Translational Musculoskeletal Research Center, Corporal Michael J. Crescenz Philadelphia VA Medical Center, Philadelphia, Pennsylvania.
Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
J Orthop Res. 2020 Nov;38(11):2521-2531. doi: 10.1002/jor.24639. Epub 2020 Mar 3.
Intervertebral disc degeneration is implicated as a leading cause of low back pain. Persistent, local inflammation within the disc nucleus pulposus (NP) and annulus fibrosus (AF) is an important mediator of disc degeneration and negatively impacts the performance of therapeutic stem cells. There is a lack of validated large animal models of disc degeneration that recapitulate clinically relevant local inflammation. We recently described a goat model of disc degeneration in which increasing doses of chondroitinase ABC (ChABC) were used to reproducibly induce a spectrum of degenerative changes. The objective of this study was to extend the clinical relevance of this model by establishing whether these degenerative changes are associated with the local expression of inflammatory cytokines and catabolic enzymes. Degeneration was induced in goat lumbar discs using ChABC at different doses. After 12 weeks, degeneration severity was determined histologically and using quantitative magnetic resonance imaging (MRI). Expression levels of inflammatory cytokines (tumor necrosis factor-α [TNF-α], interleukin-1β [IL-1β], and IL-6) and catabolic enzymes (matrix metalloproteinases-1 [MMPs-1] and 13, and a disintegrin and metalloproteinase with thrombospondin type-1 motifs-4 [ADAMTS-4]) were assessed as the percentage of immunopositive cells in the NP and AF. With the exception of MMP-1, cytokine, and enzyme expression levels were significantly elevated in ChABC-treated discs in the NP and AF. Expression levels of TNF-α, IL1-β, and ADAMTS-4 were positively correlated with histological grade, while all cytokines and ADAMTS-4 were negatively correlated with MRI T2 and T1ρ scores. These results demonstrate that degenerate goat discs exhibit elevated expression of clinically relevant inflammatory mediators, and further validate this animal model as a platform for evaluating new therapeutic approaches for disc degeneration.
椎间盘退变被认为是导致下腰痛的主要原因。椎间盘核髓(NP)和纤维环(AF)内持续的局部炎症是椎间盘退变的重要介质,对治疗性干细胞的功能产生负面影响。目前缺乏可重现临床相关局部炎症的经过验证的大型动物椎间盘退变模型。我们最近描述了一种山羊椎间盘退变模型,其中使用递增剂量的软骨素酶 ABC(ChABC)可重复性地诱导一系列退行性变化。本研究的目的是通过确定这些退行性变化是否与局部炎症细胞因子和分解代谢酶的表达相关,来扩展该模型的临床相关性。使用 ChABC 在不同剂量下诱导山羊腰椎间盘退变。12 周后,通过组织学和定量磁共振成像(MRI)确定退变程度。评估炎症细胞因子(肿瘤坏死因子-α [TNF-α]、白细胞介素-1β [IL-1β] 和白细胞介素-6 [IL-6])和分解代谢酶(基质金属蛋白酶-1 [MMP-1] 和 13、解整合素金属蛋白酶与凝血酶 1 型基序-4 [ADAMTS-4])的表达水平,作为 NP 和 AF 中免疫阳性细胞的百分比。除了 MMP-1 之外,NP 和 AF 中 ChABC 处理的椎间盘细胞因子和酶的表达水平均显著升高。TNF-α、IL1-β 和 ADAMTS-4 的表达水平与组织学分级呈正相关,而所有细胞因子和 ADAMTS-4 与 MRI T2 和 T1ρ 评分呈负相关。这些结果表明,退变的山羊椎间盘表现出临床上相关的炎症介质的表达升高,并进一步验证了该动物模型作为评估椎间盘退变新治疗方法的平台。