Submitted by Johnny Rodrigues (johnnyrodrigues@ufcg.edu.br) on 2018-10-05T15:44:13Z No. of bitstreams: 1 MARIA AUGUSTA COSTA DE MOURA - DISSERTAÇÃO PPGRN 2009..pdf: 20489965 bytes, checksum: 0a73a7a5c22f30aff53fbeab5a65304e (MD5) / Made available in DSpace on 2018-10-05T15:44:13Z (GMT). No. of bitstreams: 1 MARIA AUGUSTA COSTA DE MOURA - DISSERTAÇÃO PPGRN 2009..pdf: 20489965 bytes, checksum: 0a73a7a5c22f30aff53fbeab5a65304e (MD5) Previous issue date: 2009-08-13 / O processo de urbanização brasileiro em toda sua construção decorre do resultado do modelo capitalista de produção que determinou a migração rural para áreas urbanas. Campina Grande apresenta atualmente um processo de urbanização avançado com 95% da população concentrada na cidade fazendo uso de ocupação do solo aos moldes periféricos, caracterizando um modelo de urbanização excêntrico no sentido centroperiferia. As conformações espaciais estão imbricadas nas atividades produtivas que hierarquizam os lugares e produzem diferenciação de classes sociais. A rede urbana diferencia-se em função da complexidade econômica e social alterando o balanço energético e produzindo climas diferenciados por modificações de variáveis como a temperatura do ar, umidade e pluviosidade. Neste sentido o presente trabalho tem como objetivo verificar as relações entre a urbanização em Campina Grande, a incidência de doenças respiratórias e as variáveis climatológicas de temperatura do ar, umidade relativa do ar e pluviosidade no município, principalmente nos grupos populacionais de maior vulnerabilidade: crianças e idosos. A relevância deste estudo está ha contribuição do entendimento a nível local do comportamento da incidência das doenças respiratórias e seus determinantes ambientais e sócio-econômicos no sentido de subsidiar ações de políticas públicas locais adequadas para promoção de saúde. A base de dados utilizada constitui-se na coleta em sites oficiais; IBGE, CNM, DATASUS que foram tabulados e analisados. Na metodologia realizou-se a construção de série histórica das variáveis selecionadas no estudo através de análise gráfica para estabelecer comportamento e correlação entre elas. Ficando constatado que o crescimento econômico promove assimetria entre indicadores sociais e econômicos com altos níveis de pobreza e desigualdades sócio-espaciais contundentes, expondo grande parte da população a riscos diferenciados de saúde e predisposições aumentadas a fatores ambientais e sociais pela distribuição não-equitativa de renda. A incidência de doenças respiratórias decresceu no período de estudo e o aumento de umidade relativa do ar e as baixas temperaturas que acontecem no período da estação chuvosa tem alta relação de sazonalidade em crianças menores de 4 anos de idade. / The Brazilian process of urbanization arises as a result of the capitalist model of production that determined the rural migration to urban areas. Nowadays, Campina Grande presents an advanced process of urbanization with 95% of the population concentrated in the city using the occupation of the soil in a peripheral way, what characterizes a model of urbanization from the center to periphery. The space conformations are imbricated in productive activities that rank the places and produce differentiation in social classes. The urban network is differentiated according to economic and social complexity which is altering the energy balance and producing climates that are distinguished by changes in variables such as air temperature, humidity and rainfall. In this sense, this work aims to verify the connection between urbanization in Campina Grande, the respiratory diseases' incidence and the climate variables of temperature, humidity and rainfall in the city, especially in the most vulnerable groups: children and elderly. The relevance of this study is in the contribution to understand the standard of respiratory diseases' incidence and its environmental, social and economic determinants to support local actions of public policies to promote appropriate health. The used methodology consisted of collecting data from official sites like IBGE, CNM and DATASUS, which were tabulated and analyzed. In the methodology, it was built historical series of the selected variables in the study by graphical analysis and morbidity's coefficient to establish the behavior and the correlation between them. It has evidenced that economic growth promotes asymmetry between social and economic indicators with high levels of poverty and socio-spatial inequalities remarkable exposing a large amount of the population to different health risks and increased predisposition to environmental factors and the unfair social distribution of the income. The incidence of respiratory diseases decreased during the period of the study and it was found out that the increase in relative humidity of air and low temperatures that occur during the rainy season has a high relation of seasonality in children younger than 4 years of age.

