临床症状不同颈椎病患者颈椎间盘白细胞介素1β及白细胞介素6和环氧化酶2的表达

Expression of interleukin-1 beta, interleukin-6 and cyclooxygenase 2 in cervical intervertebral disc of cervical spondylosis patients with different clinical symptoms

背景:在颈椎的退变过程中,椎间盘细胞发生生物化学变化,此过程产生各种炎性细胞因子可能导致椎间盘突出。间盘突出后,反过来刺激周围毗邻组织产生各种炎性因子。目的:探讨白细胞介素1β、白细胞介素6、环氧化酶2在不同临床症状的颈脊髓压迫患者中的表达及意义。方法:颈前路间盘切除内固定患者的突出间盘或责任间盘,依据临床症状分为3组:髓型症状组,根性症状组,颈椎外伤组,对间盘进行苏木精-伊红染色及免疫组织化学染色进行形态学观察,对间盘免疫组织化学染色结果进行阳性细胞计数。结果与结论:1髓型症状组和根性症状组苏木精-伊红染色在突出颈椎间盘周围的炎性肉芽组织中可见炎细胞浸润以及新生血管形成;颈椎外伤组未见明显炎细胞浸润以及新生血管形成;2免疫组织化学染色髓型症状组可见白细胞介素1β、白细胞介素6表达阳性的细胞,其胞浆为棕黄色着色为主,环氧化酶2表达阳性的细胞稀少;根性症状组中可见白细胞介素1β、白细胞介素6、环氧化酶2表达阳性的细胞,数量明显多于髓型症状组;颈椎外伤组中免疫组织化学染色白细胞介素1β、白细胞介素6、环氧化酶2表达阳性细胞表达稀少;3髓型症状组及根性症状组中白细胞介素1β阳性表达率和IA值,白细胞介素6阳性表达率和IA值均显著高于颈椎外伤组(P<0.05);根性症状组中环氧化酶2阳性表达率及IA值均显著高于颈椎外伤组。4结果说明,突出的颈椎间盘可发生白细胞介素1、白细胞介素6、环氧化酶2细胞因子表达,并在颈椎间盘早期退变中发挥作用,不同临床症状的颈脊髓压迫患者这些炎症因子表达具有明显差异。

BACKGROUND： During degeneration of cervical spine, biochemical changes appeared in intervertebral disc cells. During this process, a variety of inflammatory cytokines may lead to disc herniation, which stimulates the production of a variety of inflammatory factors from surrounding adjacent tissue. OBJECTIVE： To explore the expression and significance of interleukin-1β, interleukin-6 and cyclooxygenase 2 in patients with different clinical symptoms of cervical spinal cord oppression. METHODS： Protrusion of the intervertebral disc or disc of responsibility among patients with anterior disc resection and internal fixation were divided into three groups according to clinical symptoms： myelopathic symptom group, nerve root symptom group and cervical spine trauma group. Intervertebral disc received hematoxylin-eosin staining and immunohistochemical staining for morphological observation. Positive cells were counted according to the result of immunohistochemical staining. RESULTS AND CONCLUSION： （1） Hematoxylin-eosin staining results showed visible inflammatory cell infiltration and new blood vessel formation in the myelopathic symptom group and nerve root symptom group. No remarkable inflammatory cell infiltration or new blood vessel formation was seen in cervical spine trauma group. （2） Immunohistochemical staining interleukin-113-, intedeukin-6-positive cells were seen in the myelopathic symptom group. Cytoplasm was stained tan. Cyclooxygenase 2-positive cells showed a low number. The numbers of interleukin-1β, interleukin-6- and cyclooxygenase 2-positive cells were significantly more in the nerve root symptom group than in the myelopathic symptom group. The numbers of intedeukin-li3-, intefleukin-6- and cyclooxygenase 2-positive cells were small in the cervical spine trauma group. （3） Expression rate and IA value of intedeukin-1β, expression rate and IA value of interleukln-6 were significantly higher in the myelopathic symptom group and nerve root symptom group than in the cervical spine trauma group （P 〈 0.05）. Expression rate and IA value of cyclooxygenase 2 were significantly higher in the nerve root symptom group than in the cervical spine trauma group. （4） These results suggested that interleukin-ll~, interleukin-6 and cyclooxygenase 2 expression could be found in the cervical intervertebral disc after protrusion, and played a role in early degeneration of cervical intervertebral disc. The expressions of these inflammatory factors were significantly different in patients with different clinical symptoms of cervical spinal cord compression.