Medicine and Health Sciences Commons^™

Jefferson Digital Commons Quarterly Report: October-December 2014, Daniel G. Kipnis, Msi, Kelsey Duinkerken, Msi

Jefferson Digital Commons Reports

This Jefferson Digital Commons quarterly report will cover the following:

• Assorted statistics
• New assets added to the JDC
• Historical Materials
• What people are saying about the JDC

Classification Of Current Anticancer Immunotherapies., Lorenzo Galluzzi, Erika Vacchelli, José-Manuel Bravo-San Pedro, Aitziber Buqué, Laura Senovilla, Elisa Elena Baracco, Norma Bloy, Francesca Castoldi, Jean-Pierre Abastado, Patrizia Agostinis, Ron N Apte, Fernando Aranda, Maha Ayyoub, Philipp Beckhove, Jean-Yves Blay, Laura Bracci, Anne Caignard, Chiara Castelli, Federica Cavallo, Estaban Celis, Vincenzo Cerundolo, Aled Clayton, Mario P Colombo, Lisa Coussens, Madhav V Dhodapkar, Alexander M Eggermont, Douglas T Fearon, Wolf H Fridman, Jitka Fučíková, Dmitry I Gabrilovich, Jérôme Galon, Abhishek Garg, François Ghiringhelli, Giuseppe Giaccone, Eli Gilboa, Sacha Gnjatic, Axel Hoos, Anne Hosmalin, Dirk Jäger, Pawel Kalinski, Klas Kärre, Oliver Kepp, Rolf Kiessling, John M Kirkwood, Eva Klein, Alexander Knuth, Claire E Lewis, Roland Liblau, Michael T Lotze, Enrico Lugli, Jean-Pierre Mach, Fabrizio Mattei, Domenico Mavilio, Ignacio Melero, Cornelis J Melief, Elizabeth A Mittendorf, Lorenzo Moretta, Adekunke Odunsi, Hideho Okada, Anna Karolina Palucka, Marcus E Peter, Kenneth J Pienta, Angel Porgador, George C Prendergast, Gabriel A Rabinovich, Nicholas P Restifo, Naiyer Rizvi, Catherine Sautès-Fridman, Hans Schreiber, Barbara Seliger, Hiroshi Shiku, Bruno Silva-Santos, Mark J Smyth, Daniel E Speiser, Radek Spisek, Pramod K Srivastava, James E Talmadge, Eric Tartour, Sjoerd H Van Der Burg, Benoît J Van Den Eynde, Richard Vile, Hermann Wagner, Jeffrey S Weber, Theresa L Whiteside, Jedd D Wolchok, Laurence Zitvogel, Weiping Zou, Guido Kroemer

Kimmel Cancer Center Faculty Papers

During the past decades, anticancer immunotherapy has evolved from a promising therapeutic option to a robust clinical reality. Many immunotherapeutic regimens are now approved by the US Food and Drug Administration and the European Medicines Agency for use in cancer patients, and many others are being investigated as standalone therapeutic interventions or combined with conventional treatments in clinical studies. Immunotherapies may be subdivided into "passive" and "active" based on their ability to engage the host immune system against cancer. Since the anticancer activity of most passive immunotherapeutics (including tumor-targeting monoclonal antibodies) also relies on the host immune system, this classification …

Download Entire Issue- Jefferson Interprofessional Education And Care Newsletter, Fall, 2014, Volume 5, Issue 2

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Download entire issue- Jefferson Interprofessional Education and Care Newsletter, Fall, 2014, Volume 5, Issue 2

Jefferson Teamwork Observation Guide (Jtog): A Pilot Project, David George, Md, Elizabeth Speakman, Edd, Rn, Anef, Fnap, Kellie Smith, Edd, Rn, Kevin Lyons, Phd, Carolyn Giordano, Phd

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

The critical need for students to learn to be effective members of interprofessional teams in preparation for collaborative practice-ready care provision now and in the future has been well documented1. There are increasing opportunities for students to observe interprofessional events to assist them in doing so, but often their role is passive and the teams may not demonstrate the highest level of patient-centered care, minimizing the student learning.

