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A cocktail of drugs to treat disc degeneration

THE ESSENTIAL

  • Back pain is the cause of 2.3 million working days lost in France each year
  • The main cause of back pain is low back pain
  • Drug cocktail could treat disc degeneration that causes low back pain

In the United States, more than fifteen million adults suffer from chronic back pain. In France, 64% of residents have suffered from back or joint pain in the past twelve months, according to an Opinionway survey published in 2020. Embarrassing or even disabling problems in everyday life. According to health insurance, back pain is the cause of 2.3 million workdays lost each year in the personal assistance and care sector. An observable consequence in many other sectors of activity. The main reason for this suffering is often low back pain, that is to say an intense pain in the lumbar vertebrae, located in the lower back. As we age, the frequency of low back pain may increase due to the degeneration of the discs that support these vertebrae. A phenomenon that promotes this health problem.

A new preventive treatment to prevent disc degeneration

Although low back pain affects many people, there is little treatment. When pain is present, the main ones are drugs, injections or even surgery. But these are not suitable for all patients. Some do not meet the criteria for surgery, others are not relieved by the injections. Finally, the last downside of current treatments: The prolonged use of drugs carries a risk of dependence. As for the preventive management of low back pain, doctors generally recommend practicing regular physical activity or having physiotherapy follow-up. But researchers may have just found a new preventive solution: a cocktail of drugs that eliminate aging cells and reduce disc degeneration at the base of low back pain. Their results have just been published in the journal Nature Communications.

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Senolytics replace damaged cells

Once the intervertebral discs start to age, very little regeneration occurs, explains Makarand Risbud, one of the authors. But our results show that it is possible to reduce disc degeneration associated with aging.For this, the researchers tested a treatment based on a class of molecules called senolytics, already known to scientists as a treatment against aging cells. How do senolytics work? With age, every tissue in the body accumulates senescent cells.These secrete destructive enzymes and inflammatory proteins that affect neighboring healthy cells, which eventually deteriorate.The action of senolytic drugs is simple: they kill senescent cells and damaged cells that are naturally replaced by new healthy cells.

A protective and preventive effect in the youngest mice

In their experiments, the researchers tested two senolytic drugs together: dasatinib and quercetin. They tested this cocktail, by injection weekly, on young, middle-aged and old mice. Results: The youngest rodents benefited better from this treatment than their elders. In fact, young and middle-aged mice had less disc degeneration and senescent cells when they reached old age compared to those given a placebo. In other words, this cocktail of drugs had a protective and preventive effect against back problems.

“A new preventive approach”

The therapy was most effective when we started treating the mice when these senescent cells were just starting to emerge, explains Makarand Risbud. Our results show that if given early, senolytic drugs can slow disc degeneration. This is a new preventive approach”. However, to be effective, this weekly treatment had to be administered until the mice reach old age, which would mean many years in humans. But, at this stage of their work, the researchers have not observed any harmful long-term side effects. “People may need to take this for a long time for treatment to be effective, and our data shows the drugs were well tolerated, at least in mice.“, underlines Makarand Risbud. Ultimately, the researchers wish to test this remedy on humans and thus, perhaps, offer a new therapeutic route to patients.

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