Department of Orthopedic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, P. R. China; Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, P.R. China; Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, Zhejiang Province, P.R. China; Clinical Research Center of Motor System Disease of Zhejiang Province, P.R. China.
Department of Orthopedic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou City, Zhejiang Province, P. R. China; Orthopedics Research Institute of Zhejiang University, Hangzhou City, Zhejiang Province, P.R. China; Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Hangzhou City, Zhejiang Province, P.R. China; Clinical Research Center of Motor System Disease of Zhejiang Province, P.R. China.
Spine J. 2024 Feb;24(2):373-386. doi: 10.1016/j.spinee.2023.09.012. Epub 2023 Oct 3.
In clinical practice, acute trauma and chronic degeneration of the annulus fibrosus (AF) can promote further degeneration of the intervertebral disc (IVD). Therefore, it is critical to understand the AF repair process and its consequences on IVD. However, the lack of cost-effective and reproducible in vivo animal models of AF injury has limited research development in this field.
The purpose of this study was to establish and evaluate the utility of a novel animal model for full-thickness AF injury. Three foci were proposed: (1) whether this new modeling method can cause full-layer AF damage; (2) the repair processes and pathological changes in the damaged area after AF injury, and (3) the morphological and histological changes in the IVD are after AF injury.
STUDY DESIGN/SETTING: In vivo rat AF injury model with characterization of AF damage repair, IVD degeneration.
A total of 72,300 g male rats were randomly assigned to one of the two groups: experimental or sham. Annulus fibrosus was separated layer by layer under the microscope with a #11 blade up to the AF- nucleus pulpous (NP) junction. The repair process of the horizontal AF and morphological changes in the sagittal IVD were evaluated with HE staining. Sirius red staining under polarized light. Immunofluorescence was conducted to analyze changes in the expression of COL1 and COL3 in the AF injury area and 8-OHdg, IL-6, MMP13, FSP1, and ACAN in the IVD. The disc height and structural changes after AF injury were measured using X-ray and contrast-enhanced micro-CT. Additionally, the resistance of the AF to stretching was analyzed using three-point bending.
Annulus fibrosus-nucleus pulpous border was identified to stably induce the full-thickness AF injury without causing immediate NP injury. The AF repair process after injury was slow and expressed inflammation factors continuously, with abundant amounts of type III collagen appearing in the inner part of the AF. The scar at the AF lesion had decreased resistance to small molecule penetration and weakened tensile strength. Full-thickness AF injury induced disc degeneration with loss of disc height, progressive unilateral vertebral collapse, and ossification of the subchondral bone. Inflammatory-induced degeneration and extracellular matrix catabolism gradually appeared in the NP and cartilage endplate (CEP).
We established a low-cost and reproducible small animal model of AF injury which accurately replicated the pathological state of the limited AF self-repair ability and demonstrated that injury to the AF alone could cause further degeneration of the IVD.
This in vivo rat model can be used to study the repair process of the AF defect and pathological changes in the gradual degeneration of IVD after AF damage. In addition, the model provides an experimental platform for in vivo experimental research of potential clinical therapeutics.
在临床实践中,急性创伤和纤维环(AF)的慢性退变可促进椎间盘(IVD)的进一步退变。因此,了解 AF 的修复过程及其对 IVD 的影响至关重要。然而,缺乏经济高效且可重复的 AF 损伤体内动物模型限制了该领域的研究进展。
本研究旨在建立并评估一种新型的全层 AF 损伤动物模型的效用。提出了三个重点:(1)这种新的建模方法是否可以引起全层 AF 损伤;(2)AF 损伤后损伤区域的修复过程和病理变化;(3)AF 损伤后 IVD 的形态和组织学变化。
研究设计/设置:体内大鼠 AF 损伤模型,具有 AF 损伤修复、IVD 退变的特征。
将 72300 克雄性大鼠随机分为实验组或假手术组。在显微镜下用#11 刀片将纤维环逐层分离,直至纤维环-核髓(NP)交界处。用 HE 染色评估水平纤维环的修复过程和矢状面 IVD 的形态变化。偏振光下的天狼星红染色。免疫荧光分析 AF 损伤区 COL1 和 COL3 表达的变化,以及 IVD 中 8-OHdg、IL-6、MMP13、FSP1 和 ACAN 的变化。用 X 射线和对比增强微 CT 测量 AF 损伤后椎间盘的高度和结构变化。此外,还通过三点弯曲分析纤维环的拉伸阻力。
纤维环-核髓交界处可稳定诱导全层 AF 损伤,而不会导致即刻 NP 损伤。损伤后 AF 的修复过程缓慢,并持续表达炎症因子,AF 内层出现大量 III 型胶原。AF 病变处的疤痕对小分子的渗透阻力降低,拉伸强度减弱。全层 AF 损伤引起椎间盘退变,导致椎间盘高度丢失、单侧椎体进行性塌陷和软骨下骨骨化。NP 和软骨终板(CEP)中逐渐出现炎症诱导的退变和细胞外基质代谢。
我们建立了一种低成本、可重复的 AF 损伤小型动物模型,准确复制了有限的 AF 自我修复能力的病理状态,并表明仅损伤 AF 即可导致 IVD 进一步退变。
这种体内大鼠模型可用于研究 AF 缺损的修复过程和 AF 损伤后 IVD 逐渐退变的病理变化。此外,该模型为潜在临床治疗方法的体内实验研究提供了一个实验平台。