Xiaoqiang Wang,1,2,* Silong Gao,2,* Daqian Zhou,2 Weiye Cai,3 Jiale Lv,2 Zhangchao Wei,2 Chao Song,2 Xubin Shan,4 Zongchao Liu1,2 

1Luzhou Longmatan District People’s Hospital, Luzhou, Sichuan Province, People’s Republic of China; 2Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, People’s Republic of China; 3Department of Orthopedics and Traumatology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, Jiangsu Province, 215009, People’s Republic of China; 4Gaoxian Traditional Chinese Medicine Hospital, Yibin, Sichuan Provience, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Zongchao Liu, Luzhou Longmatan District People’s Hospital, No. 2 Guanyinbao Road, Shidong Town, Longmatan District, Luzhou, Sichuan, 646000, People’s Republic of China, Email lzcxnykdx@swmu.edu.cn

Background: Programmed cell death (PCD), including pyroptosis, apoptosis, and necroptosis, plays a critical role in the pathogenesis of intervertebral disc degeneration (IVDD). PANoptosis, a recently identified form of PCD integrating pyroptosis, apoptosis, and necroptosis, may represent a more comprehensive target for therapeutic intervention in IVDD.
Objective: To explore the role of PANoptosis in IVDD and investigate the therapeutic potential and underlying mechanism of baicalin in regulating PANoptosis to alleviate disc degeneration.
Methods: We performed integrative analyses of bulk transcriptomic datasets (GSE167199, GSE245147, GSE266883) and a single-cell RNA-seq dataset (GSE244889) to identify PANoptosis-related genes involved in IVDD. The expression and function of key genes were validated using clinical samples, an IL-1β-induced NPC degeneration model in vitro, and a puncture-induced rat IVDD model in vivo treated with baicalin.
Results: Five core PANoptosis-related genes (FOS, CASP1, H1-2, BCL2L11, and H2AC6) were significantly upregulated in degenerated discs. Baicalin treatment effectively downregulated these genes at both mRNA and protein levels. Moreover, baicalin alleviated IL-1β-induced cell death in NPCs and improved histological features in the rat IVDD model.
Conclusion: Our findings reveal a critical role of PANoptosis in IVDD progression and demonstrate that baicalin alleviates disc degeneration by inhibiting PANoptosis. This study provides novel insights into PANoptosis as a promising therapeutic target for IVDD.

Keywords: intervertebral disc degeneration, Baicalin, PANoptosis, bioinformatics, single-cell