腰椎终板微骨折损伤诱发类Modic改变、椎间盘退变和脊髓致敏——一种体内大鼠模型
Lumbar endplate microfracture injury induces Modic-like changes, intervertebral disc degeneration and spinal cord sensitization - An In Vivo Rat Model.
作者信息
Wang Dalin, Lai Alon, Gansau Jennifer, Seifert Alan C, Munitz Jazz, Zaheer Kashaf, Bhadouria Neharika, Lee Yunsoo, Nasser Philip, Laudier Damien M, Holguin Nilsson, Hecht Andrew C, Iatridis James C
机构信息
Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY.
Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
出版信息
bioRxiv. 2023 Jan 30:2023.01.27.525924. doi: 10.1101/2023.01.27.525924.
: Endplate (EP) injury plays critical roles in painful IVD degeneration since Modic changes (MCs) are highly associated with pain. Models of EP microfracture that progress to painful conditions are needed to better understand pathophysiological mechanisms and screen therapeutics. : Establish in vivo rat lumbar EP microfracture model with painful phenotype. : In vivo rat study to characterize EP-injury model with characterization of IVD degeneration, vertebral bone marrow remodeling, spinal cord sensitization, and pain-related behaviors. : EP-driven degeneration was induced in 5-month-old male Sprague-Dawley rats L4-5 and L5-6 IVDs through the proximal vertebral body injury with intradiscal injections of TNFα (n=7) or PBS (n=6), compared to Sham (surgery without EP-injury, n=6). The EP-driven model was assessed for IVD height, histological degeneration, pain-like behaviors (hindpaw von Frey and forepaw grip test), lumbar spine MRI and μCT analyses, and spinal cord substance P (SubP). : EP injuries induced IVD degeneration with decreased IVD height and MRI T2 values. EP injury with PBS and TNFα both showed MC type1-like changes on T1 and T2-weighted MRI, trabecular bone remodeling on μCT, and damage in cartilage EP adjacent to the injury. EP injuries caused significantly decreased paw withdrawal threshold and reduced grip forces, suggesting increased pain sensitivity and axial spinal discomfort. Spinal cord dorsal horn SubP was significantly increased, indicating spinal cord sensitization. : EP microfracture can induce crosstalk between vertebral bone marrow, IVD and spinal cord with chronic pain-like conditions. : This rat EP microfracture model of IVD degeneration was validated to induce MC-like changes and pain-like behaviors that we hope will be useful to screen therapies and improve treatment for EP-drive pain.
终板(EP)损伤在疼痛性椎间盘退变中起关键作用,因为Modic改变(MCs)与疼痛高度相关。需要建立能进展为疼痛状态的EP微骨折模型,以更好地理解病理生理机制并筛选治疗方法。
建立具有疼痛表型的体内大鼠腰椎EP微骨折模型。
进行体内大鼠研究,以通过椎间盘退变、椎体骨髓重塑、脊髓致敏和疼痛相关行为的特征来表征EP损伤模型。
通过向椎间盘内注射TNFα(n = 7)或PBS(n = 6)对5月龄雄性Sprague-Dawley大鼠的L4-5和L5-6椎间盘进行近端椎体损伤,诱导EP驱动的退变,与假手术组(无EP损伤的手术,n = 6)进行比较。对EP驱动模型进行椎间盘高度、组织学退变、疼痛样行为(后爪von Frey和前爪抓握试验)、腰椎MRI和μCT分析以及脊髓P物质(SubP)评估。
EP损伤导致椎间盘退变,椎间盘高度和MRI T2值降低。PBS和TNFα导致的EP损伤在T1和T2加权MRI上均显示出类似MC 1型的改变,μCT上显示小梁骨重塑,损伤邻近的软骨终板受损。EP损伤导致后爪撤离阈值显著降低和抓握力减小,表明疼痛敏感性增加和脊柱轴向不适。脊髓背角SubP显著增加,表明脊髓致敏。
EP微骨折可诱导椎体骨髓、椎间盘和脊髓之间发生串扰,并伴有慢性疼痛样状态。
该大鼠IVD退变的EP微骨折模型经验证可诱导类似MC的改变和疼痛样行为我们希望这将有助于筛选治疗方法并改善对EP驱动疼痛的治疗。