Duhuo Jisheng Decoction ameliorates experimental intervertebral disc degeneration by modulating immune-inflammatory responses through regulation of macrophage polarization

Background: The predominant cause of lower back pain (LBP) is intervertebral disc degeneration (IVDD), which has a substantial financial cost to both individuals and society. In the pathophysiology of IVDD, the immune-inflammatory response is crucial. The number of macrophages in the nucleus pulposus (NP) was positively correlated with the degree of IVDD. The extracellular matrix (ECM) disintegration, pyroptosis, and apoptosis of nucleus pulposus cells (NPCs) have all been demonstrated to have a significant impact on IVDD and are closely linked to immune-inflammatory regulation. Meanwhile, we have shown that Duhuo Jisheng Decoction (DHJSD), which modulates the aforementioned pathways, can significantly alleviate IVDD. It's unclear, nevertheless, if DHJSD can lessen IVDD by regulating macrophage modulation of the immune-inflammatory response. Methods: experiments were performed to investigate the mechanism of action of DHJSD in ameliorating IVDD by regulating macrophages. Results: experiments showed that DHJSD was able to modulate macrophage polarization to regulate the immune-inflammatory response. Conclusion: We discovered that IVDD may be lessened by DHJSD by boosting M2 macrophage polarization and suppressing M1 macrophage polarization. IVDD responded better to DHJSD treatment in the intermediate and advanced stages of the disease.