Developing An Open Educational Resource For Interprofessional Education (Ipe), Susanne P. Boyle, Bsc, Msc, Phd, Fhea, Matthew Ramirez, Lynn Sheridan

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

A recent review of pre-qualifying interprofessional education in the UK reported the practical challenges of synchronising interprofessional education1. Whilst it was noted that online interprofessional courses were developed primarily to overcome timetabling conflicts of students and clinicians from various health professions, it was recognised that a blended learning approach with appropriate student support could enable an effective interprofessional education experience with lower running costs and reduced disruption. It was found, however, that despite the ubiquity of e-learning in interprofessional education there seemed to be less sharing than expected1.

Ipe Grand Rounds: A Student-Led Initiative, Claire Sokas, Chelsea Gorman

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Interprofessional Education (IPE) Grand Rounds is an innovative student-run initiative designed specifically to increase the clinical relevance of IPE for all health professions students. By creating new opportunities for students from medicine, nursing, physical therapy, occupational therapy, couple and family therapy, physician assistant and pharmacy to interact with health professionals who are actively participating in interprofessional work environments, the IPE Grand Rounds program allows students to develop a more complete picture of what it means to be a member of a collaborative practice team. During these sessions, students and panelists discuss both the benefits of working with team members from …

Successful Implementation Of The Abcdef Bundle In The Micu Through Interprofessional Collaboration And Teamwork, Julie Rogan, Rn, Msn, Accns-Ag, Aocns, Ccrn, Steven W. Gudowski, Rrt, Cara Mcdaniel, Pharmd, Bcps

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Earlier this year, members of the medical intensive care unit (MICU) attended an interprofessional workshop that utilized Awakening/Breathing/Choice of Sedation/Delirium/Early Mobility (ABCDE) bundle simulation combined with TeamSTEPPS training to empower care givers to advocate for patient safety while optimizing patient care. The ABCDE bundle is an evidence-based tool designed to implement pain, agitation, and delirium guideline recommendations into routine practice. To further improve patient safety and outcomes and build upon the ABCDE concept, the MICU team developed an interprofession-al practice project by adding routine assessment of need for indwelling Foley catheters to their daily work list, creating the “ABCDEF” bundle.

From The Editors, Elizabeth Speakman, Edd, Rn, Anef, Fnap, Christine Arenson, Md, Lauren Collins, Md, Shoshana Sicks, Edm

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Welcome to the Fall 2014 edition of the Jefferson Interprofessional Education and Care Newsletter. It has been a busy Fall at Jefferson and we are excited to share several new developments which have been pushing the envelope in IPE. In October, we hosted our 4th biennial conference, Interprofessional Care for the 21st Century: Redefining Education and Practice. This year we had a record number of conference participants and presenters joining us from a variety of national and international academic and service organizations. Our keynote speakers, Dr. George Thibault, President, Josiah Macy Jr Foundation; Dr. Barbara Brandt, Director, National Center for …

Oligomerization, Conformational Stability And Thermal Unfolding Of Harpin, Hrpzpss And Its Hypersensitive Response-Inducing C-Terminal Fragment, C-214-Hrpzpss., Pradip K Tarafdar, Lakshmi Vasudev Vedantam, Rajeshwer S Sankhala, Pallinti Purushotham, Appa Rao Podile, Musti J Swamy

Department of Biochemistry and Molecular Biology Faculty Papers

HrpZ-a harpin from Pseudomonas syringae-is a highly thermostable protein that exhibits multifunctional abilities e.g., it elicits hypersensitive response (HR), enhances plant growth, acts as a virulence factor, and forms pores in plant plasma membranes as well as artificial membranes. However, the molecular mechanism of its biological activity and high thermal stability remained poorly understood. HR inducing abilities of non-overlapping short deletion mutants of harpins put further constraints on the ability to establish structure-activity relationships. We characterized HrpZPss from Pseudomonas syringae pv. syringae and its HR inducing C-terminal fragment with 214 amino acids (C-214-HrpZPss) using calorimetric, spectroscopic and microscopic approaches. Both …

Primary Care In Geriatrics: Context, Opportunities, And Resources For Occupational Therapy, Catherine V. Piersol, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Learning Objectives:

1. Discuss health care delivery trends and system changes that offer opportunities for occupational therapy in primary care for older adults in the community.

