高迁移率族蛋白-1和白细胞介素-6在腰椎ModicⅡ型改变终板组织中的表达及意义

Protein expression levels and the significances of high mobility group box-1 and interleukin-6 in degenerative endplates with TypeⅡModic changes

目的探讨高迁移率族蛋白-1(HMGB-1)和白细胞介素-6(IL-6)在腰椎ModicⅡ型改变软骨终板组织中的蛋白表达水平及其临床意义。方法收集因单节段退变性腰椎间盘疾病行椎间融合术的患者45例,其中男19例,女26例,年龄31~69岁,平均(47.22±11.49)岁。根据手术节段有无ModicⅡ型改变,将其分为ModicⅡ型改变组(A组)和无Modic改变组(B组)。对照组(C组)为同时期因腰椎爆裂性骨折行融合手术的4例年轻患者,其中男3例,女1例,年龄17~29岁,平均(23.25±5.32)岁。对收集到的软骨终板组织行HE染色以观察其组织形态学变化,免疫组化染色以检测HMGB-1和IL-6的蛋白表达水平。结果HE染色结果显示,A、B组软骨终板均出现了不同程度的退变,A组较严重,C组未见明显退变。免疫组化染色结果显示,A、B、C组HMGB-1阳性细胞指数分别为51.00±21.20、30.23±16.86、4.93±3.13,吸光度值分别为0.142±0.044、0.101±0.050、0.038±0.008。A、B、C组IL-6阳性细胞指数分别为43.19±14.46、25.83±12.49、5.08±3.22,吸光度值分别为0.177±0.078、0.116±0.081、0.032±0.016。A、B组HMGB-1、IL-6阳性细胞指数和吸光度值均明显高于C组,A组亦明显高于B组,差异有统计学意义(P<0.05),HMGB-1与IL-6的表达水平呈中度正相关关系(P<0.05)。结论软骨终板组织中HMGB-1和IL-6表达水平升高可能是ModicⅡ型改变引起下腰痛的原因之一。

Objective To investigate the protein expression levels and significances of high mobility group box-1(HMGB-1)and interleukin-6(IL-6)in endplates with TypeⅡModic changes(MCs).Methods Forty-five patients who received single level interbody fusion(19 males,26 females)with a mean age of(47.22±11.49)years(range,31-69 years)were included in the study.Patients were divided into 2 groups,Group A in which patients with Type II MCs on magnetic resonance imaging(MRI)and Group B in which patients without MCs.In addition,4 patients(3 males,1 female)with a mean age of 23.25±5.32 years with lumbar vertebral fractures were included as the control group(Group C).Endplate specimens were stained with hematoxylin and eosin(HE)and observed with light microscopy.Concentrations of HMGB-1 and IL-6 were detected by immunochemistry.Results No obvious degeneration was observed in Group C,and the staining in Group B was lighter than Group A.The positive cell indexes of HMGB-1 in Group A,B and C were 51.00±21.20,30.23±16.86 and 4.93±3.13,respectively;while those IL-6 levels in Group A,B and C were 43.19±14.46,25.83±12.49 and 5.08±3.22,respectively.The absorbance value of HMGB-1 in Group A,B and C were 0.142±0.044,0.101±0.050 and 0.038±0.008,respectively;while those of IL-6 in Group A,B and C were 0.177±0.078,0.116±0.081 and 0.032±0.016,respectively.Immunochemistry showed that both the positive cell indexes and the absorbance values of HMGB-1 and IL-6 in Group A and B were significantly higher than those in Group C(P<0.05),and those in Group A was significantly higher than Group B(P<0.05).A positive correlation between the levels of HMGB-1 and IL-6 was noted(P<0.05).Conclusion Elevated levels of HMGB-1 and IL-6 may be the cause of low back pain in patients with degenerative endplates with TypeⅡMCs.