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The incidence of intervertebral disc calcifications (IVDCs) was examined in 52 lumbosacral spines obtained sequentially at autopsy. The presence of calcific deposits was detected by fine-grain roentgenograms. The nature of these deposits was determined by wide-angle x-ray diffraction, and histologic observations were made. A high prevalence of IVDC, 18 spines of 52, some with multiple deposits, was noted. Calcium pyrophosphate dihydrate (CPPD) deposits were found in 3% of the spines and accounted for 29% of the 42 deposits analyzed. The CPPD deposits occurred at multiple disc levels (an average of four per spine), were diffuse, and involved a major portion of the disc (nucleus pulposus, annulus fibrosus, and endplate) but were not generally associated with histologic disc degeneration. Hydroxyapatite (HA) deposits occurred in 12% of the spines, most often in the nucleus pulposus and endplate. The HA deposits appeared as small punctate radiodensities. Roentgenographic evidence of degenerative changes, i.e., disc space narrowing, endplate disruption, desiccation, and osteophyte formation, were present in all but one of the spines containing HA deposits. An additional 19% of the spines had deposits that could not be characterized by x-ray diffraction but were very similar in roentgenographic appearance to HA deposits. No conclusions could be drawn on the relationship between the presence of HA or CPPD and collagen or hexosamine content.

The elastic fiber and elastin in the human yellow ligament and intervertebral disk were studied histologically and biochemically. The elastic fiber in the human intervertebral disk, which until now had not been clearly identified microscopically, was observed clearly. We found the distribution of the elastic fiber in the intervertebral disk to be very sparse and irregular, and its diameter was small, being about one-tenth of that found in the yellow ligament. The elastin contents of the yellow ligament and intervertebral disk were 46.7% +/- 0.9% and 1.7% +/- 0.2% respectively (mean +/- SE) of the total dry weight. The amino acid composition of elastin in the yellow ligament is similar to that of other tissue, as reported in the literature; however, that found in the intervertebral disk is significantly different. It would appear, therefore, that the elastin in the intervertebral disk is of a different type from that found elsewhere.

Keratan sulphate and chondroitin sulphate can each fill space and exert swelling pressure in collagenous fibrillar matrices, but whereas the former is synthesised from glucose precursor without consuming NAD, the latter converts 2 mols of NAD for each uronate residue in the polymer chain. We suggest that the observed distribution of keratan sulphate and chondroitin sulphate in cartilage, cornea and intervertebral disc are determined by the ambient oxygen tension, and that keratan sulphate is preferentially synthesised in conditions of oxygen lack. The implications of this hypothesis in the physiology of contact lenses, cartilage degeneration, corneal scar repair and ageing are discussed.

Water content of intervertebral discs is a significant aspect of both viscoelastic behavior and age-related degenerative changes. Using water content as a dependent variable, stress-relaxation was measured using standardized anulus fibrosus specimens strained at various levels of strain. Synthesis of experimental data into a master relaxation curve allows prediction of specimen response over time intervals not readily accessible experimentally. A quantitative understanding of the role of water content may have important clinical application, since magnetic resonance imaging is a tool which should allow water content determination in vivo.

Antisera were produced which recognized specifically native type I and type II collagens and proteoglycan. These were used in immunofluorescence studies to investigate the distribution of collagens and proteoglycan in intervertebral discs from adult and newborn pigs. Cervical, thoracic and lumbar discs gave similar staining patterns. In the adult, the outer 1 mm of the annulus fibrosus resembled a perichondrium and was negative for type II collagen. The inner regions of the annulus contained proteoglycan and both types of collagen, but these molecules appeared to have separate distributions. The nucleus showed no staining for type I collagen. Newborn pig discs differed from those of the adult in that type II collagen was restricted to the central notochord and to a narrow zone surrounding it. The newborn annulus was negative for type II collagen but reacted strongly with antibodies to both type I collagen and proteoglycan. It is suggested that during development of the pig annulus fibrosus, cells producing type II collagen may migrate into this area from the central regions.

