Herniated lumbar intervertebral discs spontaneously produce matrix metalloproteinases, nitric oxide, interleukin-6, and prostaglandin E(2)
Herniated lumbar intervertebral discs spontaneously produce matrix metalloproteinases, nitric oxide, interleukin-6, and prostaglandin E(2)
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DOI：
10.1097/00007632-199602010-00003
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发表时间：
1996-02-01
期刊：
影响因子：
3
通讯作者：
Evans, CH
中科院分区：
文献类型：
--
作者：
Kang, JD;Georgescu, HI;Evans, CH
研究设计.从因持续性神经根病接受手术椎间盘切除术的患者中获得突出的腰椎间盘标本，并在体外培养以确定是否产生了各种生化因子。目的，我们的假设是炎症和组织降解的生化介质在椎间盘退变和神经根病的病理生理学中起作用。下腰痛伴或不伴神经根病是一个重要的临床问题，但下腰痛的病因和神经根病的确切病理生理学仍然难以捉摸。椎间盘退变发生的生化事件，特别是炎症和组织降解的生化介质的作用，在文献中很少受到关注。有一些初步证据表明，炎症介质可能在神经根病的病理生理学中起重要作用。从15例接受椎间盘手术的患者中获得18个腰椎间盘突出。将标本培养并孵育72小时，随后收集培养基进行生化分析。进行基质金属蛋白酶、一氧化氮、前列腺素E（2）和多种细胞因子的生化测定。作为对照组，8个腰椎间盘标本取自4例因脊柱侧凸和创伤性爆裂性骨折接受前路手术的患者，并进行类似的生化分析。与对照椎间盘相比，突出腰椎间盘的培养基显示基质金属蛋白酶活性水平增加。同样，与对照组相比，突出椎间盘中一氧化氮、前列腺素E2和白细胞介素6的水平也显著升高。在突出或对照椎间盘的培养液中均未检测到白细胞介素-1 α、白细胞介素-1 β、肿瘤坏死因子-α、白细胞介素-1受体拮抗剂蛋白和P物质。突出的腰椎间盘会自发地产生大量的基质金属蛋白酶、一氧化氮、前列腺素E2和白细胞介素6。这些产物可能与椎间盘退变的生物化学和神经根病的病理生理学密切相关。它们的确切作用当然需要进一步的研究，但它们的存在本身就暗示了椎间盘退变的生化过程。
Study Design. Herniated lumbar disc specimens were obtained from patients undergoing surgical discectomy for persistent radiculopathy and cultured in vitro to determine whether various biochemical agents were being produced.Objectives, Our hypothesis is that biochemical mediators of inflammation and tissue degradation play a role in intervertebral disc degeneration ana in the pathophysiology of radiculopathy.Summary of Background Data, Low back pain with or without radiculopathy is a significant clinical problem, but the etiology of low back pain and the exact pathophysiology of radiculopathy remain elusive. The biochemical events that occur with intervertebral disc degeneration and, in particular, the role of biochemical mediators of inflammation and tissue degradation have received sparse attention in the literature.-There is some preliminary evidence that inflammatory mediators may have an important role in the pathophysiology of radiculopathy.Methods. Eighteen herniated lumbar discs were obtained from 15 patients undergoing disc surgery. The specimens were cultured and incubated for 72 hours, and the media were collected subsequently for biochemical analysis. Biochemical assays for matrix metalloproteinases, nitric oxide,prostaglandin E(2), and a variety of cytokines were performed. As a control group, eight lumbar disc specimens were obtained from four patients undergoing anterior surgery for scoliosis and traumatic burst fractures, and similar biochemical analyses were performed.Results. The culture media from the herniated lumbar discs showed increased levels of matrix metalloproteinase activity compared with the control discs. Similarly, the levels of nitric oxide,,prostaglandin E(2), and interleukin-6 were significantly higher in the herniated discs compared with the control discs. Interleukin-1 alpha, interleukin-1 beta, tumor necrosis factor-alpha, interleukin-1 receptor antagonist protein, and substance P were not detected in the culture media of either the herniated or control discs.Conclusions. Herniated lumbar discs were making spontaneously increased amounts of matrix metalloproteinases, nitric oxide, prostaglandin E(2), and interleukin-6. These products may be involved intimately in the biochemistry of disc degeneration and the pathophysiology of radiculopathy. Their exact roles certainly need further investigation, but their mere presence implicates biochemical processes in intervertebral disc degeneration.