TREATMENT OF HERNIATED INTERVERTEBRAL DISCS WITH AUTOGENOUS CALPAIN PURIFIED FROM PATIENT'S OWN RED BLOOD CELLS

木瓜蛋白酶化学核溶解术的并发症如过敏反应和寄生虫病已有报道。为了使化学核溶解成为一种更安全的治疗方法，需要其他安全有效的酶。从患者自身红细胞中纯化的自体μ钙蛋白酶可能引起过敏反应。钙蛋白酶对兔椎间盘蛋白糖有降解活性，本研究发现正常浓度的钙蛋白酶在脑脊液中有抑制酶反应的作用。钙蛋白酶抑制素是钙蛋白酶的特异性内源性抑制剂，其分子量约为80 kDa。抑制脑脊髓液中钙蛋白酶活性的物质的分子量可能小于10 -kDa。对脑脊液进行SDS-PAGE。抗钙蛋白酶抑制剂抗体免疫印迹法未见阳性染色。脑脊液中抑制钙蛋白酶的物质可能与钙蛋白酶抑制剂不同，提示鞘内意外注射μ钙蛋白酶进行化学核溶解时，其酶活性会随脑脊液丢失。自体μ钙蛋白酶有可能预防一种主要并发症，如Paralysis。我们建议使用自体μ钙蛋白酶进行化学核溶解术是治疗椎间盘突出的一种更安全的方法。

ON THE CHEMONUCLEOLYSIS WITH CHYMOPAPAIN, COMPLICATIONS SUCH AS ANAPHYLACTIC REACTION AND PARALYSIS HAVE BEEN REPORTED. TO MEKE CHEMONUCLEOLYSIS A SAFER TREATMENT, OTHER SAFE AND POTENT ENZYMES HAVE BEEN NEEDED. AUTOGENOUS μCALPAIN AS PURIFIED FROM THE PATIENT'S OWN RED BLOOD CELLS MIGHT PRIVENT ANAPHYLACTIC REACTION. CALPAIN HAS BEEN SHOWN TO THE DEGRADATIVE ACTIVITY ON PROTEOGLYCAN OF HE INTERVERTEBRAL DISCS OF RABBITS.IN THE PRESENT STUDY, WE FOUND CEREBROSPINAL FLUID INHIBIT ENZYME REACTION OF CALPAIN IN ITS NORMAL CONCENTRAION. THE MOLECULAR WEIGHT OF CALPASTATIN, SPECIFIC ENDOGENOUS INHIBITOR OF CALPAIN, IS APPROXIMATELY 80-kDa. THE MOLECULAR WEIGHT OF THE SUBSTANCE WHICH INHIBIT CALPAIN ENZYME ACTIVITY IN CEREBROSPINAL FLUID MIGHT BE LESS THAN 10 -kDa. CEREBROSPINAL FLUID WERE SUBJECTED TO SDS-PAGE. IN THE IMMUNOBLOTTING WITH ANTICALPASTATIN ANTIBODY POSITIVE STAINING WAS NOT OBTAINED. THE SUBSTANCE WHICH INHIBIT CALPAIN IN CEREBROSPINAL FLUID MIGHT BE DIFFERENT FROM CALPASTATIN.THESE DATA SUGGEST IN CASE OF ACCIDENTAL INTRATHECAL INJECTION OF μCALPAIN FOR CHEMONUCLEOLYSIS, ITS ENZYME ACTIVITY WILL BE LOST BY CEREBROSPINAL FLUID. IT IS POSSIBLE THAT AUTOGENOUS μCALPAIN PREVENT FROM ONE OF MAJOR COMPLICATIONS SUCH AS PARALYSIS. WE SUGGEST IT MAKES CHEMONUCLEOLYSIS WITH AUTOGENOUS μCALPAIN A SAFER TREATMENT OF HENIATED INTERVERTEBRAL DISCS.