title: Demographic factors that influence human disc cell proliferation in vitro.
abstract: BACKGROUND
  Although previous work has shown that greater age, greater disc degeneration, female gender, and surgical derivation of disc tissue had deleterious effects on cell proliferative potential, relatively little is known about the association between disc cell proliferation in vitro and clinical donor characteristics.
  
  
  OBJECTIVE
  To identify the relationships between donor characteristic and the in vitro proliferative potential of human disc cells from the annulus.
  
  
  METHODS
  Studies were approved by the human subjects Institutional Review Board. Donor data included donor source, ethnicity, age, gender, smoking history, height, weight, number of years of back pain, and Thompson score. Cells cultured from the annulus were tested for proliferation.
  
  
  METHODS
  There were two study populations: 1) Comparison Group (32 control donors and 33 control surgical subjects; 60 Caucasians, 5 African-Americans). Cell proliferation, age, Thompson score, height, weight, and smoking history were statistically analyzed for control donors versus control surgical group. No significant differences were present, and these two groups were pooled to form the Comparison Group. 2) Nineteen subjects from the United Arab Emirates who underwent disc surgery.
  
  
  METHODS
  Linear models were fit to the data to determine the best prediction of cell proliferation as the outcome variable; multiple R-squared was used to determine model goodness of fit.
  
  
  METHODS
  Control donor specimens were obtained from the National Cancer Institute Cooperative Human Tissue Network, and control donor surgical specimens from disc surgeries. A standardized cell proliferation assay was used to evaluate monolayer and three-dimensional agarose cell proliferation. Data were expressed as mean cpm[(3)H]-thymidine per microgram deoxyribonucleic acid+/-SEM. Standard statistical methods used the SAS system for data analysis.
  
  
  RESULTS
  No differences were present in the Comparison Group versus the Middle Eastern group for mean Thompson score (both averaged grade III), mean age (44.3 vs. 43.0 years, respectively), gender, height, weight, length of time with back pain (1.9 years vs. 2.1 years respectively), or smoking history. Three-dimensional proliferation in agarose was not significantly different for the two groups. Monolayer proliferation, however, was significantly different (17,434+/-2,929 vs. 6,693+/-2,103, respectively), p=.019. Linear regression models were fit to the data to determine the best prediction using proliferation as the outcome variable. In the Middle Eastern group, monolayer cell proliferation bore a significant negative correlation to age (p=.02, r=-.32), whereas the Comparison Group showed no such relationship. The following equation was derived to fit these data: Log(10) of proliferation (cpm/mug deoxyribonucleic acid)=10.915-0.7919 (Middle Eastern ethnicity)-0.0296 (Age). The r(2) for this equation is 0.203 (ie, 20.3% of the change in proliferation is explained by age and Middle Eastern ethnicity). Middle Eastern ethnicity and age were significant in this equation (p=.04 and .0003, respectively).
  
  
  CONCLUSIONS
  Studies have shown that familial history, age, and smoking are important risk factors for disc degeneration in Arabic pedigrees. It is interesting that our present findings also point to age and familial history as important significant factors influencing monolayer proliferation. Further research is needed to identify the cellular basis for this influence on cellular proliferative capacity.
authors.affiliation: Department of Orthopaedic Surgery, Carolinas Medical Center, 1000 Blyth Boulevard, Charlotte, NC 28232, USA. helen.gruber@carolinashealthcare.org
authors.forename: Helen E
authors.initials: HE
authors.lastname: Gruber
authors.forename: Kelly
authors.initials: K
authors.lastname: Leslie
authors.forename: H James
authors.initials: HJ
authors.lastname: Norton
authors.forename: Daniel
authors.initials: D
authors.lastname: Heiner
authors.forename: Josh
authors.initials: J
authors.lastname: Patt
authors.forename: Edward N
authors.initials: EN
authors.lastname: Hanley
mesh_terms: D000328:Adult; D000367:Age Factors; D044383:Black People / Q000208:ethnology*; D049109:Cell Proliferation; D002478:Cells, Cultured; D002574:Cervical Vertebrae / Q000473:pathology; D003710:Demography; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000473:pathology; D016014:Linear Models; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008877:Middle East / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D012737:Sex Factors; D014019:Tissue Donors / Q000145:classification*; D044465:White People / Q000208:ethnology*; D001741:Black or African American