Immature bovine cartilages and intervertebral-disc tissue all revealed a prominent protein, not present in the adult tissues, in non-denaturing extracts made with chondroitin ABC lyase (EC 4.2.2.4), Streptomyces hyaluronidase (EC 4.2.2.1) or 1 M NaCl. The protein ran on SDS-polyacrylamide electrophoresis, before disulphide reduction, as a close doublet of bands of apparent molecular weight 110,000 and 105,000. After reduction, they dissociated respectively into two protein bands at 37,000 and 35,000, indicating that the initial molecules were disulphide-bonded trimers. Amino-terminal sequence analysis established the identity of both proteins (Mr 110,000 and Mr 105,000) as forms of the carboxypropeptide of type II collagen. The larger molecule appeared to be the trimer of intact alpha 1(II) carboxypropeptides and the smaller, a version composed of chains that were ten residues shorter at their amino-terminal ends. The material appears to be identical to chondrocalcin, a protein previously found to be enriched in fetal growth plate and named on the basis that it may play a role in cartilage calcification. The present findings, however, indicate that the protein is equally abundant in all type II collagen-synthesizing young cartilages, including nucleus pulposus of the intervertebral disc and other cartilages that never calcify.

This is a review of the recent developments in collagens, elastin, and noncollagenous protein of the normal and abnormal intervertebral disk. Much progress has been made on the chemistry of the normal disk constituents. However, little work has been done to date on the essential lesion of the early degenerative disk in humans; a major effort in this field is indicated in the next decade. The reasons are obvious, for in the unraveling of the etiology of degeneration of the intervertebral disk lies the hope and expectation of prevention of disk failure.

Assays of several proteases, incorporating guanidinium chloride extracts of human femoral head cartilage and intervertebral disc, demonstrated that both tissues contain inhibitors of certain serine proteases. Trypsin, chymotrypsin and a granule extract of human polymorphonuclear leukocytes containing elastase and cathepsin G activities, were inhibited by low molecular weight fractions prepared by Sephadex G-75 chromatography. Using a radioassay, it was further shown that these fractions inhibit proteolysis of cartilage proteoglycan. The inhibitor in intervertebral disc is concentrated in the nucleus pulposus, with a decreasing gradient to the periphery of the annulus fibrosus. It is proposed that these inhibitors confer at least partial protection against pathological proteolysis of the proteoglycans in human articular cartilage and nucleus pulposus.

In vitro 1H pulse nuclear magnetic resonance (NMR) studies on human intervertebral disc tissues were performed to establish the characteristics of relaxation processes. The spin-lattice relaxation time, bound water and dry matter content were measured. Biopsy material from fresh cadavers was taken from different discs along the spinal column and from different sectors of some single discs. It is suggested that the measured parameters correlate with the biomechanical behavior of discs, which in turn is influenced by function, by exposure to physical stresses, or by aging.

Material from 100 consecutive operations on herniated discs has been investigated for amyloid. Various degrees of amyloid degeneration were found in disc tissue from 41 patients. Material from patients over 50 years old showed significantly more amyloid than that from younger patients; there was no sex difference. Eighteen patients had previously been operated on for herniated discs; seven of these (39%) had pyrophosphate deposits in their disc tissue, often in close topographical relation to amyloid. 26% of the patients had calcium phosphate deposits and 29% had slight inflammation--both without relation to amyloid. No pathogenetic correlation between amyloid degeneration and herniation of intervertebral disc tissue could be shown.

The nucleus pulposus of cat intervertebral disc was examined after staining glycosaminoglycans with Alcian Blue and the results correlated with TEM X-ray probe microanalysis. In unstained sections a difference in copper levels between tissues and resin was detected. In tissue stained with Alcian blue before embedding, the copper levels were slightly increased and the morphological appearance of the intercellular material was amorphous. In sections restained after cutting, the relative levels of copper in the resin were considerably increased and tissue levels were significantly higher than in the resin. Moreover, the morphology of the intercellular material was altered from a rather amorphous material to a network. Sulphur levels behaved in similar manner to copper levels but any correlation between the elements was due to factors unrelated to glycosaminoglycan staining and probably resulted from contaminating sulphur.

