Fig. 2
From: Sirtuins in intervertebral disc degeneration: current understanding
SIRT in IVDD cell metabolism.SIRT1 alleviates cellular senescence and apoptosis by regulating PGC-α,FOXO3, IL-β, Akt, mTOR AMPK, and NF-KB.SIRT2 regulates ERK.SIRT3 is activated by p11k/Akt and AMPK/PGC-1α and releases SOX5 and ARID5B.SIRT4 activates FOXO1 to maintain ECM homeostasis, thereby maintaining disc integrity.SIRT5 and SIRT6 inhibit the release of inflammatory factors.SIRT5 and SIRT6 inhibit the release of inflammatory factors.SIRT6 inhibits the release of inflammatory factors. SIRT4 activates FOXO1 to maintain ECM homeostasis, thereby maintaining disc integrity.SIRT5 and SIRT6 inhibit the release of inflammatory factors. Some miRNAs can also activate SIRT to regulate cellular metabolism