Melrose J, Hall A, Macpherson C, Bellenger C R, Ghosh P
Raymond Purves Bone and Joint Research Laboratories, University of Sydney, New South Wales, Australia.
Arch Orthop Trauma Surg. 1995;114(3):145-52. doi: 10.1007/BF00443388.
Chemonucleolysis is a therapeutic procedure whereby a degradative enzyme is injected intradiscally to reduce disc height/width by depolymerisation of extracellular matrix components. This process is considered to diminish disc pressure on inflamed nerve roots, resulting in the alleviation of sciatic pain. In the present study two krill (Euphasia superba) enzyme preparations, a proteinase and an esterase preparation, were evaluated for their potential as chemonucleolytic agents. Initially, their ability to degrade several protein (azocoll, casein, proteoglycans, PGs) and peptide (CBZ-arg-4-nitroanilide, CBZ-lys-thiobenzyl ester) substrates was assessed in vitro. The krill proteinase preparation rapidly converted azocoll, casein and PGs to small peptides. Furthermore, when this degradative enzyme preparation was evaluated in vivo, a relatively low intradiscal dose (0.54 mg/disc) was found to reduce intervertebral disc widths in beagles to 48% +/- 10.5% (mean +/- SEM) of their pre-injection values within 2 weeks of administration. Moreover, the discs injected with this proteinase had reconstituted up to 80% +/- 9% (mean +/- SEM) of their pre-injection widths at the termination of the experiment (32 weeks). These data suggest that the krill protease preparation has potential as a chemonucleolytic agent which would allow disc matrix reconstitution. Conversely, the krill esterase preparation also degraded PGs, but into relatively large fragments. This limited digestion of PGs indicates that the krill esterase would be a less effective chemonucleolytic agent than the corresponding proteinase.
化学髓核溶解术是一种治疗方法,通过向椎间盘内注射一种降解酶,使细胞外基质成分解聚,从而减小椎间盘的高度/宽度。该过程被认为可减轻椎间盘对发炎神经根的压力,从而缓解坐骨神经痛。在本研究中,对两种磷虾(南极磷虾)酶制剂,一种蛋白酶制剂和一种酯酶制剂,作为化学髓核溶解剂的潜力进行了评估。首先,在体外评估了它们降解几种蛋白质(偶氮胶原、酪蛋白、蛋白聚糖,PGs)和肽(CBZ-精氨酸-4-硝基苯胺、CBZ-赖氨酸-硫代苄酯)底物的能力。磷虾蛋白酶制剂能迅速将偶氮胶原、酪蛋白和PGs转化为小肽。此外,当在体内评估这种降解酶制剂时,发现在给药后2周内,相对较低的椎间盘内剂量(0.54mg/椎间盘)可使比格犬的椎间盘宽度减小至注射前值的48%±10.5%(平均值±标准误)。此外,在实验结束时(32周),注射该蛋白酶的椎间盘已恢复至注射前宽度的80%±9%(平均值±标准误)。这些数据表明,磷虾蛋白酶制剂有潜力作为一种能使椎间盘基质重建的化学髓核溶解剂。相反,磷虾酯酶制剂也能降解PGs,但降解为相对较大的片段。PGs的这种有限消化表明,磷虾酯酶作为化学髓核溶解剂的效果不如相应的蛋白酶。