The ground substance of the intervertebral disc consists primarily of proteoglycans, which give the tissue its stiffness to compression and its resiliency. To investigate the structure and composition of these molecules, we extracted them from human infant nucleus pulposus under associative conditions and from human infant annulus fibrosus and cartilage end-plate under dissociative conditions. We examined the degree of aggregation, the composition, the electron microscopic appearance, and the dimensions of the proteoglycans of the intervertebral disc and compared their structure and dimensions with those of the proteoglycans from bovine hyaline cartilage. Aggregates represented 52 per cent of the proteoglycans of the nucleus pulposus between the ages of one and ten days but only 28 per cent between the ages of six and eight months. Preparations from the corresponding annuli contained 59 per cent aggregates at one to ten days and 47 per cent at six months. The corresponding cartilage end-plate preparations contained 45 and 40 per cent aggregates. The proteoglycans of the annulus fibrosus and cartilage end-plate contained more protein and less hexosamine than did those of the nucleus pulposus. Electron microscopy showed that approximately two-thirds of the aggregates from nucleus pulposus consisted of very short hyaluronate filaments with closely packed monomers. The other third had longer hyaluronate filaments and wider distances between monomers, and closely resembled the aggregates from the annulus fibrosus and cartilage end-plate. Aggregated monomers consisted of two segments: a thin segment connecting directly to the hyaluronic acid filament and a thick segment extending peripherally from the thin segment. The thin segment formed about 12 per cent of the total monomer length in the samples from all three disc tissues. The lower proportion of aggregated monomers, the lower protein content, and the smaller aggregates with closely packed monomers suggest that the nucleus pulposus may contain less link protein than do the annulus fibrosus and cartilage end-plate. Compared with proteoglycan aggregates from bovine hyaline cartilage, proteoglycan aggregates from human intervertebral disc were shorter and had fewer monomers and wider spacing between monomers. The aggregated monomers from the three components of the intervertebral disc had an average length of 209 +/- 90 nanometers, compared with 210 +/- 114 nanometers for monomers from hyaline cartilage of skeletally mature cows, 250 +/- 116 nanometers for monomers from hyaline cartilage of skeletally immature calves, and 288 +/- 108 nanometers for monomers from fetal animals.(ABSTRACT TRUNCATED AT 400 WORDS)

The methods of Hascall & Sajdera (1969) were used to compare the proteoglycans of human intervertebral disc with those of bovine nasal cartilage. In contrast with cartilage, most of the hexuronate of disc could be extracted at low shear with water or dilute salt solutions. Extracts of disc with 4M-guanidinium chloride were centrifugated in 0.4M-guanidinium chloride in a CsCl gradient. Analytical ultracentrifugation of the hexuronate-containing heavy component revealed two fractions. both more polydisperse than those of cartilage. Also the more rapidly sediminting component was a much smaller fraction of the total. After prior extraction with 0.4M-guanidinium chloride, 4M-guanidinium chloride extracts of disc were found, by ultracentrifugal analysis, to be enriched in components resembling the proteoglycan monomer and aggregating factors of cartilage.

Substance P, a physiologically potent neuropeptide is known to participate in the sensory, and especially nociceptive, transmission of neural impulses. On histologic grounds, the nerve terminals of the sinuvertebral nerve formerly have been suggested to be sensory in character and to mediate the low-back pain syndrome. Samples of paramedullary ligamentous structures were collected on disc operations. A positive immunoreaction as an indicator of substance P was confirmed in some nerve terminals of the posterior longitudinal ligament. Neither the yellow ligament nor the intervertebral disc showed such nociceptive-type nerves.

We have put forward a number of questions about the role of the intervertebral disk in idiopathic scoliosis which are based on experimental evidence and current connective tissue research. It is regrettable that the last two decades have not seen a single major advance in the treatment of scoliosis based on a scientific understanding of the etiology and mechanisms of curve progression. The efficacy of early detection and surgical techniques cannot be denied but orthopedic surgery is not relieved of the responsibility of pursuing the causation and pathogenesis of scoliotic curvature. Spinal fusion for scoliosis cuts across the fundamental principle of orthopedic surgery--the preservation of musculoskeletal function--a maximum which Trueta enunciated so strongly through his surgical lifetime. Clearly, a sacrifice of spinal mobility is not a final acceptable solution to the malady.

Fifteen lumbar spines were collected postmortem. The intervertebral discs were assigned morphological grades and were analyzed for water, collagen, and proteoglycan. In order of increasing degeneration, five grade 0, four grade 1, 45 grade 2, 12 grade 3A, and nine grade 3B discs were identified. The proteoglycan concentration fell progressively with increasing grade, although the concentrations of each component overlapped extensively among the grades. Grade 2 discs showed no consistent differences from adjacent grade 3A or 3B discs in the same spine. All discs in seven of the eight spines with grade 3A or 3B discs and all discs in three spines with no grade 3A or 3B discs had proteoglycan concentrations below 52 mg/g fresh weight. Four of five spines with at least one disc of proteoglycan concentration above this value contained no grade 3A or 3B discs. These observations support the hypothesis that low proteoglycan concentrations in all the discs of a spine precede degeneration.

