白细胞介素27参与了腰椎间盘突出症的病理过程

Interleukin-27 is associated with the pathogenesis of lumbar disc herniation

背景:炎症是腰椎间盘突出症发生的重要机制,Th17细胞在免疫激活中起着关键作用。白细胞介素27可以通过下调白细胞介素6和转化生长因子β的表达抑制Th17细胞分化,在多种自身免疫性疾病中发挥重要作用,然而人们对白细胞介素27和腰椎间盘突出症之间的关系知之甚少。目的:检测腰椎间盘突出症患者血液及髓核中白细胞介素27表达情况,探讨它与腰椎间盘突出症的关系。方法:选择腰椎间盘突出症患者36例,健康志愿者18例,急诊手术的腰椎爆裂性骨折患者8例。腰椎间盘突出症患者行开窗髓核摘除、腰椎后路椎间融合器融合或经椎间孔椎间融合器融合手术,术前使用目测类比评分法评估患者的疼痛强度。取腰椎间盘突出症患者与健康志愿者血液样本,ELISA法检测术前外周血血清白细胞介素27、白细胞介素17表达情况;取腰椎间盘突出症患者髓核样本与腰椎爆裂性骨折患者的髓核样本(视为正常髓核样本),qRT-PCR与Western blot测定髓核组织中白细胞介素27、白细胞介素17 mRNA及蛋白的表达情况。结果与结论:①腰椎间盘突出症患者血清的白细胞介素27表达水平显著高于健康对照组(P<0.001);白细胞介素17在腰椎间盘突出症患者血清中的表达水平也明显升高;②在蛋白水平,腰椎间盘突出症患者髓核中的白细胞介素27及白细胞介素17表达水平明显高于正常髓核(P<0.001);③在mRNA水平,腰椎间盘突出症患者髓核中白细胞介素27及白细胞介素17表达水平明显高于正常髓核(P<0.001);④轻度疼痛患者白细胞介素27表达水平高于重度疼痛患者(P<0.01);⑤提示炎症是腰椎间盘突出症患者疼痛的原因,白细胞介素27参与了腰椎间盘突出症的病理过程。

BACKGROUND:Inflammation is an important mechanism underlying lumbar disc herniation.Th17 cells play a key role in immune activation.Interleukin-27 can inhibit Th17 cell differentiation by down-regulating the expression of interleukin-6 and transforming growth factor-β,and plays an important role in a variety of autoimmune diseases.However,little is known about the relationship between interleukin-27 and lumbar disc herniation.OBJECTIVE:To investigate the levels of interleukin-27 in patients with lumbar disc herniation,and to explore their association with lumbar intervertebral disc herniation.METHODS:This study enrolled 36 patients with lumbar disc herniation,18 healthy controls,and 8 patients undergoing emergency surgery for thoracolumbar burst fracture.Patients with lumbar disc herniation received posterior fenestration discectomy,posterior lumbar interbody fusion(PLIF)or transforaminal lumbar interbody fusion.The pain intensity of the patients was scored using a visual analogue scale(VAS)before operation.Serum interleukin-27 and interleukin-17 levels in peripheral blood were determined by enzyme linked immunosorbent assay(ELISA).Samples of nucleus pulposus from patients with lumbar disc herniation and those with thoracolumbar burst fractures(considered as normal nucleus pulposus samples)were taken for detection of interleukin-27 and interleukin-17 mRNA and protein using quantitative real-time PCR and western blot assay,respectively.RESULTS AND CONCLUSION:Patients with lumbar disc herniation had significantly higher serum interleukin-27 levels than healthy controls(P<0.001).Interleukin-17 levels were also significantly higher in the patients with lumbar disc herniation.The protein and mRNA expression levels of interleukin-27 and interleukin-17 in the nucleus pulposus were significantly higher in patients with lumbar disc herniation than patients with thoracolumbar burst fractures(P<0.001).The expression of interleukin-27 was significantly higher in patients with mild pain than those with severe pain(P<0.01).To conclude,inflammation is responsible for the pain experienced by patients with lumbar disc herniation,and interleukin-27 is involved in the pathogenesis of lumbar disc herniation.