New Review in Chinese Medical Journal Collates Findings on Abnormal Spinal Curvature in Adolescents

BEIJING, Nov. 30, 2021 /PRNewswire/ -- As the human body's central support structure, the spine helps with correct posturing, gait, and movement by linking the shoulder, the hip, and the limbs. Any spinal injury due to an accident or incorrect posturing can cause abnormal curving of the spine. Adolescent idiopathic scoliosis (AIS) is a spine deformity that develops early-on in adolescents. Despite significant efforts, the causes and clinical aspects of AIS development are not well appreciated.

Now, a group of researchers from Peking Union Medical College Hospital, Beijing, led by Dr. Qian-Yu Zhuang have reviewed relevant studies on AIS and drawn important observations that can potentially contribute to its treatment. Their review was published on 20 February 2020 in Chinese Medical Journal.

Through an extensive literature survey, they have demarcated their observations into nine aspects involved in AIS pathogenesis. Detailing these aspects, Prof. Zhuang says, "We found that the different theories that can explain the etiology of this serious medical condition can be divided into nine aspects that include insights from bone marrow-derived mesenchymal stem cell studies, genetic studies, tissue analysis, spine biomechanics measurements, neurologic analysis, hormone studies, biochemical analysis, environmental factor analysis, and lifestyle explorations."

The review focuses on various perspectives of alterations in bone formation associated with AIS, which may have a molecular or lifestyle basis. While genetic and epigenetic variations make up the molecular etiological factors, studies on bone tissue shed light on structural abnormalities in AIS. Bone marrow-derived mesenchymal stem cells (BM-MSC) differentiate poorly into bone cells in patients with AIS, thereby resulting in low bone mineral density and compromised bone formation, aligning with the development of AIS. BM-MSC may thus serve as an important target for potential therapeutic interventions.

Further on, neurological, hormone, and biochemical studies highlight the role of an altered vestibular system (involved in body balance); alterations in hormones like melatonin, leptin, estrogen, growth hormone, and calmodulin; and aberrant bone mineral, vitamin D, and lipid metabolism, respectively, in AIS patients. Correspondingly, studies assessing environmental influences and lifestyle factors suggest that high environmental selenium and chlorine, gut-microbiome alterations, and certain physical activities contribute to the onset and progression of AIS. Interestingly, some studies also propose an integrated theory of AIS, which explains how internal and external factors collectively contribute to the condition.

Prof. Zhuang concludes with the applications of their work by saying, "This is the first review to include the perspective of BM-MSCs in the etiology of AIS. We hope that there will be some breakthrough in its treatment focusing on hormones and MSCs in the future, which will give patients more options for conservative treatment."

Reference
Title of original paper: Research progress on the etiology and pathogenesis of adolescent idiopathic scoliosis
Journal: Chinese Medical Journal
DOI: https://doi.org/10.1097/CM9.0000000000000652

Contact:
Peifang Wei
86-10-51322170
[email protected] 

SOURCE Chinese Medical Journal

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