies targeting vasculature-related pathways; with the aim of informing subsequent mechanistic studies and translational therapeutic development.
Keywords:
VEGF
intervertebral disc degeneration
blood vessels
lymphatic vessels
discogenic pain
vascular system
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5.9
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4.9W
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22.7W
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