Peroxiredoxin Ⅱ在退变椎间盘髓核中的表达及其临床意义

目的:检测PeroxiredoxinⅡ在腰椎间盘髓核组织中的表达,分析其在椎间盘退变中的临床意义。方法:用蛋白免疫印迹(Western blot)的方法检测PeroxiredoxinⅡ在正常、突出及脱出腰椎间盘髓核中的表达情况。结果:PeroxiredoxinⅡ在退变椎间盘髓核中表达丰富,而在正常椎间盘髓核中表达微弱,两者比较差异显著(P<0.05),在突出和脱出椎间盘髓核中表达无显著性差异(P>0.05)。结论:PeroxiredoxinⅡ在正常及退变腰椎间盘髓核组织中差异表达。     

Peroxiredoxin Ⅱ在退变椎间盘髓核中的表达及临床意义

目的:检测Pcroximdoxin Ⅱ在腰椎间盘髓核组织中的表达,分析其在椎间盘退变中的临床意义.方法:用蛋白免疫印迹(Western blot)的方法检测Peroxiredoxin Ⅱ在正常、突出及脱出腰椎间盘髓核中的表达情况.结果:Peroxiredoxin Ⅱ在退变椎间盘髓核中表达丰富,而在正常椎问盘髓核中表达微弱,两者比较差异显著(P<0.05),在突出和脱出椎间盘髓核中表达无显著性差异(P>0.05).结论:Peroxiredoxin Ⅱ在正常及退变腰椎间盘髓核组织中差异表达.     

PeroxiredoxinⅡ在退变椎间盘髓核中的表达及其临床意义

目的：检测PeroxiredoxinⅡ在腰椎间盘髓核组织中的表达,分析其在椎间盘退变中的临床意义。方法：用蛋白免疫印迹（Western blot）的方法检测PeroxiredoxinⅡ在正常、突出及脱出腰椎间盘髓核中的表达情况。结果：PeroxiredoxinⅡ在退变椎间盘髓核中表达丰富,而在正常椎间盘髓核中表达微弱,两者比较差异显著（P〈0.05）,在突出和脱出椎间盘髓核中表达无显著性差异（P〉0.05）。结论：PeroxiredoxinⅡ在正常及退变腰椎间盘髓核组织中差异表达。     

人椎间盘髓核来源的诱导多能干细胞重编程及功能的研究

椎间盘退变始发于髓核组织,获得足够有功能的髓核细胞是研究及治疗椎间盘退变的关键.而人诱导多能干细胞(induced pluripotent stem cell,iPSC)不仅为建立疾病模型以研究疾病发生发展机制开辟了道路,还在再生医学领域展现出了广阔的应用前景.我们首先从椎间盘退变患者微创手术获得的髓核组织内分离髓核细胞,将携带OCT3/4、SOX2、KLF4和c-MYC的仙台病毒(Sendai virus,Se V)转染髓核细胞,重编程获得iPSC.通过检测多能细胞特异性标志、体内成瘤实验、甲基化及核型分析对所获得的iPSC进行鉴定.并以皮肤成纤维细胞来源iPSC作为对照,在二维和三维水凝胶中对iPSC进行定向分化,检测髓核细胞相关蛋白和基因的表达,比较分析2种iPSC向髓核细胞的分化效率.结果显示,iPSC能表达多能细胞特异性标志,具有正常的二倍体核型,畸胎瘤实验显示三个胚层的出现.诱导分化后的iPSC表达髓核相关基因和蛋白,在水凝胶中诱导培养后,iPSC表达更多的髓核相关基因和蛋白.髓核来源的iPSC与成纤维细胞来源的iPSC相比,可表达更多的髓核相关基因和蛋白.本研究首次将患者退变髓核细胞重编程成iPSC,并在水凝胶内将其诱导分化为髓核样细胞,为椎间盘退变个体化细胞治疗奠定基础.     

人骨形态蛋白-2对椎间盘细胞蛋白多糖和Ⅱ型胶原的影响

目的研究人骨形态蛋白(human bone morphogenetic protein-2,hBMP-2)对体外培养人腰椎间盘髓核细胞Ⅱ型胶原和aggrecan的影响。方法人退变髓核细胞体外分离培养,通过免疫组织化学鉴定椎间盘细胞。利用ELISA法检测对照组和不同剂量hBMP-2(10ng/ml和100ng/ml)组Ⅱ型胶原和aggrecan的表达水平。用RT-PCR检测细胞Ⅱ型胶原和aggrecan的mRNA表达水平。结果加入hBMP-2后Ⅱ型胶原和aggrecan表达增加,并存在剂量依赖关系(P<0.01)。在第6天RT-PCR结果显示hBMP-2组aggrecan和Ⅱ型胶原mRNA的表达高于对照组,并且随剂量增高aggrecan和Ⅱ型胶原mRNA的表达量逐渐增加。结论hBMP-2可促进体外培养人腰椎间盘细胞合成代谢,Ⅱ型胶原和aggrecan表达量增加,并存在剂量依赖关系,提示hBMP-2可能对退变椎间盘具有修复功能。     

