疝出型和退变突出型腰椎间盘组织中白细胞介素-17表达及与Modic改变的病理机制

发布时间：2018-10-31 18:43

【摘要】：目的探讨白细胞介素(IL)-17在疝出型和退变突出型腰椎间盘组织中表达的差异及Modic改变与突出类型的相关性和病理机制。方法确诊并行手术治疗的单节段腰椎间盘突出患者62例,根据椎间盘突出类型分为损伤疝出组41例和退变突出组21例。根据磁共振成像(MRI)将病例分为Modic改变组22例和非Modic改变组40例。术中取椎间盘标本,采用苏木素-伊红(HE)染色、免疫组化染色、SYBR green法荧光定量PCR观察并检测椎间盘组织病理改变和IL-17表达情况。结果损伤疝出组新生血管化发生率明显高于退变突出组(P0.01)。退变突出组IL-17阳性细胞数明显低于损伤疝出组(P0.01)。损伤疝出组椎间盘组织中IL-17 mRNA表达量明显高于退变突出组(P0.01)。Modic改变组椎间盘组织中IL-17 mRNA表达量明显高于非Modic改变组(P0.01)。疝出型IL-17 mRNA表达量与Modic改变之间存在明显相关性(R=0.61,P0.001)。结论损伤疝出型腰椎间盘髓核组织中存在明显的局部炎性反应;IL-17在损伤疝出型椎间盘表达明显,提示介导了椎间盘神经根微环境的免疫炎症变化;自身免疫反应参与了Modic改变的病理机制。
[Abstract]:Objective to investigate the expression of interleukin-17 (IL) 17) in herniated and degenerative lumbar intervertebral disc tissues, and to explore the relationship between Modic changes and herniation type. Methods Sixty-two patients with single segment lumbar disc herniation were divided into injury herniation group (41 cases) and degenerative herniation group (21 cases) according to the type of disc herniation. According to magnetic resonance imaging (MRI), the patients were divided into Modic change group (n = 22) and non-Modic group (n = 40). Intraoperative specimens of intervertebral discs were stained with hematoxylin-eosin (HE) and immunohistochemical, SYBR green quantitative PCR was used to detect the pathological changes and IL-17 expression of intervertebral discs. Results the incidence of neovascularization in the hernia injury group was significantly higher than that in the degenerative herniation group (P 0.01). The number of IL-17 positive cells in degenerative herniation group was significantly lower than that in injured hernia group (P0.01). The expression of IL-17 mRNA in the injured hernia group was significantly higher than that in the degenerative herniation group (P0.01). Modic was significantly higher than that in the non-Modic change group (P0.01). There was a significant correlation between the expression of IL-17 mRNA in hernia type and the change of Modic (P 0.001). Conclusion there is a significant local inflammatory response in the nucleus pulposus of the injured herniated lumbar intervertebral disc and the expression of IL-17 in the injured herniated disc suggests that it mediates the changes of immune inflammation in the microenvironment of the nerve root of the intervertebral disc. Autoimmune response is involved in the pathological mechanism of Modic changes.
【作者单位】：焦作市人民医院骨科;
【基金】：河南省重点科技攻关基金资助项目(No.1321023104)
【分类号】：R681.53

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