Chymopapain, chemonucleolysis, and nucleus pulposus regeneration.
Chymopapain, chemonucleolysis, and nucleus pulposus regeneration.
复制标题
DOI：
10.2106/00004623-198365090-00002
复制
发表时间：
1983-12
期刊：
影响因子：
--
通讯作者：
D. Bradford;K. M. Cooper;T. Oegema
中科院分区：
文献类型：
--
作者：
D. Bradford;K. M. Cooper;T. Oegema
在成年杂种犬中，将木瓜凝乳蛋白酶体内注射到椎间盘中，两周后会导致椎间盘间隙变窄，髓核、软骨终板和纤维环中的蛋白多糖（如番红-O染色所示）完全丧失。 [35S]硫酸盐标记和蛋白聚糖分离证明，髓核保留了合成蛋白聚糖的能力，但这些蛋白聚糖被内源性蛋白水解活性降解。木瓜凝乳蛋白酶治疗三个月后，椎间盘高度增加。在纤维环和软骨终板中恢复了强烈的番红-O 染色，并且在细胞核中非常明显。存在的蛋白多糖作为聚集体被回收，其中蛋白多糖单体比对照中的稍大。木瓜凝乳蛋白酶治疗六个月后，椎间盘高度进一步增加，正常组织学也已恢复。从髓核中分离出的蛋白多糖的化学成分和物理性质与对照组基本相同。这些观察结果表明，注射木瓜凝乳蛋白酶后，细胞核可以再生。临床相关性 我们的观察表明，木瓜凝乳蛋白酶对椎间盘具有深远但可逆的影响。注射木瓜凝乳蛋白酶后椎间盘的放射线狭窄与蛋白多糖含量和结构的损失相关。木瓜凝乳蛋白酶注射后正常椎间盘高度的恢复是通过用正常蛋白多糖重建椎间盘来解释的。在实验动物中，用木瓜凝乳蛋白酶进行化学溶核似乎比手术切除更不可能永久改变髓核的生物化学。
UNLABELLED In the adult mongrel dog, in vivo injection of chymopapain into the intervertebral disc resulted in disc-space narrowing at two weeks, with a complete loss of proteoglycan (as indicated by safranin-O staining) from the nucleus pulposus, the cartilaginous end-plates, and the annulus fibrosus. As demonstrated by [35S]sulphate-labeling and proteoglycan isolation, the nucleus pulposus retained the ability to synthesize proteoglycans, but these were degraded by endogenous proteolytic activity. Three months after chymopapain treatment the intervertebral disc showed an increase in height. There was a return of intense safranin-O staining in the annulus and the cartilaginous end-plates, and very prominently in the nucleus. The proteoglycans that were present were recovered as aggregates, with the proteoglycan monomer being slightly larger than in the controls. Six months after chymopapain treatment the intervertebral disc had increased further in height, and normal histology had been restored. The chemical composition and physical properties of the proteoglycans that were isolated from the nucleus pulposus were essentially the same as those from the controls. These observations suggest that the nucleus can regenerate following the injection of chymopapain. CLINICAL RELEVANCE Our observations demonstrate that chymopapain has a profound but reversible effect on the intervertebral disc. The radiographic narrowing of the intervertebral disc following chymopapain injection correlates with the loss of proteoglycan content and structure. The restoration of normal disc height following chymopapain injection is explained by reconstitution of the intervertebral disc with normal proteoglycans. In experimental animals, chemonucleolysis with chymopapain appears to be less likely than surgical excision to permanently alter the biochemistry of the nucleus pulposus.