2. Describe the contributions of occupational therapy on the interprofessional primary care team.

3. Utilize current resources and evidence that support the role of occupational therapy in geriatric primary care.

Agenda:

1. Overview of primary care.

2. Health trends and reform initiatives that open doors for occupational therapy.

3. Opportunities (and barriers) for occupational therapy in primary care

4. Current NIH funded study testing a primary care occupational therapy intervention.

5. Resources and Discussion. …

Kallikrein Family Proteases Klk6 And Klk7 Are Potential Early Detection And Diagnostic Biomarkers For Serous And Papillary Serous Ovarian Cancer Subtypes., Ayala Tamir, Ushma Jag, Sreeja Sarojini, Craig Schindewolf, Takemi Tanaka, Rajendra Gharbaran, Hiren Patel, Anil Sood, Wei Hu, Ruzeen Patwa, Patrick Blake, Polina Chirina, Jin Oh Jeong, Heejin Lim, Andre Goy, Andrew Pecora, K Stephen Suh

Department of Medicine Faculty Papers

BACKGROUND: Early detection of ovarian cancer remains a challenge due to widespread metastases and a lack of biomarkers for early-stage disease. This study was conducted to identify relevant biomarkers for both laparoscopic and serum diagnostics in ovarian cancer.

METHODS: Bioinformatics analysis and expression screening in ovarian cancer cell lines were employed. Selected biomarkers were further validated in bio-specimens of diverse cancer types and ovarian cancer subtypes. For non-invasive detection, biomarker proteins were evaluated in serum samples from ovarian cancer patients.

RESULTS: Two kallikrein (KLK) serine protease family members (KLK6 and KLK7) were found to be significantly overexpressed relative to normal …

Toward An Improved Understanding Of The Ionizing Radiation Induced Dna Damage/Response Networks In Human Malignancies., Daphne A Haas-Kogan, David R Raleigh, Adam Paul Dicker

Department of Radiation Oncology Faculty Papers

No abstract provided.

Alternative Approaches To Lung Insults, Melpo Christofidou-Solomidou, Ph.D.

Division of Pulmonary and Critical Care Medicine Presentations and Grand Rounds

Objectives:

• Provide an understanding of current available botanical agents and their usefulness in lung disease;

• Provide an overview of current complementary approaches to lung disease and active areas of research in pre-clinical testing;

Overall Goals and Objectives:

Following this activity, a participant should be able to:

1. Recognize recent advances and developments in Pulmonary Medicine & Critical Care and translate into clinical practice

2. Integrate perspectives of multiple disciplines into decision-making on behalf of patients through structured plans for patient care.

3. Develop areas for future research and discuss appropriate methods to address these needs.

4. Summarize and continually …

Plumbing And Wiring: Atherosclerosis In Epilepsy., Scott Mintzer, Md

Department of Neurology Faculty Papers

Over the long term, epilepsy is clearly associated with cognitive impairment. This has been demonstrated functionally, using neuropsychological testing, and reinforced by structural studies showing progressive atrophy in patients with chronic epilepsy ^1-3. The prevailing explanation for this, of course, has been the direct and cumulative effects of seizures on the brain. The basic science literature is chock full of studies showing impairment of neuronal function after seizures, both acutely and chronically. And for those of us who see patients, the progressive memory complaints and clear-cut decline in function seen in those with drug-resistant epilepsy — particularly temporal lobe …

Pediatric Emergency Medical Care In Yerevan, Armenia: A Knowledge And Attitudes Survey Of Out-Of-Hospital Emergency Physicians., Aline A. Baghdassarian, Ross I. Donaldson, Andrew D Depiero, Nancy L Chernett, Harsh P. Sule Md

Department of Emergency Medicine Faculty Papers

BACKGROUND: Out-of-hospital emergency care is at an early stage of development in Armenia, with the current emergency medical services (EMS) system having emergency physicians (EPs) work on ambulances along with nurses. While efforts are underway by the Ministry of Health and other organizations to reform the EMS system, little data exists on the status of pediatric emergency care (PEC) in the country. We designed this study to evaluate the knowledge and attitudes of out-of-hospital emergency physicians in pediatric rapid assessment and resuscitation, and identify areas for PEC improvement.