Über die Ätiologie und Epidemiologie der Erkrankungen des Respirationstraktes im Frühneolithikum Mitteleuropas gibt es bislang keine umfassenden Studien. Die Häufigkeit, mögliche Geschlechts- und Altersunterschiede, Populationsunterschiede und Erkenntnisse über mögliche Ursachen und auslösende Faktoren der Atemwegserkrankungen zur Zeit der Bandkeramik sind von besonderem Interesse. Zudem soll aufgezeigt werden wie wichtig es ist, alle Strukturen zu untersuchen, die den „knöchernen Respirationstrakt“ repräsentieren. Von den ersten Ackerbauern und Viehzüchtern aus Wandersleben (Thüringen, Kreis Gotha) lagen insgesamt 112 erwachsene Individuen zur Untersuchung vor. Rippen und Schädel wurden mit paläopathologischen Methoden untersucht. Diese waren neben einer makroskopischen Begutachtung der Knochen, röntgenologische, endoskopische, lupenmikroskopische, lichtmikroskopische und rasterelektronenmikroskopische Untersuchungen, um eine verlässliche Diagnosestellung zu gewährleisten. 100 % (n = 71/71) der befundbaren Individuen zeigten Spuren chronischer Erkrankungen im Bereich der knöchernen Strukturen, die die oberen Atemwege umgeben. Bei 76,8% (n = 53/69) der Individuen mit befundbaren Rippen konnten Spuren von chronischen Erkrankungen aufgezeigt werden. Signifikante Geschlechts- oder Altersunterschiede bestehen insgesamt nicht. Bei der linearbandkeramischen Population aus Wandersleben ist davon auszugehen, dass es sich in vielen Fällen um Chronifizierungen von Erkältungskrankheiten und um die Folgen einer vergleichbar schlechten Luftqualität hauptsächlich im Haus handelt. Dazu haben die damaligen Lebensumstände, vor allem aber die sesshafte Lebensweise und Wirtschaftszweige mit Ackerbau und Viehzucht, maßgeblich beigetragen.:1 Einleitung ............................................................................................................................ 1 2 Material ............................................................................................................................... 3 3 Methoden ........................................................................................................................... 18 3.1 Vorarbeiten.............................................................................................................................18 3.2 Alters- und Geschlechtsbestimmung......................................................................................18 3.3 Paläopathologische Untersuchungsmethoden ........................................................................19 3.3.1 Dokumentation der erhaltenen Funde und der Befunde .................................................19 3.3.2 Makroskopische und lupenmikroskopische Untersuchung ............................................19 3.3.3 Röntgenologische Untersuchung ....................................................................................19 3.3.4 Endoskopische Untersuchung ........................................................................................19 3.3.5 Fotografie .......................................................................................................................20 3.3.6 Herstellung von Ab- und Ausgüssen ..............................................................................20 3.3.7 Rasterelektronenmikroskopische Untersuchung ............................................................20 3.3.8 Lichtmikroskopische Untersuchung ...............................................................................21 3.4 Statistik...................................................................................................................................21 3.5 Auswertung ............................................................................................................................22 4 Ergebnisse und Befunde .................................................................................................... 24 4.1 Alters- und Geschlechtsverteilung .........................................................................................24 4.1.1 Altersverteilung und Sterblichkeit ..................................................................................24 4.1.1.1 Altersverteilung der erwachsenen Individuen mit erhaltenen Schädeln ....................28 4.1.1.2 Altersverteilung der erwachsenen Individuen mit erhaltenen Rippen........................32 4.1.1.3 Altersverteilung der erwachsenen Individuen mit erhaltenen Schädeln und Rippen. 36 4.1.2 Geschlechtsverteilung ....................................................................................................41 4.1.2.1 Geschlechtsverteilung der erwachsenen Individuen mit erhaltenen Schädeln ...........47 4.1.2.2 Geschlechtsverteilung der erwachsenen Individuen mit erhaltenen Rippen ..............49 4.1.2.3 Geschlechtsverteilung der erwachsenen Individuen mit erhaltenen Schädeln und Rippen.........................................................................................................................50 4.2 Knöcherne Schädelstrukturen ................................................................................................54 4.2.1 Begrenzung der Apertura piriformis ..............................................................................54 4.2.1.1 Anatomische Grundlagen...........................................................................................54 4.2.1.2 Veränderte Aperturae piriformes................................................................................55 4.2.1.3 Individuen mit veränderten Aperturae piriformes.....................................................66 4.2.1.4 Zur Klinik der Begrenzung der Apertura piriformis ..................................................72 4.2.1.5 Ausgewählte Fallbeispiele..........................................................................................72 4.2.1.6 Zusammenstellung der morphologischen Veränderungen an der Aperturae piriformes..... ...............................................................................................................74 4.2.2 Nasenhöhle .....................................................................................................................78 4.2.2.1 Anatomische Grundlagen........................................................................................................ 