退行性变腰椎间盘中基质细胞衍生因子1的表达及意义

Expression and significance of stromal cell derived factor-1 in the intervertebral disk after lumbar disc degeneration

背景:目前腰椎间盘退行性变确切的发病机制并不十分清楚。炎症参与腰椎间盘退行性变的发病机制,基质细胞衍生因子1属于趋化因子家族成员,与炎症有关。目的:检测腰椎间盘退行性变患者椎间盘中基质细胞衍生因子1的表达水平,分析其与病情严重程度的关系。方法:选取84例腰椎间盘退行性变患者和28例椎体爆裂性骨折患者,收集2组患者术后的椎间盘组织,用酶联免疫吸附的方法测定椎间盘中基质细胞衍生因子1的表达水平。根据Schneiderman标准进行分级,分析椎间盘中的基质细胞衍生因子1水平与疾病分级的关系。结果与结论:与椎体爆裂性骨折患者相比,腰椎间盘退行性变患者的腰椎间盘组织中基质细胞衍生因子1水平明显升高,差异有显著性意义(P<0.01)。Schneiderman4级的患者椎间盘组织中基质细胞衍生因子1水平明显高于Schneiderman2级和3级的患者,而Schneiderman3级的患者椎间盘组织中基质细胞衍生因子1水平明显高于2级患者。另外,Spearman相关分析也显示,基质细胞衍生因子1的蛋白水平与Schneiderman分级呈正相关(r=0.412,P<0.01)。提示腰椎间盘退行性变患者椎间盘中基质细胞衍生因子1的表达增高,与疾病严重程度呈正相关,可能参与了腰椎间盘退行性变的发病机制。

BACKGROUND： Exact pathogenesis of lumbar clisc degeneration is not very clear. Inflammation is involved in the mechanism of lumbar disc degeneration. Stromal cell derived factor-1, which belongs to chemokine family, is related to inflammation.OBJECTIVE： To determine the expression of stromal cell derived factor-1 in the intervertebral disk of patients with lumbar disc degeneration, and then to analyze the association of the expression levelsof stromal cell derived factor-1 with the severity Of lumbar disc degeneration. METHODS： Eighty-four patients with lumbar disc degeneration （lumbar disc degeneration group） and 28 patients with disc burst fractures （control group） were enrolled in this study. The intervertebral disk tissues were collected after surgery. The protein level of stromal cell derived factor-1 was determined by enzyme linked immunosorbent assay. The grade of disc degeneration was determined according to Schneiderman＇s classification. Association between the levels of stromal Cell derived factorol and the Schneiderman＇s grade was analyzed. RESULTS AND CONCLUSION： The stromal cell derived factor-1 levels in the intervertebral disk were significantly elevated in the lumbar disc degeneration group compared with the control group （P 〈 0.01）. The levels of stromal cell derived factor-1 were significantly increased in lumbar disc degeneration patients with grade 4 compared with those with grades 2 and 3. Furthermore, lumbar disc degeneration patients with grade 3 showed significantly elevated stromal cell derived factor-1 levels compared with those with grade 2. Spearman correlation analysis indicated that stromal cell derived factor-1 levels were positively correlated with Schneiderman＇s grades （r=0.412, P 〈 0.01 ）. These findings indicate that the levels of stromal cell derived factor-1 are significantly elevated in the intervertebral disk of patients with lumbar disc degeneration, and positively associated with the severity of lumbar disc degeneration. Stromal cell derived factor-1 may be involved in the mechanism of lumbar disc degeneration.