METHODS: We distributed an anonymous, self-administered Knowledge and Attitudes survey to a …

2014 Jcipe Conference, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

The internationally-renowned Jefferson Center for Interprofessional Education (JCIPE) hosted a conference, Interprofessional Care for the 21st Century: Redefining Education and Practice, in Philadelphia on October 10-12, 2014. Conference presentations and posters have been loaded in the Jefferson Digital Commons.

Hormone-Induced Calcium Oscillations Depend On Cross-Coupling With Inositol 1,4,5-Trisphosphate Oscillations., Lawrence D Gaspers, Paula J Bartlett, Antonio Politi, Paul Burnett, Walson Metzger, Jane Johnston, Suresh K Joseph, Thomas Höfer, Andrew P Thomas

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Receptor-mediated oscillations in cytosolic Ca(2+) concentration ([Ca(2+)]i) could originate either directly from an autonomous Ca(2+) feedback oscillator at the inositol 1,4,5-trisphosphate (IP3) receptor or as a secondary consequence of IP3 oscillations driven by Ca(2+) feedback on IP3 metabolism. It is challenging to discriminate these alternatives, because IP3 fluctuations could drive Ca(2+) oscillations or could just be a secondary response to the [Ca(2+)]i spikes. To investigate this problem, we constructed a recombinant IP3 buffer using type-I IP3 receptor ligand-binding domain fused to GFP (GFP-LBD), which buffers IP3 in the physiological range. This IP3 buffer slows hormone-induced [IP3] dynamics without changing steady-state …

Predicting Invasiveness In Early Stage Lung Cancer, Julie Linek, Md

Division of Pulmonary and Critical Care Medicine Presentations and Grand Rounds

Objectives:

To discuss characteristic pathologic and radiologic correlates of tumor invasiveness in lung adenocarcinoma and their associated clinical implications.

To describe current advances in cancer biology related to the acquisition of tumor invasion and metastasis.

To identify areas for further research which have clinical impact for prognostication and treatment of early stage lung cancer.

Overall Goals and Objectives:

Following this activity, a participant should be able to:

1. Recognize recent advances and developments in Pulmonary Medicine & Critical Care and translate into clinical practice

2. Integrate perspectives of multiple disciplines into decision-making on behalf of patients through structured plans …

Camk2n1 Inhibits Prostate Cancer Progression Through Androgen Receptor-Dependent Signaling., Tao Wang, Shuiming Guo, Zhuo Liu, Licheng Wu, Mingchao Li, Jun Yang, Ruibao Chen, Xiaming Liu, Hua Xu, Shaoxin Cai, Hui Chen, Weiyong Li, Shaohua Xu, Liang Wang, Zhiquan Hu, Qianyuan Zhuang, Liping Wang, Kongming Wu, Jihong Liu, Zhangqun Ye, Jun-Yuan Ji, Chenguang Wang, Ke Chen

Department of Cancer Biology Faculty Papers

Castration resistance is a major obstacle to hormonal therapy for prostate cancer patients. Although androgen independence of prostate cancer growth is a known contributing factor to endocrine resistance, the mechanism of androgen receptor deregulation in endocrine resistance is still poorly understood. Herein, the CAMK2N1 was shown to contribute to the human prostate cancer cell growth and survival through AR-dependent signaling. Reduced expression of CAMK2N1 was correlated to recurrence-free survival of prostate cancer patients with high levels of AR expression in their tumor. CAMK2N1 and AR signaling form an auto-regulatory negative feedback loop: CAMK2N1 expression was down-regulated by AR activation; while …

The Induction Of The P53 Tumor Suppressor Protein Bridges The Apoptotic And Autophagic Signaling Pathways To Regulate Cell Death In Prostate Cancer Cells., Lymor Ringer, Paul Sirajuddin, Lucas Tricoli, Sarah Waye, Muhammad Umer Choudhry, Erika Parasido, Angiela Sivakumar, Mary Heckler, Aisha Naeem, Iman Abdelgawad, Xuefeng Liu, Adam S Feldman, Richard J Lee, Chin-Lee Wu, Venkata Yenugonda, Bhaskar Kallakury, Anatoly Dritschilo, John Lynch, Richard Schlegel, Olga Rodriguez, Richard Pestell, Maria Laura Avantaggiati, Chris Albanese

