Sainoh Takeshi, Orita Sumihisa, Miyagi Masayuki, Sakuma Yoshihiro, Yamauchi Kazuyo, Suzuki Miyako, Kubota Go, Oikawa Yasuhiro, Inage Kazuhide, Sato Jun, Fujimoto Kazuki, Shiga Yasuhiro, Inoue Gen, Aoki Yasuchika, Takahashi Kazuhisa, Ohtori Seiji
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Department of Orthopaedic Surgery, Kitasato University, Kanagawa, Japan.
J Orthop Res. 2015 Oct;33(10):1508-14. doi: 10.1002/jor.22925. Epub 2015 May 29.
The pathological mechanism of intractable low back pain is unclear. However, intervertebral disc (IVD) degeneration is a primary cause of low back pain, and pain-related mediators, such as interleukin-6 (IL-6), have been correlated with discogenic pain. The objective of this study is to elucidate the mechanism of local IL-6 and IL-6 receptor (IL-6R) expression after IVD injury as well as determine the involvement of IL-6/IL-6 signaling in discogenic pain. To do this, quantitative and immunohistological analyses in a mouse model of IVD injury were performed. Firstly, we measured the local expression levels of IL-6 and IL-6R in IVDs by enzyme-linked immunosorbent assay (ELISA). Secondly, we immunohistochemically confirmed their localization in injured IVDs. Lastly, we evaluated the effects of intradiscal injection of an IL-6 inhibitor by evaluating pain-related protein, calcitonin gene-related peptide (CGRP), expression in dorsal root ganglia (DRG) neurons that innervate IVDs. Injured IVDs showed increased production of IL-6 and IL-6R. IL-6 and IL-6R expression in the injured IVD were predominantly localized in the annulus fibrosus and endplate, and intradiscal injection of the IL-6 inhibitor suppressed CGRP expression in the DRG neurons. These results show that IL-6 and IL-6R expression levels are responsive to IVD injury and that inhibition of IL-6/IL-6R signaling may be a promising analgesic treatment for degenerative disc diseases.
顽固性腰痛的病理机制尚不清楚。然而,椎间盘退变是腰痛的主要原因,且疼痛相关介质,如白细胞介素-6(IL-6),已被证实与椎间盘源性疼痛相关。本研究的目的是阐明椎间盘损伤后局部IL-6和IL-6受体(IL-6R)的表达机制,并确定IL-6/IL-6信号通路在椎间盘源性疼痛中的作用。为此,我们在椎间盘损伤的小鼠模型中进行了定量和免疫组织学分析。首先,我们通过酶联免疫吸附测定(ELISA)测量了椎间盘内IL-6和IL-6R的局部表达水平。其次,我们通过免疫组织化学方法证实了它们在损伤椎间盘内的定位。最后,我们通过评估支配椎间盘的背根神经节(DRG)神经元中疼痛相关蛋白降钙素基因相关肽(CGRP)的表达,来评价椎间盘内注射IL-6抑制剂的效果。损伤的椎间盘显示出IL-6和IL-6R产生增加。IL-6和IL-6R在损伤椎间盘中的表达主要定位于纤维环和终板,并且椎间盘内注射IL-6抑制剂可抑制DRG神经元中CGRP的表达。这些结果表明,IL-6和IL-6R的表达水平对椎间盘损伤有反应,并且抑制IL-6/IL-6R信号通路可能是治疗退行性椎间盘疾病的一种有前景的镇痛方法。