Nucleus pulposus was taken at necropsy from five mongrel dogs and tested in an enzyme linked immunoabsorbent assay (ELISA) system designed to indicate the presence of IgG and IgM. This assay positively identified IgG. Agarose-bound Protein A was used to treat the nucleus pulposus material to extract the IgG. Repeating the ELISA using Protein A-treated nucleus pulposus showed that the ELISA was greatly diminished in activity, confirming the presence of whole molecules of IgG in nucleus pulposus. Investigators have postulated an immunologic basis for spinal pain syndromes. None to date has demonstrated IgG in the nucleus pulposus. This IgG may be a mediator by which an inflammatory response is activated which contributes to the clinical picture of chronic back and radicular pain.

Chondrocalcinosis of the intervertebral discs is a common finding in patients who have had prior surgical procedures involving the same or adjacent disc space. The crystals in the tissues have the characteristic morphologic and spectrophotometric features of calcium pyrophosphate dihydrate. None of the patients described herein had clinical or radiographic evidence of crystal accumulation in sites remote from the surgical procedure. We propose that the surgical trauma may have played a role in the induction of the crystal deposits.

Annulus fibrosus of intervertebral discs from diabetic and non-diabetic sand rats were examined by microspectrophotometry for fibronectin content. This was higher in the diabetic animals both in the dorsal and ventral parts and in the outer and inner lamellae of the annulus. It is suggested that diabetes-related changes in fibronectin are similar to changes in annular collagen observed in species other than sand rats.

A highly sensitive proteoglycan-binding assay was developed for the detection and determination of small amounts of hyaluronate. Application of this assay to human intervertebral-disc tissue showed that the radial distribution of hyaluronate closely followed the distribution of proteoglycans.

Proteoglycans extracted with 4M-guanidinium chloride from pig intervetebral discs, and purified by equilibrium density-gradient centrifugation in CsCl, were of smaller hydrodynamic size than those extracted and purified in the same way from the laryngeal cartilage of the same animal. Whether this difference in size arose from degradation during the extraction and purification of the proteoglycans of the disc was investigated. Purified proteoglycans labelled either in the chondroitin sulphate chains or in the core protein were obtained from laryngeal cartilage by short-term organ culture. These labelled proteoglycans were added at the beginning of the extraction of the disc proteoglycans, and labelled cartilage and unlabelled disc proteoglycans were isolated and purified together. There was no appreciable loss of radioactivity after density-gradient centrifugation nor decrease in hydrodynamic size of the labelled cartilage proteoglycans on chromatography on Sepharose 2B, when these were present during the extraction of disc proteoglycans. It is concluded that disc proteoglycans are intrinsically of smaller size than cartilage proteoglycans and this difference in size does not arise from degradation during the extraction.

Pepsin-soluble collagen was extracted from three histologically proven cases of chordoma and nucleus pulposus. The collagen types of these materials were investigated by differential salting-out, SDS-PAGE (sodium dodecyl sulphate-polyacrylamide gel electrophoresis) of native collagen and their CNBr (cyanogen bromide) cleaved peptides, and their amino acid compositions. Although the collagen of nucleus pulposus was type II, that of chordoma was largely type I. Collagen of notochord, the origin of nucleus pulposus, is known to be type II. Further investigation is necessary in view of the fact that collagen of chordoma, a tumor believed to be derived from notochord, is not type II.

The total nitrogen, collagen and non-collagenous protein (NCP) content of the nucleus pulposus (NP), transitional zone (TZ) and annulus fibrosus (AF) of the beagle (a chondrodystrophoid breed) and greyhound (a non-chondrodystrophoid breed) intervertebral discs have been determined over the age range birth to 124 months. Discs were sampled at three spinal levels - lumbosacral, lumbar and thoracic regions. The beagle NP attains an average NP collagen content of 25% dry weight before 11 months of age, whereas the greyhound NP content is less than 5% collagen for most of its life. The NCP of the young greyhound disc is greater than that of the beagle of corresponding age. Plots of the ratio of collagen/NCP for discal regions at various ages highlight the large differences between the two breeds of dog. It is suggested that these differences in protein distribution are related to the elevated incidence of intervertebral disc prolapse in the beagle.