78 4.2.2.2 Veränderte Nasenhöhlen ............................................................................................80 4.2.2.3 Individuen mit veränderten Nasenhöhlen ...................................................................90 4.2.2.4 Zur Klinik der Nasenhöhle .........................................................................................97 4.2.2.5 Ausgewählte Fallbeispiele..........................................................................................98 4.2.2.6 Zusammenstellung der morphologischen Veränderungen in der Nasenhöhle .........102 4.2.3 Sulcus lacrimalis maxillae............................................................................................106 4.2.3.1 Anatomische Grundlagen.........................................................................................106 4.2.3.2 Veränderte Sulci lacrimales maxillae.......................................................................108 4.2.3.3 Individuen mit veränderten Sulci lacrimales maxillae .............................................118 4.2.3.4 Zur Klinik des Sulcus lacrimalis maxillae ...............................................................125 4.2.3.5 Ausgewählte Fallbeispiele........................................................................................125 4.2.3.6 Zusammenstellung der morphologischen Veränderungen des Sulcus lacrimalis maxillae.....................................................................................................................128 4.2.4 Nasennebenhöhlen .......................................................................................................133 4.2.4.1 Anatomische Grundlagen.........................................................................................133 4.2.4.2 Veränderte Nasennebenhöhlen.................................................................................137 4.2.4.3 Individuen mit veränderten Nasennebenhöhlen .......................................................159 4.2.4.4 Zur Klinik der Nasennebenhöhlen ...........................................................................171 4.2.4.5 Ausgewählte Fallbeispiele........................................................................................174 4.2.4.6 Zusammenstellung der morphologischen Veränderungen in den Nasennebenhöhlen.....................................................................................................186 4.3 Pneumatische Räume des Schläfenbeins..............................................................................202 4.3.1 Mittelohr.......................................................................................................................202 4.3.1.1 Anatomische Grundlagen.........................................................................................202 4.3.1.2 Betroffene Mittelohren.............................................................................................204 4.3.1.3 Individuen mit betroffenen Mittelohren...................................................................214 4.3.1.4 Zur Klinik des Mittelohres .......................................................................................220 4.3.1.5 Ausgewählte Fallbeispiele........................................................................................221 4.3.1.6 Zusammenstellung der morphologischen Veränderungen der Mittelohren .............222 4.3.2 Warzenfortsatz .............................................................................................................225 4.3.2.1 Anatomische Grundlagen.........................................................................................225 4.3.2.2 Betroffene Warzenfortsätze......................................................................................226 4.3.2.3 Individuen mit betroffenen Warzenfortsätzen ..........................................................236 4.3.2.4 Zur Klinik des Warzenfortsatzes..............................................................................243 4.3.2.5 Ausgewählte Fallbeispiele........................................................................................244 4.3.2.6 Zusammenstellung der morphologischen Veränderungen der Warzenfortsätze......248 4.4 Rippen ..................................................................................................................................253 4.4.1 Allgemeine Anatomie des Brustkorbes........................................................................253 4.4.2 Zusammenstellung morphologischer Veränderungen an den Rippen..........................264 4.4.2.1 Impressionen ............................................................................................................265 4.4.2.2 Neubildungen ...........................................................................................................278 4.4.2.3 Differentialdiagnostisch relevante Veränderungen ..................................................314 4.4.2.4 