Miyazaki Shingo, Diwan Ashish D, Kato Kenji, Cheng Kevin, Bae Won C, Sun Yang, Yamada Junichi, Muehleman Carol, Lenz Mary E, Inoue Nozomu, Sah Robert L, Kawakami Mamoru, Masuda Koichi
Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho Chuo-Ku, Kobe, 650-0017, Hyogo, Japan.
Eur Spine J. 2018 Apr;27(4):739-751. doi: 10.1007/s00586-018-5488-1. Epub 2018 Feb 19.
To elucidate the effects of growth differentiation factor-6 (GDF6) on: (i) gene expression of inflammatory/pain-related molecules and structural integrity in the rabbit intervertebral disc (IVD) degeneration model, and (ii) sensory dysfunction and changes in pain-marker expression in dorsal nerve ganglia (DRGs) in the rat xenograft radiculopathy model.
Forty-six adolescent rabbits received anular-puncture in two non-consecutive lumbar IVDs. Four weeks later, phosphate-buffered saline (PBS) or GDF6 (1, 10 or 100 µg) was injected into the nucleus pulposus (NP) of punctured discs and followed for 4 weeks for gene expression analysis and 12 weeks for structural analyses. For pain assessment, eight rabbits were sacrificed at 4 weeks post-injection and NP tissues of injected discs were transplanted onto L5 DRGs of 16 nude rats to examine mechanical allodynia. The rat DRGs were analyzed immunohistochemically.
In GDF6-treated rabbit NPs, gene expressions of interleukin-6, tumor necrosis factor-α, vascular endothelial growth factor, prostaglandin-endoperoxide synthase 2, and nerve growth factor were significantly lower than those in the PBS group. GDF6 injections resulted in partial restoration of disc height and improvement of MRI disc degeneration grades with statistical significance in rabbit structural analyses. Allodynia induced by xenograft transplantation of rabbit degenerated NPs onto rat DRGs was significantly reduced by GDF6 injection. Staining intensities for ionized calcium-binding adaptor molecule-1 and calcitonin gene-related peptide in rat DRGs of the GDF6 group were significantly lower than those of the PBS group.
GDF6 injection may change the pathological status of degenerative discs and attenuate degenerated IVD-induced pain.
阐明生长分化因子-6(GDF6)对以下方面的影响:(i)兔椎间盘退变模型中炎症/疼痛相关分子的基因表达及结构完整性;(ii)大鼠异种移植神经根病模型中背根神经节(DRG)的感觉功能障碍及疼痛标志物表达变化。
46只青春期兔在两个非连续的腰椎间盘进行纤维环穿刺。4周后,将磷酸盐缓冲盐水(PBS)或GDF6(1、10或100μg)注入穿刺椎间盘的髓核,随后进行4周的基因表达分析和12周的结构分析。为进行疼痛评估,在注射后4周处死8只兔,并将注射椎间盘的髓核组织移植到16只裸鼠的L5背根神经节上,以检测机械性异常疼痛。对大鼠背根神经节进行免疫组织化学分析。
在GDF6处理的兔髓核中,白细胞介素-6、肿瘤坏死因子-α、血管内皮生长因子、前列腺素内过氧化物合酶2和神经生长因子的基因表达明显低于PBS组。在兔的结构分析中,注射GDF6导致椎间盘高度部分恢复,MRI椎间盘退变分级改善,具有统计学意义。将兔退变髓核异种移植到大鼠背根神经节诱导的异常疼痛通过注射GDF6显著减轻。GDF6组大鼠背根神经节中离子钙结合衔接分子-1和降钙素基因相关肽的染色强度明显低于PBS组。
注射GDF6可能改变退变椎间盘的病理状态,减轻退变椎间盘引起的疼痛。