A sensitive method for the determination of chondroitin 4- and 6-sulphate is presented. After chondroitinase digestion of the chondroitin sulphate preparations, the obtained disaccharides are separated on a weak anion-exchange resin in a high-performance liquid chromatography system. The method was used to study 4-sulphate to 6-sulphate ratios in chondroitin sulphates prepared from bovine nasal cartilage and human nucleus pulposus. The results show clearly that these two preparations contain considerable amounts of both isomers.

Slices of the intervertebral disc swell rapidly in aqueous solutions. Following swelling, a large proportion of the proteoglycans leach out. These changes can introduce artifacts into in vitro experimental work. Swelling results from the large Gibbs-Donnan osmotic pressure of the proteoglycans which the collagen network of the disc is unable to oppose alone. Swelling can be prevented by applying pressure to disc slices either mechanically or with iso-osmotic solutions.

This study was undertaken to examine and quantitate the chemical injury and repair of the dog nucleus pulposus in collagenase-induced chemonucleolysis. Thirty three adult mongrel dogs were used into which the purified collagenase was injected at a rate of 200 units. The dogs were sacrificed after roentgenography. Disc specimens were stained primarily with safranin-O for microscopic study, and fresh tissues were used for electron microscopic study. For immunohistochemical analysis, paraffin sections were reacted with anti-bovine types I, II and III collagen antibodies. Two weeks after the injection, the height of the injected disc was reduced by about 50% and there was no sign of recovery for 52 weeks. There was a profound loss of safranin-O stainability in the nucleus pulposus, annulus fibrosus and cartilagenous endplate. By 8 weeks, regeneration of the nucleus pulposus began and chondrocytes appeared from the junctional area. The regenerated nucleus pulposus was stained well with safranin-O and consisting largely of type II collagen immunohistochemically. In the regenerated nucleus pulposus, collagen fibers and proteoglycans were reconstructed in a net-work with hyaluronic acids.

The chemical composition of the intervertebral disc of 9-month-old chondrodystrophoid and nonchondrodystrophoid dogs was studied for collagen, noncollagenous protein and glycosaminoglycan. Content of these substances differed significantly between breeds. The differences were most marked in the nucleus pulposus; the noncollagenous protein content of the nonchondrodystrophoid breed was higher than in that of the chondrodystrophoid dogs. The total nitrogen value of the nonchondrodystrophoid nuclei pulposi was less than that of the corresponding chondrodystrophoid discs mainly because of the high collagen content of the latter discs. Histochemically, it was found that the nuclei pulposi of the nonchondrodystrophoid breed contains larger amounts of glycosaminoglycan than in the discs of the chondrodystrophoid breeds.

To attempt to understand the etiology of failures of chemonucleolysis, biochemical analyses were performed on intervertebral disk material to determine if the enzyme had actually digested the nucleus pulposus proteoglycans. This information was then correlated with the clinical laboratory data to see if a pattern evolved for the failures. Nine chymopapain treated disks, 6 untreated herniated disks and 6 lumbar disks from scoliotic patients were obtained at surgery. The results indicated that 6 out of 9 patients treated with chymopapain had a marked reduction in the proteoglycan (hexosamine) content of their disk compared to the untreated controls. There was a significant inverse correlation of intrinsic lysosomal enzymes and hexosamine content in those cases where the chymopapain failed to destroy the proteoglycan. The other 3 patients, however, had hexosamine levels virtually identical to those disks not treated with chymopapain. The clinical evaluation, consisting of preoperative myelograms, diskograms, the surgeon's observations at laminectomy and evaluation of the postoperative regimen did not explain the failures. This study suggests that the chymopapain failures are not the result of inactivity of the enzyme or failure to digest the nuclear material in at least 6 of the 9 cases. However, there were 3 patients where either the enzyme was not reaching the nuclear material or it was inactive.

