WISP-1 Induced by Mechanical Stress Contributes to Fibrosis and Hypertrophy of the Ligamentum Flavum Through Hedgehog-Gli1 Signaling

The study investigated the role of WISP-1 in the fibrosis and hypertrophy of the ligamentum flavum (LF), which contributes to lumbar spinal canal stenosis. It was found that mechanical stress increased WISP-1 expression in LF fibroblasts, which in turn induced fibrogenesis through the Hedgehog-Gli1 signaling pathway. This process was confirmed in vitro and in a hypertrophic LF rabbit model. The study demonstrated that cyclopamine, a Hedgehog pathway inhibitor, reduced fibrosis-related changes, suggesting that targeting Hedgehog signaling could be a potential therapeutic approach for LF fibrosis.