Institute of Pathology, Philipps University, and University Hospital Giessen and Marburg, 35033 Marburg, Germany.
Center for Orthopedics and Trauma Surgery, Philipps University, and University Hospital Giessen and Marburg, 35033 Marburg, Germany.
Biomolecules. 2021 Nov 24;11(12):1752. doi: 10.3390/biom11121752.
The most common spinal disorder in elderly is lumbar spinal stenosis (LSS), resulting partly from ligamentum flavum (LF) hypertrophy. Its pathophysiology is not completely understood. The present study wants to elucidate the role of estrogen receptor α (ER α) in fibroblasts of hypertrophied LF. LF samples of 38 patients with LSS were obtained during spinal decompression. Twelve LF samples from patients with disk herniation served as controls. Hematoxylin & Eosin (H&E) and Elastica stains and immunohistochemistry for ER α were performed. The proportions of fibrosis, loss and/or degeneration of elastic fibers and proliferation of collagen fibers were assessed according to the scores of Sairyo and Okuda. Group differences in the ER α and Sairyo and Okuda scores between patients and controls, male and female sex and absence and presence of additional orthopedic diagnoses were assessed with the Mann-Whitney test. There was a tendency towards higher expression of ER α in LF fibroblasts in the hypertrophy group ( = 0.065). The Sairyo and Okuda scores were more severe for the hypertrophy group but, in general, not statistically relevant. There was no statistically relevant correlation between the expression of ER α and sex ( = 0.326). ER α expression was higher in patients with osteochondrosis but not statistically significant ( = 0.113). In patients with scoliosis, ER α expression was significantly lower ( = 0.044). LF hypertrophy may be accompanied by a higher expression of ER α in fibroblasts. No difference in ER α expression was observed regarding sex. Further studies are needed to clarify the biological and clinical significance of these findings.
老年人最常见的脊柱疾病是腰椎管狭窄症（LSS），部分原因是黄韧带（LF）肥厚。其病理生理学尚未完全了解。本研究旨在阐明雌激素受体α（ERα）在肥厚 LF 成纤维细胞中的作用。在脊柱减压过程中从 38 例 LSS 患者中获得 LF 样本。12 例椎间盘突出症患者的 LF 样本作为对照。进行了苏木精和伊红（H&E）和弹力纤维染色以及 ERα的免疫组织化学染色。根据 Sairyo 和 Okuda 的评分评估纤维化、弹性纤维丢失和/或变性以及胶原纤维增生的比例。使用 Mann-Whitney U 检验评估患者与对照组、男性与女性以及是否存在其他骨科诊断之间 ERα和 Sairyo 和 Okuda 评分的组间差异。肥大组 LF 成纤维细胞中 ERα的表达呈增高趋势（=0.065）。肥大组的 Sairyo 和 Okuda 评分更严重，但总体上无统计学意义。ERα的表达与性别之间无统计学相关（=0.326）。骨软骨病患者的 ERα表达较高，但无统计学意义（=0.113）。在脊柱侧凸患者中，ERα的表达明显降低（=0.044）。LF 肥厚可能伴有成纤维细胞中 ERα表达增加。ERα的表达在性别方面无差异。需要进一步研究阐明这些发现的生物学和临床意义。
