Department of Anesthesiology, Maoming People's Hospital, China.
Adv Clin Exp Med. 2022 Jul;31(7):723-730. doi: 10.17219/acem/146968.
The miR-21 has been implicated in the process of neuroinflammation as well as neuropathic pain.
To explore the relationship between the plasma and local expression of miR-21 with disease severity of lumbar disc herniation (LDH) patients with sciatic pain.
Ninety-two LDH patients with sciatic pain and 25 scoliosis patients as painless controls were enrolled in the current study. Samples from nucleus pulposus (NP), annulus fibrosus (AF) and soft tissues around nerve root (STANR) were obtained. The plasma and local expressions of miR-21 were detected with quantitative reverse transcription polymerase chain reaction (qRT-PCR). The visual analogue scale (VAS) for lumbar pain and leg pain, and Japanese Orthopedic Association (JOA) score were selected to evaluate the clinical severity. The degree of disc compression on nerve was evaluated using the Pfirrmann grade based on the magnetic resonance imaging (MRI) findings. For the convenience of analysis, LDH patients with sciatic pain were classified into a severe pain (SP) group (VAS ≥ 6) and a mild-moderate pain (MP) group (VAS < 6). Receiver operating characteristic (ROC) curve analysis was performed to detect the potential diagnostic power of miR-21 with regard to the Pfirrmann grade.
There were no significant differences in serum miR-21 expressions among SP LDH patients, MP LDH patients and scoliosis painless controls. Local expressions of miR-21 in STANR, AF and NP were all drastically upregulated in the SP group in comparison with the MP group and scoliosis painless group. Local NP and STANR miR-21 expressions were positively associated with the Pfirrmann grade. Local miR-21 expressions in STANR and AF were positively associated with VAS score and negatively related to JOA score. The ROC curve analysis indicated that both STANR and AF miR-21 expressions may serve as significant diagnostic factors for the Pfirrmann grade.
Increased local miR-21 expressions are linked with clinical severity of LDH in patients with sciatic pain.
miR-21 参与了神经炎症和神经病理性疼痛的过程。
探讨血浆和局部表达 miR-21 与伴有坐骨神经痛的腰椎间盘突出症（LDH）患者疾病严重程度的关系。
本研究纳入了 92 例伴有坐骨神经痛的 LDH 患者和 25 例无症状对照组的脊柱侧弯患者。采集了椎间盘核（NP）、纤维环（AF）和神经根周围软组织（STANR）的样本。采用定量逆转录聚合酶链反应（qRT-PCR）检测血浆和局部 miR-21 的表达。采用视觉模拟量表（VAS）评估腰痛和腿痛，采用日本骨科协会（JOA）评分评估临床严重程度。根据磁共振成像（MRI）结果，采用 Pfirrmann 分级评估神经受压程度。为了便于分析，将伴有坐骨神经痛的 LDH 患者分为重度疼痛（SP）组（VAS≥6）和轻度中度疼痛（MP）组（VAS<6）。采用受试者工作特征（ROC）曲线分析 miR-21 对 Pfirrmann 分级的潜在诊断能力。
SP LDH 患者、MP LDH 患者和脊柱侧弯无痛对照组之间，血清 miR-21 表达无显著差异。与 MP 组和脊柱侧弯无痛组相比，SP 组 STANR、AF 和 NP 局部 miR-21 表达均显著上调。NP 和 STANR 局部 miR-21 表达与 Pfirrmann 分级呈正相关。STANR 和 AF 局部 miR-21 表达与 VAS 评分呈正相关，与 JOA 评分呈负相关。ROC 曲线分析表明，STANR 和 AF 局部 miR-21 表达均可能是 Pfirrmann 分级的重要诊断因素。
伴有坐骨神经痛的 LDH 患者局部 miR-21 表达增加与疾病严重程度相关。
