Department of Neurosurgery, University Hospital of Ioannina, Greece.
J Neurosurg Spine. 2011 Feb;14(2):268-72. doi: 10.3171/2010.9.SPINE09935. Epub 2010 Dec 24.
The authors studied the histological alterations and the expression of matrix metalloproteinase (MMP)-1 and MMP-3 in disc specimens of patients who had undergone operations for lumbar disc herniation.
Forty-three lumbar disc specimens were evaluated histopathologically for degenerative changes and immunohistochemical expression of MMP-1 and MMP-3. The observed degenerative changes provided a degenerative score that was applied in each patient. Sections of disc immunostained for MMP-1 and MMP-3 were evaluated semiquantitatively. Patients were categorized in 3 age groups: < 30 years, between 30 and 60 years, and > 60 years of age. The expression of MMP-1 and MMP-3 were correlated to patient's age, degenerative score, and grade of lumbar disc herniation.
There was no statistically significant difference in the degenerative score between the age groups. Degenerative changes were more pronounced in greater grades of herniation (p < 0.0001). In the group of patients < 30 years of age there was a significant correlation between MMP-1 and MMP-3 expression and both degenerative score and herniation grade. For the group of patients 30-60 years of age, there was no significant difference between MMP-1 expression and degenerative score, but the correlation between MMP-1 expression and grade of herniation was significant. There was a significant correlation between MMP-3 expression and both degenerative score and herniation grade. Regarding the patients > 60 years of age, there was a significant correlation between MMP-1 and MMP-3 expression and both degenerative score and herniation grade. There was a significantly lower expression of both MMP-1 and MMP-3 in the group < 30 years of age compared with the other ages. No significant correlation was found in MMP-1 and MMP-3 expression between the groups of patients who were 30-60 and > 60 years of age. Interestingly, in age groups > 30 years, there were no statistically significant differences between the expression of MMP-1 and MMP-3, whereas in patients < 30 years of age the expression of MMP-3 was significantly lower than the expression of MMP-1.
The expression of MMP-1 and MMP-3 were strongly correlated to the age of the patients and the grade of herniation. An important finding in this study is the differential expression of MMP-1 and MMP-3 between the age groups. In the young age group it appears that deregulation of MMP-1 expression is higher than that of MMP-3 in the pathogenesis of lumbar disc herniation.
作者研究了接受腰椎间盘突出症手术患者的椎间盘标本的组织学改变以及基质金属蛋白酶（MMP）-1 和 MMP-3 的表达。
对 43 个腰椎间盘标本进行组织病理学退行性改变和 MMP-1 和 MMP-3 的免疫组织化学表达评价。在每位患者中应用观察到的退行性改变提供退行性评分。用 MMP-1 和 MMP-3 对椎间盘进行免疫组织化学染色的切片进行半定量评价。患者分为 3 个年龄组：<30 岁、30-60 岁和>60 岁。MMP-1 和 MMP-3 的表达与患者年龄、退行性评分和腰椎间盘突出症的严重程度相关。
各组之间的退行性评分无统计学差异。在更大程度的突出症中退行性改变更明显（p<0.0001）。在<30 岁的患者组中，MMP-1 和 MMP-3 的表达与退行性评分和突出症分级均呈显著相关。对于 30-60 岁的患者组，MMP-1 表达与退行性评分之间无显著差异，但 MMP-1 表达与突出症分级的相关性显著。MMP-3 表达与退行性评分和突出症分级均呈显著相关。对于>60 岁的患者，MMP-1 和 MMP-3 的表达与退行性评分和突出症分级均呈显著相关。与其他年龄组相比，<30 岁的患者 MMP-1 和 MMP-3 的表达均显著降低。在 30-60 岁和>60 岁的患者组之间，MMP-1 和 MMP-3 的表达均无显著相关性。有趣的是，在>30 岁的年龄组中，MMP-1 和 MMP-3 的表达之间无统计学差异，而在<30 岁的患者中，MMP-3 的表达明显低于 MMP-1 的表达。
MMP-1 和 MMP-3 的表达与患者年龄和突出症分级密切相关。本研究的一个重要发现是 MMP-1 和 MMP-3 在不同年龄组之间的表达差异。在年轻组中，MMP-1 表达失调似乎高于 MMP-3 在腰椎间盘突出症发病机制中的失调。
