Li Yi-Fan, Tang Xian-Zhong, Liang Chao-Ge, Hui Yao-Ming, Ji Yun-Han, Xu Wei, Qiu WenJun, Cheng Li-Ming
Department of Orthopedic Surgery, Tongren Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai 200336, P.R. China.
Department of Spine Surgery, Tongji Hospital Affiliated to Tongji University School of Medicine Shanghai 200065, P.R. China.
Int J Clin Exp Pathol. 2015 Jan 1;8(1):719-26. eCollection 2015.
The present study was designed to evaluate the role of growth differentiation factor-5 (GDF-5) and bone morphogenetic protein type II receptor (BMPR-II) in the development of lumbar intervertebral disc degeneration (IDD). A total of 24 patients with lumbar IDD (experiment group) and 6 patients with lumbar vertebral fracture (control group) were enrolled in the study. Tissue samples of IVD from the experiment group and control group were obtained during lumbar fusion operation, respectively. Fixation and decalcification of IVD tissue were performed, and then HE staining was carried out to observe the morphological changes of the lumbar IVD tissues. The expression of GDF-5 and BMPRII in human lumbar IVD was detected by immunohistochemical staining. HE staining results showed that non- and minimal degeneration was found in 11 cases (score range, 0-3), moderate degeneration in 12 cases (score range, 4-8), and severe degeneration in 7 cases (score range, 9-12). According to the immunohistochemical results, the positive expression rates of GDF-5 and BMPRII in NP were higher than those in AF of the non- and minimal degeneration group, moderate degeneration group and severe degeneration group (all P < 0.05). However, no significant difference in GDF-5 or BMPRII positive expression was observed among the normal, non- and minimal, moderate and severe degeneration groups in neither NP area nor AF area (all P > 0.05). In conclusion, our results showed that GDF-5 and BMPRII expressed both in normal and degenerated IVD tissues, and GDF-5 might have an inhibition effect on degenerated lumbar IVD, suggesting that gene therapy may be a useful approach in producing physiological effects during early- and late-phase of lumbar IDD.
本研究旨在评估生长分化因子5(GDF-5)和骨形态发生蛋白II型受体(BMPR-II)在腰椎间盘退变(IDD)发展中的作用。本研究共纳入24例腰椎IDD患者(实验组)和6例腰椎骨折患者(对照组)。分别在腰椎融合手术中获取实验组和对照组的椎间盘组织样本。对椎间盘组织进行固定和脱钙处理,然后进行苏木精-伊红(HE)染色以观察腰椎间盘组织的形态学变化。采用免疫组织化学染色法检测人腰椎椎间盘中GDF-5和BMPRII的表达。HE染色结果显示,11例(评分范围0 - 3)为无退变和轻度退变,12例(评分范围4 - 8)为中度退变,7例(评分范围9 - 12)为重度退变。根据免疫组织化学结果,在无退变和轻度退变组、中度退变组及重度退变组中,髓核(NP)中GDF-5和BMPRII的阳性表达率均高于纤维环(AF)(均P < 0.05)。然而,在正常组、无退变和轻度退变组、中度退变组及重度退变组的NP区域和AF区域中,GDF-5或BMPRII阳性表达均无显著差异(均P > 0.05)。总之,我们的结果表明,GDF-5和BMPRII在正常和退变的椎间盘组织中均有表达,且GDF-5可能对退变的腰椎间盘有抑制作用,提示基因治疗可能是在腰椎IDD早期和晚期产生生理效应的一种有效方法。