Kimmel Cancer Center Faculty Papers

The p53 tumor suppressor protein plays a crucial role in influencing cell fate decisions in response to cellular stress. As p53 elicits cell cycle arrest, senescence or apoptosis, the integrity of the p53 pathway is considered a key determinant of anti-tumor responses. p53 can also promote autophagy, however the role of p53-dependent autophagy in chemosensitivity is poorly understood. VMY-1-103 (VMY), a dansylated analog of purvalanol B, displays rapid and potent anti-tumor activities, however the pathways by which VMY works are not fully defined. Using established prostate cancer cell lines and novel conditionally reprogrammed cells (CRCs) derived from prostate cancer patients; …

The Future Of Population-Based Reimbursement, David Chin, Md, Mba

College of Population Health Forum

David C. Chin, MD, MBA is a Distinguished Scholar at the Johns Hopkins Bloomberg School of Public Health and Johns Hopkins School of Medicine, where he focuses on novel industry/academic research partnerships and preparing health systems and academic medical centers for success under accountable care.

Dr. Chin will describe the Maryland-All payer system as a model of innovative population-based reimbursement. He will discuss early adaptive strategies, including ways in which health care systems will need to change. Dr. Chin will also provide a comparison of the new incentives in the model vs. fee-for-service.

Prior to joining Hopkins Dr. Chin has …

A Plausible Mechanism, Based Upon Short-Root Movement, For Regulating The Number Of Cortex Cell Layers In Roots., Shuang Wu, Chin-Mei Lee, Tomomi Hayashi, Simara Price, Fanchon Divol, Sophia Henry, Germain Pauluzzi, Christophe Perin, Kimberly L Gallagher

Department of Bioscience Technologies Faculty Papers

Formation of specialized cells and tissues at defined times and in specific positions is essential for the development of multicellular organisms. Often this developmental precision is achieved through intercellular signaling networks, which establish patterns of differential gene expression and ultimately the specification of distinct cell fates. Here we address the question of how the SHORT-ROOT (SHR) proteins from Arabidopsis thaliana (AtSHR), Brachypodium distachyon (BdSHR), and Oryza sativa (OsSHR1 and OsSHR2) function in patterning the root ground tissue. We find that all of the SHR proteins function as mobile signals in A. thaliana and all of the SHR homologs physically interact …

Ido2 In Immunomodulation And Autoimmune Disease., George C Prendergast, Richard Metz, Alexander J Muller, Lauren M F Merlo, Laura Mandik-Nayak

Department of Microbiology and Immunology Faculty Papers

IDO2 is a relative of IDO1 implicated in tryptophan catabolism and immune modulation but its specific contributions to normal physiology and pathophysiology are not known. Evolutionary genetic studies suggest that IDO2 has a unique function ancestral to IDO1. In mice, IDO2 gene deletion does not appreciably affect embryonic development or hematopoiesis, but it leads to defects in allergic or autoimmune responses and in the ability of IDO1 to influence the generation of T regulatory cells. Gene expression studies indicate that IDO2 is a basally and more narrowly expressed gene than IDO1 and that IDO2 is uniquely regulated by AhR, which …

New Posters Added To The Jefferson Digital Commons, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

15 new posters have been deposited in the Jefferson Digital Commons

Mouse Hepatitis Virus Infection Upregulates Genes Involved In Innate Immune Responses., Dhriti Chatterjee, Sankar Addya, Reas S Khan, Lawrence C. Kenyon, Alexander Choe, Randall J Cohrs, Kenneth S Shindler, Jayasri Das Sarma

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Neurotropic recombinant strain of Mouse Hepatitis Virus, RSA59, induces meningo-encephalitis, myelitis and demyelination following intracranial inoculation. RSA59 induced neuropathology is partially caused by activation of CNS resident microglia, as demonstrated by changes in cellular morphology and increased expression of a microglia/macrophage specific calcium ion binding factor, Iba1. Affymetrix Microarray analysis for mRNA expression data reveals expression of inflammatory mediators that are known to be released by activated microglia. Microglia-specific cell surface molecules, including CD11b, CD74, CD52 and CD68, are significantly upregulated in contrast to CD4, CD8 and CD19. Protein analysis of spinal cord extracts taken from mice 6 days post-inoculation, …

Screen Time Overtime: Should A “Screen Time Diet” Be Part Of Healthy Everyday Activities And Routines For Families And Their Young Children?, Sarah Jamieson, Ots, Mary Muhlenhaupt, Otd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

Introduction:

Though television is still the primary form of media for children, almost one-third of TV programming is accessed through smart phones, tablets, and computers (Strasburger et al., 2013).

