Back pain: Ccn2a protein reversed Intervertebral disc (IVD) degeneration in animal model

In a recent in-vivo study on Zebrafish, researchers successfully induced disc regeneration in a degenerated disc by activating an endogenous Ccn2a-FGFR1-SHH signalling cascade. This suggests that Ccn2a protein could be exploited in promotion of IVD regeneration for treatment of backpain.  

Back pain is a common health problem. It is one of the most common reasons for people to seek appointment with doctors. The condition is mainly due to degeneration of intervertebral disc (IVD) which occurs naturally due to wear and tear or ageing. Analgesics and anti-inflammatories along with physiotherapy are currently used to treat the symptoms. In severe cases, disc replacement or disc fusion surgery may be resorted. As such, there is no cure. No known medical treatment or procedure is helpful in restoring disc homeostasis. The solution to the problem lies in finding a way to supress the disc degeneration and/or to induce disc regeneration.  

In an in-vivo study on Zebrafish, reported on 6th January 2023, the researchers discovered that Cellular communication network factor 2a (Ccn2a), a protein secreted by the cells of the intervertebral disc induces disc regeneration in old degenerated discs by promoting cell proliferation and cell survival by modulation of the FGFR1-SHH (Fibroblast growth factor receptor-Sonic Hedgehog) pathway.  

Apparently, this is for the first time that disc regeneration in a degenerated disc has been induced in vivo by activating an endogenous signalling cascade.  

This development may be a steppingstone towards designing a novel strategy to suppress disc degeneration or induce disc regeneration in degenerated human discs.  



Rayrikar A.Y., et al 2023. Ccn2a-FGFR1-SHH signaling is necessary for intervertebral disc homeostasis and regeneration in adult zebrafish. Development. Volume 150, Issue 1. Published 06 January 2023. DOI: 


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