Nerves are more abundant than blood vessels in the degenerate human intervertebral disc.
Nerves are more abundant than blood vessels in the degenerate human intervertebral disc.
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DOI：
10.1186/s13075-015-0889-6
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发表时间：
2015-12-21
影响因子：
4.9
通讯作者：
Le Maitre CL
中科院分区：
文献类型：
--
作者：
Binch AL;Cole AA;Breakwell LM;Michael AL;Chiverton N;Creemers LB;Cross AK;Le Maitre CL
慢性腰痛（LBP）是全球最常见的残疾原因。围绕LBP的新想法正在出现，这些想法基于对人类IVD的机械，生物和化学影响之间的相互作用。退化的IVD被认为是由感觉神经纤维支配并由血管血管化，并推测其有助于疼痛感觉。然而，神经和血管长入的发生率，以及这些特征是否总是相关的，是未知的。我们研究了大量人类椎间盘中椎间盘髓核（NP）中神经和血管的存在。对61例人IVD样本进行免疫组织化学，以识别和定位IVD不同区域内的神经（神经丝200 [NF 200]/蛋白基因产物9.5）和血管（CD 31）。NF 200的免疫阳性在尸检组织内的IVD的所有区域内被确定。可见神经穿过板层脊并穿过基质向NP细胞突出。在NP深处发现神经，在许多情况下，但不总是，在靠近裂隙或基质减少的区域观察到神经。15%的样本变性，神经和血管阴性，而所有样本中有16%的神经和血管变性。我们鉴定出52%的退化样本有神经但没有血管。有趣的是，只有4%的样本变性，没有神经，但血管阳性。在研究的85个样本中，只有6%的样本是非变性的，没有神经和血管，7%的样本有神经但没有血管。本研究解决了大量人体样本中神经和血管长入IVD的争议话题。我们的研究结果表明，神经是存在于一个大比例的NP样本退化IVD。这项研究表明神经长入和IVD变性之间可能存在联系，并表明神经可以在没有血管的情况下迁移。
Chronic low back pain (LBP) is the most common cause of disability worldwide. New ideas surrounding LBP are emerging that are based on interactions between mechanical, biological and chemical influences on the human IVD. The degenerate IVD is proposed to be innervated by sensory nerve fibres and vascularised by blood vessels, and it is speculated to contribute to pain sensation. However, the incidence of nerve and blood vessel ingrowth, as well as whether these features are always associated, is unknown. We investigated the presence of nerves and blood vessels in the nucleus pulposus (NP) of the IVD in a large population of human discs. Immunohistochemistry was performed with 61 human IVD samples, to identify and localise nerves (neurofilament 200 [NF200]/protein gene product 9.5) and blood vessels (CD31) within different regions of the IVD. Immunopositivity for NF200 was identified within all regions of the IVD within post-mortem tissues. Nerves were seen to protrude across lamellar ridges and through matrix towards NP cells. Nerves were identified deep within the NP and were in many cases, but not always, seen in close proximity to fissures or in areas where decreased matrix was seen. Fifteen percent of samples were degenerate and negative for nerves and blood vessels, whilst 16 % of all samples were degenerate with nerves and blood vessels. We identified 52 % of samples that were degenerate with nerves but no blood vessels. Interestingly, only 4 % ofall samples were degenerate with no nerves but positive for blood vessels. Of the 85 samples investigated, only 6 % of samples were non-degenerate without nerves and blood vessels and 7 % had nerves but no blood vessels. This study addresses the controversial topic of nerve and blood vessel ingrowth into the IVD in a large number of human samples. Our findings demonstrate that nerves are present within a large proportion of NP samples from degenerate IVDs. This study shows a possible link between nerve ingrowth and degeneration of the IVD and suggests that nerves can migrate in the absence of blood vessels.