Human nucleus pulposus and annulus fibrosus, obtained at autopsy from patients 7-30 years of age, were extracted with 2 M guanidine-HCl (pH 5.82) to remove proteoglycans, then stirred with pepsin in 0.5 M acetic acid, followed by three 24-h extractions with 1 M NaCl (pH 7.5) and one 24-h extraction with 2 M KSCN (potassium thiocyanate) (pH 7.2). Pepsin and NaCl solubilized an average of about 30% of nucleus pulposus collagen and 18% of annulus fibrosus collagen. KSCN extracted a further 34% of nucleus pulposus collagen and only 4% of annulus fibrosus collagen. CM-cellulose chromatography of nucleus and annulus collagen purified from the pepsin, NaCl and KSCN supernatants consistently revealed only one peak, always appearing slightly ahead of the alpha1 position for rat tail tendon type I collagen. Polyacrylamide and SDS-gel electrophoresis consistently revealed only one band with the mobility of alpha1 chains. Amino acid composition of collagen from nucleus and annulus is comparable to those of mammalian and avian cartilage type II collagen, and distinctly different from those of rat tail tendonand guinea pig skin type I collagens. Periodate oxidation of nucleus and annulus collagens showed that 81% and 67%, respectively, of the hydroxylysine residues survive treatment, compared to 71% for bovine articular cartilage collagen and 17% for guinea pig skin collagen. Total hexose analysis revealed 1.8 muM and 2.0 muM hexose per muM periodate-stable hydroxylysine in nucleus and annulus collagens, respectively. Ion exchange chromatography showed the presence of glucose and galactose in a ratio of 0.92:1 in nucleas collagen and 1.07:1 in annulus collagen. Pepsin-solubilized, NaCl-extracted collagen from nucleus and annulus formed native-type fibrils in vitro. The banding patterns of ATP-induced segment-long-spacing precipitates of nucleus and annulus collagens were identical to each other and indistinguishable from those of cartilage (type II) collagen, but distinctly different from those of rat tail tendon (type I) collagen. These data suggest that the collagen which can be extracted after limited pepsin attack of human nucleus and annulus is of the form [alpha1 (II)]3.

Proteoglycans of 18 lumbar discs obtained at surgery for lumbar disc lesion were studied biochemically and immunologically (using monoclonal antibody that recognizes core protein of annulus fibrosus proteoglycans) and compared with the results of similar studies on discs obtained at autopsy and Zielke's operation for scoliosis. Disc proteoglycans showed a decrease in extraction and hexuronic acid/protein weight ratio with age in both surgical and post-mortem specimens. Although the molecular weight of proteoglycan monomer seemed to show a slight decrease, that of chondroitin sulfate chain showed no change with age in surgical discs. The proportion of proteoglycan aggregate showed a decrease with age until 40 years old, it went up thereafter because of the loss of proteoglycan monomers. This biochemical degeneration paralleled discogramic degeneration and monoclonal antibody that recognized core protein showed a strong affinity with severely degenerated discs. Besides aging, lumbar instability seemed to exert a profound influence on the progression of degeneration.

Proteoglycan was prepared from three pools of normal human intervertebral discs by extraction with buffered 4M-guanidinium chloride followed by CsCl-density-gradient ultracentrifugation. Chromatography on agarose (Bio-Gel A-150m) and on DEAE-cellulose suggested a single polydisperse proteoglycan species. The intrinsic viscosities of three preparations were 166, 122 and 168 ml/g. After degradation with 0.5M-KOH containing 0.02M-NaBH4, the glycosaminoglycans were recovered quantitatively and their Ca2+ salts separated into a hexuronate-rich fraction (fraction 1), which was precipitated in 0-45% (v/v) ethanol, and a hexose-rich fraction (fraction2), which was precipitated in 45-70% (v/v) ethanol. Qualitative and quantitative analyses of the glycosaminoglycans revealed fraction 1 to be chondroitin sulphate, and fraction 2 to be keratan sulphate; the latter was contaminated with protein and possibly a small amount of another glycosaminoglycan. For both glycosaminoglycans, plots of log(mol.wt.) against weight fell close to a normal distribution. The mode for chondroitin sulphate was close to 20000; that for keratan sulphate, 10000. A threefold range of molecular weight included the central 16-84% [+/- 1 S.D. of log(mol.wt.)] of the weight of both fractions.