Überblick über die häufigsten Veränderungen an den Rippen.................................339 4.4.2.5 Gruppen von intravitalen Veränderungen an den Rippen ........................................347 4.4.3 Veränderte Rippen........................................................................................................353 4.4.3.1 Krankheitshäufigkeiten der Rippen I bis XII ...........................................................366 4.4.3.2 Durchschnittliche Anzahl kranker Rippen ...............................................................401 4.4.3.3 Am häufigsten erhaltene Brustkorbbereiche ............................................................410 4.4.4 Individuen mit veränderten Rippen..............................................................................413 4.4.4.1 Übersicht über pathologische Veränderungen an den Rippen .................................423 4.5 Knöcherne Strukturen der oberen und unteren Atemwege und knöcherne Strukturen, die mögliche Komplikationen der Erkrankungen der oberen Atemwege anzeigen...................429 5 Diskussion .......................................................................................................................441 5.1 Diskussion der Alters- und Geschlechtsverteilung und der Sterblichkeit ............................441 5.2 Diskussion der Erkrankungen der oberen Atemwege ..........................................................443 5.2.1 Klinische Diskussion der oberen Atemwegserkrankungen der Erwachsenen von Wandersleben ...............................................................................................................443 5.2.1.1 Häufigste Erkrankungen der oberen Atemwege.......................................................446 5.2.1.1.1 Sinusitiden..........................................................................................................447 5.2.1.1.2 Pansinusitis.........................................................................................................454 5.2.1.1.3 Chronische Sinusitiden und Osteome ................................................................456 5.2.1.1.4 Chronische Rhinitiden und Sinusitiden..............................................................458 5.2.1.1.5 Fortleitungen der Rhinitiden auf die vordere knöcherne Nasenöffnung und den knöchernen Tränennasengang.............................................................................463 5.2.1.1.6 Komplikationen der Rhinitis und der Sinusitis (Rhinosinusitis) mit spezieller Betrachtung des Mittelohres und des Warzenfortsatzes .....................................468 5.2.1.1.7 Spezifische Infektionen der oberen Atemwege mit Tuberkulose als Schwerpunkt..........................................................................................................472 5.3 Diskussion der Erkrankungen der unteren Atemwege .........................................................476 5.3.1 Klinische Diskussion der unteren Atemwegserkrankungen der Erwachsenen von Wandersleben ...............................................................................................................476 5.3.1.1 Erkrankungen der unteren Atemwege ......................................................................476 5.3.1.2 Krankhafte Veränderungen an den Rippen der Individuen von Wandersleben .......480 5.4 Zusammenfassende Diskussion der Erkrankungen der oberen und unteren Atemwege ......491 5.4.1 Diskussion der Erkrankungen der oberen und unteren Atemwege ..............................491 5.4.2 Diskussion der Atemwegserkrankungen der Erwachsenen von Wandersleben in Bezug auf die Lebensumstände im Neolithikum ..........................................................495 5.4.2.1 Außenluftfaktoren ....................................................................................................497 5.4.2.1.1 Klima und Wetter ...............................................................................................497 5.4.2.1.2 Allergene............................................................................................................499 5.4.2.1.3 Zoonosen ............................................................................................................503 5.4.2.1.4 Rauch .................................................................................................................505 5.4.2.2 Innenluftfaktoren ......................................................................................................507 5.4.2.2.1 Rauch .................................................................................................................507 5.4.2.2.2 Allergene und Zoonosen ....................................................................................510 5.4.2.2.3 Natürliche Radioaktivität ...................................................................................514 5.4.2.2.4 Ernährungszustand .............................................................................................515 5.4.2.3 Erkrankungen ...........................................................................................................520 5.4.2.4 Nutzung der Zähne als Werkzeug ............................................................................525 5.4.3 Diskussion der Atemwegserkrankungen der Kinder von Wandersleben .....................526 5.4.4 Zusammenfassender Überblick über Atemwegserkrankungen und deren möglichen Entstehungsursachen in Wandersleben .......................................................528 5.4.5 Vergleich der Atemwegserkrankungen der erwachsenen Individuen von Wandersleben mit anderen Populationen......................................................................530 5.4.5.1 Vergleich der unspezifischen Erkrankungen der Atemwege ...................................532 5.4.5.2 Vergleich der spezifischen Erkrankungen der unteren Atemwege ..........................538 5.4.6 Abschließende Zusammenfassung für Wandersleben..................................................540 6 Zusammenfassung........................................................................................................... 