脊柱结核患者髓核中KLF4的表达及其与临床资料的相关性

Expression of KLF4 in the nucleus pulposus of patients with spinal tuberculosis and its correlation with clinical data

目的探究Krüppel样因子4(Krüppel like factor 4,KLF4)在脊柱结核(spinal tuberculosis,STB)患者髓核组织中的表达及其与患者临床资料的相关性。方法选取2022年2月至2023年2月间我院确诊并行手术治疗的20例脊柱结核患者(STB组),术中收集结核病灶髓核组织;选取同期入院接受手术治疗的椎间盘突出症患者15例及外伤性脊柱骨折患者9例分别作为椎间盘突出组(ID组)和正常对照组(Ctrl组),术中收集髓核组织。免疫组织化学及RT-qPCR测定髓核组织中KLF4的表达水平,并分析其与症状持续时间、疼痛强度、C-反应蛋白(C-reactive protein,CRP)、血沉(Erythrocyte sedimentation rate,ESR)等临床资料的相关性。同时,免疫组织化学检测并分析脊柱结核患者髓核组织中γ干扰素(interferon-γ,IFN-γ)与KLF4之间的相关性。结果免疫组织化学检测显示脊柱结核组和椎间盘突出组髓核中KLF4免疫反应性较对照组明显增强;RT-qPCR测定显示脊柱结核组和椎间盘突出组KLF4 mRNA水平较对照组明显升高。同时,脊柱结核组患者KLF4基因表达水平与症状持续时间、疼痛强度、C-反应蛋白和血沉成显著正相关,而与患者的年龄、性别以及患病的脊柱节段无显著相关性。此外,脊柱结核组患者髓核组织中IFN-γ的表达显著升高,且其表达水平与KLF4呈明显的正相关。结论脊柱结核患者髓核组织中KLF4基因表达显著增高,且与预后相关,对脊柱结核的诊断及疗效评价具有重要的参考价值。

Objective To examine the expression of Krüppel like factor 4(KLF4)in the nucleus pulposus tissue of patients with spinal tuberculosis(STB)and its correlation with clinical data.Methods Twenty patients diagnosed with spinal tuberculosis and undergoing surgical treatment from February 2022 to February 2023 were selected(STB group),and nucleus pulposus tissue was collected during surgery.Fifteen patients with intervertebral disc herniation and nine patients with traumatic spinal fractures undergoing surgery in the same period were selected as the intervertebral disc herniation group(ID group)and the normal control group(Ctrl group),respectively,with nucleus pulposus tissue collected during surgery.The expression levels of KLF4 in the nucleus pulposus tissues were measured by immunohistochemistry and RT-qPCR,and their correlations with symptoms duration,pain intensity,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and other clinical data were analyzed.Additionally,the correlation between interferon-γ(IFN-γ)and KLF4 in the nucleus pulposus tissues of the spinal tuberculosis patients was assessed using immunohistochemistry.Results Immunohistochemical analysis showed that the immunoreactivity of KLF4 in the nucleus pulposus of the spinal tuberculosis group and the intervertebral disc herniation group was significantly stronger than that in the control group.RT-qPCR analysis showed that the levels of KLF4 mRNA in the spinal tuberculosis group and the intervertebral disc herniation group were significantly higher than those in the control group.Furthermore,the expression level of KLF4 in the spinal tuberculosis group was significantly positively correlated with symptoms duration,pain intensity,CRP,and ESR,but not significantly correlated with age,gender,or the spinal segment affected.In addition,the expression of IFN-γin the nucleus pulposus tissues of the spinal tuberculosis group was significantly elevated,and its expression level was significantly positively correlated with KLF4.Conclusion The expression of KLF4 gene in the nucleus pulposus tissues of patients with spinal tuberculosis is significantly increased and is correlated with prognosis,which may have important implications for the diagnosis and efficacy evaluation of spinal tuberculosis.