椎间盘内注射生长分化因子5及成骨蛋白1对椎间盘退变影响的研究进展

STUDY PROGRESS OF GROWTH DIFFERENTIATION FACTOR 5 OR OSTEOGENIC PROTEIN 1 INJECTION INTO A DEGENERATED DISC

目的介绍生长分化因子5(growth differentiation factor5,GDF-5)、成骨蛋白1(osteogenic protein1,OP-1)在椎间盘退变中的研究进展及应用前景。方法广泛查阅国内外近年相关文献,并行综合分析。结果生长因子是治疗椎间盘退变潜力最大的一类蛋白质。体外研究表明,外源性GDF-5显著增加髓核和纤维环细胞的脱氧核糖核酸酶和蛋白聚糖的含量,GDF-5(200ng/mL)、OP-1明显刺激蛋白聚糖和胶原合成。体内研究表明,GDF-5(100μg)、OP-1(100μg混入10μL5%乳糖中)椎间盘内注射能促进椎间隙高度的恢复,增加MRI评分,组织学分级有统计学意义。结论重组人GDF-5、OP-1能有效刺激椎间盘细胞的新陈代谢、增加ECM合成,因此椎间盘内单一注射重组人GDF-5、OP-1对退变椎间盘具有可修复能力。单一外源性生长因子直接注射对延缓椎间盘退变显示出美好前景。

Objective To review the advance in the experimental studies and evaluate the potential therapeutic application of the growth differentiation factor 5（GDF-5） and osteogenic protein 1 （OP-1） in intervertebral disc degeneration. Methods Relevant literature at home and abroad published in recent years was searched and analyzed comprehensively. Results The growth factor was one of the most potential proteins in curing the intervertebral disc degeneration. In vitro, exogenous GDF-5 or OP-1 increased the deoxyribonucleic acid and proteoglycan contents of both nucleus pulposus and annlus fibrosis cells types significantly. GDF-5 at 200 ng/mL or OP-1 significantly stimulated proteoglycan synthesis and collagen synthesis. In vivo, the injection of GDF-5（100μg） or OP-1（100 μg in 10 μL 5% lactose） resulted in a restoration of disc height, improvement of magnetic resonance imaging scores, and histologic grading scores had statistical significance. Conclusion A single injection of GDF-5 or OP- 1 has a reparative capacity on intervertebral discs, presumably based on its effect to stimulate matrix metabolism of intervertebral disc cells and enhance extracellular matrix production. A single injection of exogenous GDF-5 or OP-1 in the degenerated disc shows a good prospect.