542 7 Literaturverzeichnis......................................................................................................... 546 Befundkatalog der untersuchten Cranien und Costae aus der Skeletserie Wandersleben (geordnet nach Fundnummern) Im Katalog angewandte Methoden zur Befunderhebung und Erklärungen zum Katalog ....... I Literatur ................................................................................................................................. X Curriculum Vitae

Cette thèse répond à un double objectif, elle s’est concentrée d’une part sur le rôle joué par l’énergie dans le développement industrielle et économique des pays et d’autres parts sur les retombées de son usage sur l’environnement et l’état de santé des individus. Nous avons élaboré et exploité une base de données relative à la région de Sfax, qui a été utilisée pour l’analyse empirique adaptée à chaque axe de recherche. Le cheminement suivi pour argumenter cette thèse nous a amené à constituer trois chapitres. Au niveau du premier chapitre, nous avons particulièrement apprécié le rôle que l’énergie a préoccupé dans le développement économique des nations. Suite à notre analyse empirique, deux résultats principaux sont annoncés, d’abord, la présence d’un effet de long terme entre la consommation de l’énergie et le développement économique dans la région de Sfax impliquant ainsi sa dépendance économique à l’énergie, ensuite, l’existence d’une relation de causalité unidirectionnelle partant de la consommation de l’énergie vers la croissance économique. Dans un deuxième chapitre, nous nous sommes intéressés à étudier l’impact de la consommation de l’énergie sur la détérioration de la qualité de l’environnement. Deux points sont mis en valeur. Premièrement, une corrélation est détectée entre la consommation de l’énergie et les polluants suivants : PM10, SO2 et NO2. Deuxièmement, la présence de l’O3 troposphérique dans l’air n’est pas subordonnée à la consommation de l’énergie mais plutôt aux réactions photochimiques impliquant le NO2 et l’oxygène sous l’effet des rayons solaires ultra-violets. Finalement, les facteurs météorologiques et surtout la température (T) et l’humidité relative (HR) agissent sur la dispersion des polluants et leur accumulation autour de leurs sources d’émissions. Le dernier chapitre s’est focalisé sur l’analyse de l’impact sanitaire de la pollution atmosphérique. Adapté au contexte de la région de Sfax, trois constats principaux sont détectés. Tout d’abord, les maladies cardiovasculaires sont affectées par les émissions de S02 tandis que les maladies respiratoires sont influencées par les émissions de SO2 et O3. Ensuite, une corrélation est justifiée entre l’O3 te le NO2 qui confirme la réaction chimique de piégeage de l’ozone déjà indiquée. Enfin, nous avons déduit que la vitesse de vent (VV) impacte la distribution des polluants principalement le NO2, le SO2 et les PM10. La température (T) affecte à son tour les admissions hospitalières pour motif cardiovasculaire. / This thesis has a dual purpose; it focused on the one hand on the role of energy in the industrial and economic development of the country and on the other hand on the impact of its use on the environment and health status of individuals. We developed and operated a database on the Sfax region, which has been used for empirical analysis suited to each area of ​​research. The path followed to argue this thesis has led us to establish three chapters.At the first chapter, we particularly appreciated the role of energy in economic development of nations. Following our empirical analysis, two main results are announced, first, the presence of a long-term effect between energy consumption and economic development in the region of Sfax implying its economic dependence on energy. Then the existence of unidirectional causal relationship starting from energy consumption to economic growth. In the second chapter, we are interested in studying the impact of energy consumption on the deterioration of the environment quality. Two points are emphasized, first, a correlation is found between energy consumption and the following pollutants: PM10, SO2 and NO2. Secondly, the presence of tropospheric ozone (O3) in the air is not conditional on the energy consumption but rather to photochemical reactions involving NO2 and oxygen under the influence of solar ultraviolet radiation. Finally, weather factors, especially temperature (T) and relative humidity (RH) affect the dispersion of pollutants and their accumulation around their emission sources. The last chapter is focused on the analysis of the health impact of air pollution. Adapted to the region of Sfax, three main findings are detected. First, cardiovascular diseases are affected by S02 emissions and while respiratory diseases are influenced by emissions of SO2 and O3. Then, a correlation is justified between O3 NO2, confirming the chemical reaction of ozone scavenging already indicated. Finally, we concluded that the wind speed (VV) affects the distribution of pollutants mainly NO2, SO2 and PM10. Temperature (T) in turn affects hospital admissions for cardiovascular reasons.

