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甲氨蝶呤通过内质网应激信号通路预防硬膜外纤维化。

Methotrexate prevents epidural fibrosis through endoplasmic reticulum stress signalling pathway.

作者信息

Chen Hui, Yan Lianqi, Wang Jingcheng, Sun Yu, Li Xiaolei, Zhao Shuai, Wang Daxin, Zhu Gengyao, Liang Yuan

机构信息

Department of Orthopedics, Clinical medical college of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China.

Department of Orthopedics, Clinical medical college of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou 225001, China.

出版信息

Eur J Pharmacol. 2017 Feb 5;796:131-138. doi: 10.1016/j.ejphar.2016.12.032. Epub 2016 Dec 21.

Abstract

Lumbar laminectomy is one of the most common treatments for lumbar disc herniation and other lumbar disorders with serious complications, such as failed back surgery syndrome, mainly caused by epidural fibrosis (EF). The developing fibrosis causes radicular pain after the laminectomy or discectomy. Methotrexate (MTX) is a folic acid antagonist that has shown anti-proliferative effects in previous studies. The aim of our experiment is to study whether MTX has positive effects on the outcome of the laminectomy in rats. Our finding first demonstrated the beneficial effect of topical application of MTX in laminectomy models. As the results of a macroscopic scoring system, hydroxyproline content analysis, histological evaluation, the number of fibroblasts and immunohistochemistry showed that MTX suppressed the EF compared with the control group, and the inhibiting effect was in a dose-dependent manner. Furthermore, we hypothesized that the endoplasmic reticulum (ER) stress mediated the suppression effect of the EF. To verify this point of view, fibroblast cells cultured from epidural scar tissues of rats were used. CCK-8 assay, Western blot (for apoptotic genes, such as cleaved PARP) and annexin V-FITC/PI double-labelling showed that MTX could induce cell apoptosis. The expression of CHOP and GRP78 and the activation of ER stress-associated genes strongly suggested that ER stress mediated the apoptotic signalling pathway; immunohistochemistry of GRP78 and CHOP further verified this. Our findings indicate that topical application of MTX could indeed reduce EF, and the application of MTX could induce apoptosis through ER stress in rats.

摘要

腰椎椎板切除术是治疗腰椎间盘突出症和其他腰椎疾病最常用的方法之一,但该手术会引发严重并发症,如腰椎手术失败综合征,主要原因是硬膜外纤维化(EF)。纤维化的发展会在椎板切除术后或椎间盘切除术后导致神经根性疼痛。甲氨蝶呤(MTX)是一种叶酸拮抗剂,在先前的研究中已显示出抗增殖作用。我们实验的目的是研究MTX对大鼠椎板切除术的结果是否有积极影响。我们的研究首次证明了在椎板切除术模型中局部应用MTX的有益效果。通过宏观评分系统、羟脯氨酸含量分析、组织学评估、成纤维细胞数量和免疫组织化学的结果表明,与对照组相比,MTX抑制了EF,且抑制作用呈剂量依赖性。此外,我们推测内质网(ER)应激介导了对EF的抑制作用。为了验证这一观点,我们使用了从大鼠硬膜外瘢痕组织培养的成纤维细胞。CCK-8检测、蛋白质印迹法(检测凋亡基因,如裂解的PARP)和膜联蛋白V-FITC/PI双标记显示MTX可诱导细胞凋亡。CHOP和GRP78的表达以及ER应激相关基因的激活强烈表明ER应激介导了凋亡信号通路;GRP78和CHOP的免疫组织化学进一步证实了这一点。我们的研究结果表明,局部应用MTX确实可以减少EF,并且MTX的应用可以通过大鼠的ER应激诱导细胞凋亡。

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