The collagenolytic enzyme systems in the human, normal, and prolapsed intervertebral discs have been studied. Normal discs obtained postmortem contained a novel collagenase with specificity toward Type II collagen and gelatin but with little or no activity against Type I collagen. A method whereby enzymes are detected quantitatively in extracts of human tissue using specific substrates, without prior chromatographic separation of the enzymes, has been developed and used to study 14 normal discs and 35 surgically excised prolapsed discs. No differences were observed between annulus and nucleus extracts of normal discs either in the pattern of enzymes or the quantity. The intermediate zone between nucleus and annulus was excised and was not tested. Highly significant differences were observed between the enzyme patterns of the normal and prolapsed discs. The major collagenolytic activity of normal discs is against Type II collagen and 1 alpha 2 alpha 3 alpha collagen, there is little activity toward Type I collagen and virtually none toward elastin. Conversely, the prolapsed disc is more highly active against the substrates elastin and Type I collagen than against Type II collagen or 1 alpha 2 alpha 3 alpha collagen. The individual patterns of enzymes of the 35 prolapsed discs were virtually identical. Similarly there was little internal variation between the patterns of enzymes extracted from discs, obtained postmortem, which were apparently normal. The striking difference between the normal and prolapsed disc could be an important factor in the pathogenesis of disc prolapse.

Fibronectin stains were carried out and evaluated by microspectrophotometric techniques in annuli fibrosi of vertebral discs of sand rats (Psammomys obesus) of both sexes and two age groups, 13-18 months and over 2 years of age. The distribution of fibronectin in the annulus shows a centripetal gradient from the outer to the inner laminae. Fibronectin was significantly more abundant in the annuli of old than of young animals of corresponding sex. Sex differences were not significant. The dorsal segment contained more fibronectin than the ventral, but the difference was statistically significant only in the aged females. The outer laminae of the annuli appeared consistently higher in fibronectin content than the inner laminae.

The nucleus pulposus (NP) and annulus fibrosus (AF) of immature rabbit intervertebral discs (IVD) have been subjected to the dissociative extraction procedure of Sajdera and Hascall (1969). The soluble, insoluble and unextracted fractions so obtained were analysed for total nitrogen, collagen, tyrosine, uronic acid, hexosamine and sialic acid content. A high proportion of non-collagenous protein, hexose and sialic acid in the NP insoluble fraction suggests the presence of glycopeptides associated with collagen and/or proteoglycans. The levels of proteoglycan in the soluble NP and AF fraction are similar. Immature (soluble) collagen, however, resides largely in the AF region. The metabolism of rabbit IVD protein components was also investigated both chemically and by autoradiography. L-Tyrosine-3,5-H3 was administered intraperitoneally (3 mc/kg) to 4 week-old rabbits. Animals were sacrificed at various time intervals and the harvested tissues extracted as before and lumbar discs collected. The levels of L-Tyrosine-3,5-H3 in the NP and AF insoluble and soluble fractions were determined using a tritium scintillation counting procedure and localisation by autoradiography. Pronounced extracellular activity of proteoglycan and glycoprotein is not evident before 24 hours. Soluble collagen, however, is synthesized and dispersed within 4 hours of isotope administration.

The link proteins of the human intervertebral disc were studied in tissue extracts by sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS/PAGE), followed by immunoblotting, using a specific monoclonal antibody. Three link proteins were detected, corresponding in electrophoretic mobility to those present in articular cartilage. As with articular cartilage, the largest link protein predominates in the young, whereas in the adult the smallest link protein is equally abundant and internal fragmentation of the link proteins occurs. Only in the newborn is the quantity of extractable link protein comparable to that from articular cartilage. In the adult, the disc contains much less link protein than is present in autologous articular cartilage. Neither the amount nor heterogeneity of the link protein differs among different levels within the lumbar spine, although the proportions of the three proteins can differ between the anulus fibrosus and nucleus pulposus. The anulus always contained more extractable link protein relative to tissue wet weight than the nucleus, and the nuclear link protein, at least in adolescents, contained a greater proportion of the smallest link protein. Such changes in the quantity and structure of the disc link proteins may affect the properties of the proteoglycan aggregates and, thus, could influence disc function.

A patient with erosive peripheral arthritis in whom vasculitis and monoclonal IgG kappa paraprotein were associated with sacroiliitis and widespread destruction of intervertebral discs is reported. Crystals resembling apatite were identified in intervertebral disc material, and we postulate that the discitis was accelerated by apatite deposition. Our case illustrates a unique example of axial involvement in rapidly progressive joint disease.