白细胞介素23/辅助性T17细胞轴与腰椎间盘突出症的相关性

Correlation between interleukin 23/helper T17 cell axis and lumbar disc herniation

背景:对于腰椎间盘突出症的发生,白细胞介素23促进辅助性T17细胞进一步分泌白细胞介素17,白细胞介素17协同肿瘤坏死因子α促进各种炎症递质产生,从而介导炎症反应和自身免疫反应,引起坐骨神经痛等症状。目的:探讨白细胞介素23/辅助性T17细胞轴与腰椎间盘突出症的关系。方法:选取38例髓核标本,其中30例取自腰椎间盘突出症患者,8例取自腰椎骨折患者,同时在入院时抽取两组患者的外周血样本。所有患者均收治于南通大学附属医院脊柱外科,根据临床症状、影像学检查及术中所见确诊。采用免疫组化法检测两组患者髓核组织中白细胞介素23的表达,采用ELISA法检测两组患者髓核组织和外周血中白细胞介素17、白细胞介素23、肿瘤坏死因子α水平,并进行Pearson相关性分析。结果与结论:试验组髓核组织中白细胞介素23阳性表达率高于对照组(P<0.01);试验组髓核组织、外周血中白细胞介素17、白细胞介素23、肿瘤坏死因子α水平均明显高于对照组(P<0.01);试验组髓核组织中的3个细胞因子两两之间均呈显著正相关关系(r>0.5,P<0.01)。结果表明,腰椎间盘突出症与白细胞介素23/辅助性T17细胞轴炎症反应关系密切。

BACKGROUND:For lumbar disc herniation,interleukin-23 promotes the Th17 cells to secrete interleukin-17,and then interleukin-17 cooperates with tumor necrosis factor-αto produce inflammation mediators.It would aggravate inflammation and autoimmune response,and then cause some symptoms such as sciatica.OBJECTIVE:To explore the association between interleukin-23/Th17 axis and lumbar disc herniation.METHODS:Thirty-eight samples of nucleus pulposus were selected,of which 30 were taken from patients with lumbar disc herniation(trial group)and 8 from patients with lumbar vertebral fractures(control group).Peripheral blood samples were meanwhile taken from two groups of patients on admission.All patients,who were admitted to the Department of Spine Surgery,Affiliated Hospital of Nantong University,were diagnosed based on clinical symptoms,imaging examinations and intraoperative confirmation.Immunohistochemical method was used to detect the expression of interleukin 23 in the nucleus pulposus tissue,and ELISA assay was used to detect the levels of interleukin 17,interleukin 23,and tumor necrosis factor-αin the nucleus pulposus tissue and peripheral blood.Pearson correlation analysis was then performed.RESULTS AND CONCLUSION:Immunohistochemistry detection showed that the expression of interleukin-23 was significantly higher in the trial group than the control group(P<0.01).The levels of interleukin-17,interleukin-23 and tumor necrosis factor-αin the nucleus pulpous and peripheral blood all significantly increased in the trial group compared with the control group(P<0.01).There was a significant positive correlation between these three cytokines in the nucleus pulposus tissue of the trial group(r>0.5,P<0.01).To conclude,lumbar disc herniation is closely related to interleukin-23/Th17 axis inflammatory response.