腰椎退变及其与小关节囊和黄韧带中胶原和弹性蛋白表达的关系。
Degeneration of the lumbar spine and its relation to the expression of collagen and elastin in facet joint capsules and ligament flavum.
机构信息
Department for Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.
Institute for Anatomy, Leipzig University, Leipzig, Germany.
出版信息
Acta Orthop Traumatol Turc. 2022 May;56(3):210-216. doi: 10.5152/j.aott.2022.21314.
OBJECTIVE
The aim of the study was to assess the relationship between the expression of elastin, collagen type I, II,III and the degenera- tion of the facet joint capsule and the ligamentum flavum.
METHODS
10 patients (4 male, 6 female) (mean age 61 ± 14,9) undergoing surgery for degenerative lumbar spine syndrome and 5 cadav- ers (3 male, 2 female) (age of death 87 ± 8,6 years) were included in this study. One set of tissue samples was taken from each patient in the patient group intraoperatively and two sets of samples were taken from each cadaver in the cadaver group posthumosly from the ligamentum flavum (medial and lateral) and from the facet joint capsules (superior and inferior articular process) at the L4/5 segment. Western blot analysis was performed for collagen types I, II, III and for elastin. Disc degeneration was scored according to the Pfirmann Classification, facet joint arthrosis was scored according to the Fujiwara Classification and their relationship with protein expression was investigated.
RESULTS
There was a strong expression of Collagen type I in the patient group (PG) compared to the body donor group (BDG) in the facet joint capsule (FJC) and in the lateral samples of the ligamentum flavum. Samples of the FJC showed lower expression of elastin in the PG compared with the BDG, but without statistical significance. An increased expression of collagen type I compared to elastin in the PG could be shown. In contrast, elastin predominated in the samples of the BDG group compared to collagen type I (collagen type I/ elastin PG: PAsup 2,78; PAinf 2,61; LFmed 2,23; 225 LFlat 1,83; BDG: PAsup 0,15; PAinf 0,2; LFmed 0,2; LFlat 0,27). Rank correlation coefficient according to Spearman showed low to moderate correlations for collagen type I, III and elastin for the degree of disc degeneration accord- ing to Pfirrmann and the degree of facet joint osteoarthritis according to Fujiwara, all of them without statistical significance.
CONCLUSION
This study has shown us that in the context of degenerative changes of the lumbar spine, there is an increased expression of collagen type I and a dominance over elastin.
LEVEL OF EVIDENCE
Level III, Diagnostic Study.
目的
本研究旨在评估弹力蛋白、I 型、II 型和 III 型胶原的表达与小关节囊和黄韧带退变之间的关系。
方法
本研究纳入了 10 名接受退行性腰椎综合征手术的患者（4 男，6 女；平均年龄 61±14.9 岁）和 5 具尸体（3 男，2 女；死亡年龄 87±8.6 岁）。在患者组中，每个患者在术中取一组组织样本，在尸体组中，每个尸体的黄韧带（内侧和外侧）和小关节囊（上下关节突）在 L4/5 节段取两组样本。进行了 I 型、II 型和 III 型胶原以及弹力蛋白的 Western blot 分析。根据 Pfirrmann 分级对椎间盘退变进行评分，根据 Fujiwara 分级对小关节关节炎进行评分，并研究其与蛋白表达的关系。
结果
与尸体供体组（BDG）相比，患者组（PG）的小关节囊（FJC）和黄韧带外侧样本中 I 型胶原表达较强。PG 中的 FJC 样本中弹力蛋白的表达低于 BDG，但无统计学意义。可以显示 PG 中 I 型胶原的表达高于弹力蛋白。相比之下，BDG 组样本中弹力蛋白的表达明显高于 I 型胶原（PG 中 I 型胶原/弹力蛋白：PAsup 2.78；PAinf 2.61；LFmed 2.23；LFlat 2.25；BDG：PAsup 0.15；PAinf 0.2；LFmed 0.2；LFlat 0.27）。Spearman 秩相关系数显示，根据 Pfirrmann 分级的椎间盘退变程度和根据 Fujiwara 分级的小关节关节炎程度与 I 型、III 型胶原和弹力蛋白的相关性较低至中度，均无统计学意义。
结论
本研究表明，在腰椎退行性变的情况下，I 型胶原表达增加，弹力蛋白占优势。
证据水平
III 级，诊断研究。
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