Repetitive in vivo manual loading of the spine elicits cellular responses in porcine annuli fibrosi

Back pain and intervertebral disc degeneration are prevalent, costly, and widely treated by manual therapies, yet the underlying causes of these diseases are indeterminate as are the scientific bases for such treatments. The present studies characterize the effects of repetitive in vivo manual loads on porcine intervertebral disc using RNA deep sequencing. A single session of repetitive manual loading applied to the lumbar spine induced both up- and down-regulation of a variety of genes transcribed by cells in the ventral annuli fibrosi. The effect of manual therapy at the level of loading was greater than at a level distant to the applied load. Gene ontology and molecular pathway analyses categorized biological, molecular, and cellular functions influenced by repetitive manual loading, with over-representation of membrane, transmembrane, and pericellular activities. The present studies support previous findings of intervertebral disc cell mechanotransduction, and are the first to report comprehensively on the repertoire of gene targets influenced by mechanical loads associated with manual therapy interventions. The present study defines the cellular response of repeated, low-amplitude loads on the annuli fibrosi and lays the foundation for future work defining how the intervertebral disc responds to single or low-frequency manual loads typical of those applied clinically. Overall design: Examination of a single session of repetitive manual loading applied to the lumbar spine on the ventral annulus fibrosus Raw data were not provided for GSM5077456, GSM5077457 or GSM5077459.