Emerging evidence shows that
obesity and
type 2 diabetes (T2D) are associated with
intervertebral disc degeneration (IDD). However, the underlying mechanisms are still obscure. Here, we found that serum
glucose concentrations were significantly increased in T2D-IDD patients. Detection of molecular changes indicated that two
glucose transporters (GLUTs), including GLUT1 and GLUT4, were hyperactivated in these IDD patients with
obesity. Using a microarray assay to detect the dysregulated genes in IDD patients with
obesity, we identified 33 differentially expressed genes and verified only two proapoptotic genes, including Puma (p53 upregulated modulator of apoptosis) and BAX (BCL2 associated X) responded to
glucose. The mechanistic investigation revealed that
carbohydrate-responsive
element-
binding protein (ChREBP) coupled with the
histone acetyltransferase p300 to bind to the promoter of Puma and BAX genes and activated their expression in the condition of high
glucose. The accumulation of Puma and BAX triggered
mitochondrial dysfunction and
caspase activation, resulting in apoptosis. Moreover, we found that
glucose could accelerate the occurrence of IDD in a rat model. Interestingly, we administrated two GLUT inhibitors (BAY-876 and
Fasentin) in rats injected
glucose and found that these two inhibitors could reverse the defects of IDD by decreasing apoptosis. Our in vitro and in vivo data support a model in which high
glucose activates the ChREBP/p300 transcriptional complex to bind to the promoters of Puma and BAX, causing apoptosis and IDD pathogenesis. Our discovery suggests that the control of
glucose absorption in T2D-IDD patients may decrease the outcome of IDD.