European Spine Journal

, Volume 23, Supplement 3, pp 344–353 | Cite as

Biochemical composition and turnover of the extracellular matrix of the normal and degenerate intervertebral disc

  • Sarit Sara SivanEmail author
  • Anthony J. Hayes
  • Ellen Wachtel
  • Bruce Caterson
  • Yulia Merkher
  • Alice Maroudas
  • Sharon Brown
  • Sally Roberts
Review article



The intervertebral disc (IVD) is a complex cartilaginous structure which functions to resist biomechanical loads during spinal movement. It consists of the highly viscous cartilaginous nucleus pulposus, which is surrounded laterally by a thick outer ring of fibrous cartilage—the annulus fibrosus—and sandwiched inferiorly and superiorly by the cartilage end-plates. The main extracellular matrix molecules of the disc are collagens, proteoglycans, glycoproteins and elastin. The disc also contains appreciable amounts of water, matrix-degrading protease enzymes and their inhibitors, soluble signalling molecules and various metabolic breakdown products.


This review provides a comprehensive description of the biochemical composition of the extracellular matrix of the IVD and, specifically, the proteases involved in its molecular turnover. Quantitation of the turnover rates using racemization of aspartic acid as a molecular clock is also discussed.


Molecular turnover rates of the major constituent matrix macromolecules of the IVD are found to be particularly slow, especially in the case of collagen. Over a normal human life span, this slow turnover may compromise the structural integrity of the IVD extracellular matrix essential for normal physiological functioning.


Intervertebral disc Turnover of extracellular matrix Collagen Elastin Proteoglycans Matrix metalloproteinases Aspartic acid racemization 



Authors would like to thank Dr. Michelle Kumin for her help and suggestions in writing this article. They are grateful to EA Kerr and J Menage for help in preparation of the manuscript. The research leading to these results has received funding from the European Community’s Seventh Framework Programme (FP7, 2007–2013) under grant agreement no. HEALTH-F2-2008-201626 (Genodisc) and FP7-People-2007-2-2-ERG (grant agreement 224834). A.M.S.S. and Y.M acknowledge support from the Charles W. McCutchen Foundation.

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Sarit Sara Sivan
    • 1
    Email author
  • Anthony J. Hayes
    • 2
  • Ellen Wachtel
    • 3
  • Bruce Caterson
    • 2
  • Yulia Merkher
    • 1
  • Alice Maroudas
    • 1
  • Sharon Brown
    • 4
  • Sally Roberts
    • 4
  1. 1.Department of Biomedical EngineeringTechnion, Israel Institute of TechnologyHaifaIsrael
  2. 2.School of BiosciencesCardiff UniversityCardiffWales, UK
  3. 3.Faculty of ChemistryWeizmann Institute of ScienceRehovotIsrael
  4. 4.Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust and ISTMKeele UniversityShropshireUK

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