血小板衍生生长因子-BB 的表达与肥厚腰椎黄韧带纤维化程度成正比吗？
Is platelet-derived growth factor-BB expression proportional to fibrosis in the hypertrophied lumber ligamentum flavum?
机构信息
Department of Orthopedic and Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Republic of China.
出版信息
Spine (Phila Pa 1976). 2010 Dec 1;35(25):E1479-86. doi: 10.1097/BRS.0b013e3181f3d2df.
STUDY DESIGN
A clinical and experimental assessment using human samples of lumbar ligamentum flavum (LF).
OBJECTIVE
To identify platelet-derived growth factor-BB (PDGF-BB) expression in hypertrophied LF of patients with lumbar spinal canal stenosis (LSS) and relate it to fibrosis.
SUMMARY OF BACKGROUND DATA
Recent studies showed that fibrosis in LF hypertrophy was due to accumulation of inflammation-related scar tissue. PDGF-BB participates in scar formation and collagen development in wound healing and fibrosis diseases. However, it is unclear whether PDGF-BB expression is associated with fibrosis of the hypertrophied LF in LSS.
METHODS
In all, 10 patients of LSS was enrolled in this study, while 10 patients of lumbar disc herniation (LDH) as a control group. LF thickness was measured by axial T1-weighted magnetic resonance imaging. Fibrosis was graded and type of collagen was identified. The location and the expression of PDGF-BB were analyzed using immunohistochemical stains, real-time polymerase chain reaction, and Western Blotting. Correlation among LF thickness, fibrosis, and PDGF-BB expression was analyzed.
RESULTS
LF thickness was 5.3 ± 1.0 mm (range from 3.9 to 7.5 mm) in the LSS group and 2.8 ± 0.7 mm (range from 1.69 to 3.8 mm) in the LDH group. Obvious fibrosis was observed in all samples of the LSS group, and correlated to LF thickness of the dural, middle, and dorsal layers (P < 0.05), respectively. PDGF-BB was detected in the hypertrophied LF, particularly in the dorsal layer. PDGF-BB expression was higher in the LSS group than that in the LDH group (P < 0.05), and in the dorsal layer than the dural layer in the LSS group (P < 0.05). PDGF-BB mRNA correlated significantly to thickness of LF (r = 0.41) and the severity of fibrosis (r = 0.69) (P < 0.05).
CONCLUSION
A higher PDGF-BB expression existed in the hypertrophied LF of patients with LSS and could be a risk factor of the fibrosis.
研究设计
使用人类腰椎黄韧带（LF）标本进行临床和实验评估。
目的
鉴定腰椎管狭窄症（LSS）患者肥厚 LF 中的血小板衍生生长因子-BB（PDGF-BB）表达，并将其与纤维化相关联。
背景资料概要
最近的研究表明，LF 肥厚中的纤维化是由于炎症相关的瘢痕组织积累所致。PDGF-BB 参与伤口愈合和纤维化疾病中的瘢痕形成和胶原发育。然而，尚不清楚 PDGF-BB 表达是否与 LSS 中肥厚 LF 的纤维化相关。
方法
共纳入 10 例 LSS 患者和 10 例腰椎间盘突出症（LDH）患者作为对照组。采用轴向 T1 加权磁共振成像测量 LF 厚度。对纤维化进行分级，并鉴定胶原类型。使用免疫组织化学染色、实时聚合酶链反应和 Western Blotting 分析 PDGF-BB 的位置和表达。分析 LF 厚度、纤维化和 PDGF-BB 表达之间的相关性。
结果
LSS 组 LF 厚度为 5.3 ± 1.0mm（范围 3.9 至 7.5mm），LDH 组为 2.8 ± 0.7mm（范围 1.69 至 3.8mm）。所有 LSS 组标本均观察到明显的纤维化，与硬膜、中层和背层的 LF 厚度分别相关（P < 0.05）。在肥厚的 LF 中检测到 PDGF-BB，尤其是在背层。LSS 组的 PDGF-BB 表达高于 LDH 组（P < 0.05），LSS 组背层高于硬膜层（P < 0.05）。PDGF-BBmRNA 与 LF 厚度（r = 0.41）和纤维化严重程度（r = 0.69）显著相关（P < 0.05）。
结论
LSS 患者肥厚 LF 中存在更高的 PDGF-BB 表达，可能是纤维化的危险因素。
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