青少年特发性脊柱侧凸患者关节突软骨中转化生长因子-β_1及碱性成纤维细胞生长因子表达的研究

Expression of transforming growth factor-β_1 and basic fibroblast growth factor in articular process cartilages of adolescent idiopathic scoliosis

目的研究青少年特发性脊柱侧凸(AIS)畸形最严重顶椎凸、凹侧下关节突软骨中转化生长因子-β1(TGF-β1)、碱性成纤维细胞生长因子(bFGF)的表达特点。方法22例AIS患者为研究对象,18例先天性脊柱侧凸(CS)患者作为对照。取两组患者的顶椎和端椎凸、凹侧的下关节突,采用HE染色、免疫组化和原位杂交方法进行研究,观察关节突的病理改变和TGF-β1、bFGF在关节突中分布的特点。将所得的免疫组化和原位杂交图像输入图像分析系统,进行半定量分析。结果TGF-β1、bFGF在AIS和CS中有基本相似的表达特点,免疫组化和原位杂交方法均显示顶椎凹侧的表达高于凸侧(165.4±59.2vs128.1±50.6,168.3±46.8vs126.5±47.0;96.4±28.4vs76.6±29.9,101.8±39.4vs73.7±31.6;114.4±59.4vs77.1±52.2,109.8±51.0vs69.5±40.1;137·2±50·2vs93·4±72·2,138·4±75·8vs80·0±67·6;P<0.05);上、下端椎的凸凹侧之间及凸、凹侧的上下端椎之间的表达差异无统计学意义。结论AIS顶椎关节突软骨呈现退变及发育不全等征象,凹侧较凸侧明显。AIS中TGF-β1、bFGF在顶椎凹侧表达的增高可能为脊柱畸形后异常的生物力学引起了关节突细胞间基质重建而进行代偿的结果,异常压应力可能起着非常重要的作用。

Objective To investigate the characteristics of the expression of transforming growth faetor-β1（TGF-β1 ） and basic fibroblast growth factor （bFGF） in the apical articular process cartilages of adolescent idiopathic scoliosis （AIS） patients. Methods The specimens of articular processes of 22 AIS patients and 18 congenital scoliosis （CS） patients were collected during operation. The pathology of the processes was observed with H. E staining. Immunohistochemistry and in situ hybridization were adopted to detect the expression of TGF-β1 and bFGF. The differences in the pathological changes, and expression of TGF-β1 and bFGF between the apical processes and the end processes, the convex processes and the concave processes, and the AIS processes and CS processes. The images of immunohistochemistry and in situ hybridization were input into the image analysis system and were analyzed semi-quantitatively. The SAS （8. 01 ） software was adopted and （ 128.1 ± 50.6 vs 165.4 ± 59.2, 126.5 ± 47.0 vs 168.3 ± 46.8 ; 76.6 ± 29. 9 vs96.4 ±28.4, 73.7 ±31.6 vs 101.8 ±39.4; 77.1±52.2 vs 114.4 ±59.4, and69.5 ±40.1 vs 109.8 ± 51.0 （ P 〈 0. 05 ） was defined as the significant levels. Results The expression of TGF-β1 and the expression of bFGF were not significantly different between the AIS patients and the CS patients. The TGF- β1 expression in the concave side of the apical vertebrae of the AIS group was 165.4 ± 59.2, significantly higher than that in the convex sides （ 128.1 ± 50.6, P = 0.03 ）, and the TGF-β1 expression in the concave side of the apical vertebrae of the CS group was 168.3 ± 46.8, significantly higher than that of the convex side （ 126.5 ±47.0 , P =0.02）. However, there was no statistically significant differences in the TGF-β1 expression between the concave and convex sides of the upper and lower end vertebrae and between the upper and lower end vertebrae. The bFGF expression in the concave side of the apical vertebrae of the AIS group,and the bFGF expression in the concave side of the apical vertebrae of the CS group was 101.8± 39.4, significantly higher than that of the convex side （73.7 ± 31, P = 0.02）. However, there were no statistically significant differences in the bFGF expression between the concave and convex sides of the upper and lower end vertebrae and between the upper and lower end vertebrae. Conclusion The cartilages of the apical processes show some signs of regression and hypoplasia in AIS patients, especially at the concave side in comparison with the convex side. Increase of TGF-β1 and bFGF in the concave sides of apical processes in AIS may be the results of reconstruction of extracellular matrix and the compensation reactions which are caused by abnormal biomechanical forces, especially compressive stresses.