•Families do not adhere to AAP’s guidelines (Brown, 2011)

•Research suggests detrimental effect on young children

OT’s are an integral resource to help families design healthy recreational “screen time diets.”

Bronchial Thermoplasty – Principles And Controversies, David Manoff, Md

Division of Pulmonary and Critical Care Medicine Presentations and Grand Rounds

Objectives:

1) Learn the indications and contraindications to bronchial thermoplasty.

2) Develop a basic understanding of the controversies about, and the barriers to, the use of thermoplasty.

3) Understand the peri-procedural care and follow-up of patients who receive bronchial thermoplasty.

No Audio. PowerPoint slides only.

Management Of Head And Neck Pseudoaneurysms: A Review Of 33 Consecutive Cases., Eliza Anderson, Nohra Chalouhi, Md, Aaron Dumont, Stavropoula Tjoumakaris, Mario Zanaty, Robert H. Rosenwasswer Md, Robert M Starke, Pascal Jabbour Md

Department of Neurosurgery Faculty Papers

Background. Endosaccular coiling, vessel occlusion, stenting, stent-assisted coiling, and flow diversion are all endovascular treatment options for pseudoaneurysms (PAs) of the head and neck. We explore different clinical situations in which these were selected for PA management at a single institution. Methods. Over a period of ten years, 33 patients presented to our hospital with PAs of the head and neck. Their outcomes and procedural complications are discussed. Results. We observed a complication rate of 18.2% (6 of 33), consisting predominantly of infarcts following vessel occlusion. As measured by the modified Rankin Scale, 25 (75.8%) patients had achieved favorable outcomes …

Predictors Of Infections Following Cranioplasty: A Retrospective Review Of A Large Single Center Study., Mario Zanaty, Nohra Chalouhi, Md, Robert M Starke, Rohan Chitale, Md, Shannon Hann, Md, Cory D Bovenzi, Mark P Saigh, Eric W Schwartz, Emily S I Kunkel, Alexandra S Efthimiadis-Budike, Pascal Jabbour Md, Richard Dalyai, Robert H. Rosenwasswer Md, Stavropoula Tjoumakaris

Department of Neurosurgery Faculty Papers

Introduction. The variables that predispose to postcranioplasty infections are poorly described in the literature. We formulated a multivariate model that predicts the risk of infection in patients undergoing cranioplasty. Method. Retrospective review of all patients who underwent cranioplasty following craniectomy from January, 2000, to December, 2011. Tested predictors were age, sex, diabetic status, hypertensive status, reason for craniectomy, urgency status of craniectomy, location of cranioplasty, reoperation for hematoma, hydrocephalus postcranioplasty, and material type. A multivariate logistic regression analysis was performed. Results. Three hundred forty-eight patients met the study criteria. Infection rate was 26.43% (92/348). Of these cases with infection, 56.52% …

Loss Of Hif-1Α In The Notochord Results In Cell Death And Complete Disappearance Of The Nucleus Pulposus., Christophe Merceron, Laura Mangiavini, Alexander Robling, Tremika Leshan Wilson, Amato J Giaccia, Irving Shapiro, Ernestina Schipani, Makarand V Risbud

Department of Orthopaedic Surgery Faculty Papers

The intervertebral disc (IVD) is one of the largest avascular organs in vertebrates. The nucleus pulposus (NP), a highly hydrated and proteoglycan-enriched tissue, forms the inner portion of the IVD. The NP is surrounded by a multi-lamellar fibrocartilaginous structure, the annulus fibrosus (AF). This structure is covered superior and inferior side by cartilaginous endplates (CEP). The NP is a unique tissue within the IVD as it results from the differentiation of notochordal cells, whereas, AF and CEP derive from the sclerotome. The hypoxia inducible factor-1α (HIF-1α) is expressed in NP cells but its function in NP development and homeostasis is …