Selected aspects of the mortality development in the USA since the turn of the millennium Abstract The main goal of the thesis was to analyze the development of mortality from selected causes in the USA between the years 1999 and 2019. The selected causes are long-term leading causes of death in the USA. These include cardiovascular diseases, malignant neoplasms, chronic lower respiratory diseases, external causes and cerebrovascular diseases. The current disease covid-19 was included in the selected causes of death, as according to preliminary data, it was the third leading cause of death in the USA in the year 2020. The first part presents the mortality rates in the USA from different perspectives to create the context of the current development of mortality trends and also characterizes the individual causes of death, which are then addressed in the analytical part of the thesis. Furthermore, the healthcare system of the USA is described, as it is one of the factors influencing the mortality rate and also because it differs significantly from the systems known in Europe. The second part presents the development of mortality from selected causes of death, according to sex and individual US states. Methods used in the analytical part of the thesis were the gross mortality rate, direct and indirect...

Detection of early pathophysiological changes of breathing in children with chronic respiratory disease MD. Vaclav Koucky - Ph.D. thesis Abstract Introduction: Currently, there are different methods for infant pulmonary function testing (iPFT) and morphological assessment of microscopic changes in endobronchial biopsy samples (EBB). In research setting, they allow detection of early pathophysiological changes of breathing in small children with chronic respiratory disease, respectively in risk of its development. Their clinical significance, however, is not fully acknowledged. The aim of this thesis is to evaluate the safety, feasibility and clinical significance of iPFT and EBB in infants younger than 2 years of age. In addition, the relationship between functional and morphological changes of respiratory tract and the function of peripheral chemoreceptors was studied in selected patients' subgroups. Methods: Fifty-five infants with cystic fibrosis (CF), 35 physician-confirmed recurrent wheezers (AB), 9 infants with congenital diaphragmatic hernia, 7 with interstitial lung disease (chILD) and 3 with primary ciliary dyskinesia (PCD) were enrolled. All infants underwent iPFT and relevant clinical history data were recorded. Based on patients' age, CF group was divided into CFmalí (< 6 months) and CFvelcí (>...

<p dir="ltr">People suffering from COPD are also known to suffer from other musculoskeletal issues like fracture risk, back pain, etc. Intervertebral disc degeneration (IVD) is a prominent cause of back pain and inflammation, influenced by factors such as aging, sudden loading, and genetics. <i>SERPINA1</i>, a common genetic variant in individuals with chronic obstructive pulmonary disease (COPD), encodes the alpha-antitrypsin protein (AAT). AAT deficiency is also associated with IVD degeneration, bone loss, and gait impairment. Currently, AAT-deficient individuals receive costly and short-lived weekly AAT injections, with no established guidelines for managing IVD degeneration and osteoporosis. Our primary research objective was to examine the effects of <i>serpinA1a/c</i> using a mouse model with global knockout (KO) of <i>serpinA1a/c</i>, generated through CRISPR technology, on intervertebral discs (IVD) and bone. We found that global deletion of <i>serpinA1a/c</i> was found to cause IVD elastin degradation, leading to a loss of mechanical properties. Moreover, <i>serpinA1</i> was associated with increased bone-resorbing cells (osteoclasts) and a reduction in bone-forming cells (osteoblasts). Notably, sexual dimorphism was observed, with female IVDs exhibiting less degeneration than male counterparts, and <i>serpinA1a/c</i> KO mice were protected from mechanically-induced tail compression. Even in human IVDs, males expressed more AAT-1 compared to female IVDs. There are no FDA-approved drugs currently existing for IVD degeneration. Since IVD degeneration frequently occurs in individuals with osteoporosis, it shows a probable cross-talk happening between IVD and bone. In our study, we found the association of <i>serpinA1 </i>with estrogen receptor alpha and osteoclasts. Hence, we investigated the potential of raloxifene, an FDA-approved selective estrogen receptor modulator (SERM) typically prescribed to post-menopausal women for osteoporosis treatment, in averting IVD degeneration and improving mechanical characteristics in IVD. Our findings suggest that raloxifene injection may retard IVD degeneration induced by AAT deficiency, particularly in male mice. Furthermore, the latter study touched upon a conditional <i>serpinA1a</i> mouse model crossed with aggrecan-cre, specifically targeting <i>serpinA1a</i>-expressing cells in the IVD while sparing bone. Conditional <i>serpinA1a</i> deletion induced mild IVD degeneration without affecting bone loss. In summary, this study serves as a foundation for testing potential treatments for AAT patients with IVD degeneration and osteoporosis. It also provides compelling evidence for considering raloxifene as a treatment option for IVD degeneration in AAT-deficient patients experiencing IVD-related pain.</p>