改良胶原酶消化法分离培养人原代髓核细胞

目的:优化人原代髓核细胞的体外分离培养方法,为椎间盘退变的防治研究提供种子细胞。方法:无菌环境中摘取人椎间盘髓核组织,采用多次胶原酶消化法分离提取原代人髓核细胞,置于5%CO2培养箱中37℃恒温培养,倒置相差显微镜中观察细胞形态,采用MTT法绘制细胞生长曲线,甲苯胺蓝染色法检测髓核细胞内蛋白多糖的表达情况,细胞免疫荧光染色法检测Ⅱ型胶原蛋白表达情况。结果:本研究中获得的细胞形态不规则,呈梭形或多角形,原代细胞48 h内贴壁,培养第8天左右细胞融合度可达90%,第三代细胞12 h内即可贴壁,生长至融合90%约需5d。甲苯胺蓝染色及细胞免疫荧光染色均阳性,提示所得细胞具有分泌蛋白多糖及Ⅱ型胶原蛋白的功能。结论:改良胶原酶消化法可获得大量纯净的人髓核细胞,提高培养效率,原代及传代细胞具备类软骨细胞表型,且活性及功能均较为稳定,可作为椎间盘组织工程研究的种子细胞。     

沉默信息调节因子2同源蛋白1通过Akt/PKB通路抑制人退变椎间盘髓核细胞凋亡

沉默信息调节因子2同源蛋白1(silent mating type information regulation 2 homolog 1, SIRT1/sirtuin 1)是组蛋白去乙酰化酶,参与表观遗传修饰调节,促进多种细胞的生存,但目前对椎间盘髓核细胞的作用未见研究．为了阐明临床不同来源的椎间盘髓核手术标本SIRT1的表达变化,用免疫组化、定量RT-PCR、Western blot方法对中老年腰椎间盘突出症病人及青壮年腰椎骨折病人术中髓核标本进行研究,表明老年人髓核SIRT1的mRNA及蛋白质水平均显著低于青壮年的髓核．同时,用resveratrol(SIRT1激动剂)、烟碱(SIRT1抑制剂)、SIRT1-siRNA对培养的退变髓核细胞进行处理或转染后,用流式细胞仪检测凋亡率变化,结果表明resveratrol能显著促进退变髓核细胞生存,相反,当烟碱或SIRT1-siRNA转染后则显著促进髓核细胞凋亡．为了进一步分析SIRT1抑制退变髓核细胞凋亡的分子机制,应用Western blot及抑制剂方法研究表明,当SIRT1-siRNA转染髓核细胞后能降低磷酸化Akt蛋白的表达,而白藜芦醇处理则促进磷酸化Akt蛋白的表达,当用LY294002(PI3K抑制剂)或Akt-siRNA转染后显著抑制髓核细胞的生存率．研究结果表明,SIRT1通过Akt通路能显著抑制髓核细胞凋亡,为深入揭示退变性椎间盘疾病的病理生理及生物治疗提供新的思路和靶点．     

缺氧诱导因子-1α和血管内皮生长因子在突出腰椎间盘中的表达及意义

目的探讨缺氧诱导因子-1α（hypoxia—induciblefactor-1α,HIF-1α）和血管内皮生长因子（vascular endothelial growth factor,VEGF）在突出腰椎间盘组织中的表达及意义。方法采用链霉亲和素-过氧化物酶复合物（SABC）免疫组化方法,测定40例腰椎间盘突出症患者椎间盘组织中HIF-1α和VEGF的表达情况。结果退变椎间盘组织中HIF-1α和VEGF呈高表达,HIF-1α和VEGF在髓核的表达显著高于纤维环;纤维环破裂型显著高于纤维环完整型;各组中HIF-1α和VEGF的表达均高度相关。结论HIF-1α和VEGF共同参与了椎间盘退变;HIF-1α可能通过上调VEGF的表达来促进椎间盘组织中新生血管的形成,进而延缓椎间盘退变的发生。     

不同月龄大鼠椎间盘退变与多效生长因子表达的关系

目的观察不同月龄大鼠椎间盘的形态学变化并检测椎间盘中多效生长因子（pleiotrophin,PTN）的表达,探讨PTN与椎间盘退变的关系。方法取Wistar大鼠50只,以1,3,6,12,18个月龄不同分为5组,每组10只。采用苏木精-伊红染色观察椎间盘的形态学变化。采用SABC免疫组织化学方法,检测椎间盘中PTN的表达情况;结果（1）随着月龄的增加,椎间盘组织结构紊乱的程度逐渐增加,髓核内基质降解、正中出现空腔,胶原纤维增生、粗大、排列紊乱、并可见纤维断裂或缺失。（2）随着大鼠月龄的增加（1-12月龄）,椎间盘细胞中PTN的表达有逐渐减低的趋势,但至18月龄,PTN表达又有所增加;6和12月龄组椎间盘细胞中PTN的表达显著低于1月龄组,而18月龄组PTN的表达显著高于12月龄组。同月龄组椎间盘细胞中,PTN在终板的表达高于髓核和纤维环,髓核和纤维环中PTN的表达未见明显差异。结论大鼠椎间盘结构随月龄增加发生退行性变,PTN参与了大鼠椎间盘的退变,并可能通过促进椎间盘组织中新生血管的形成,延缓椎间盘的退变。     

椎间盘退变纤维环及髓核异常表达基因的比较及生物信息学分析

目的:通过对已公开发表的基因芯片表达谱数据进行研究,探究椎间盘退变过程中纤维环与髓核组织的基因表达差异,并采用生物信息学方法对差异进行分析。方法:经GEO数据库选取两组椎间盘退变相关的基因芯片表达谱数据GSE23130及GSE67567,GSE23130所研究标本来源于正常及退变纤维环组织,GSE67567标本来源于正常及退变髓核组织。对上述数据系列进行质量分析,GSE23130及GSE67567各有10例样本数据被纳入实验。采用Gene Spring 13.0软件对GSE23130正常及退变纤维环间差异表达基因及GSE67567正常及退变髓核间差异表达基因分别进行筛选,利用KEGG PATHWAY和DAVID功能注释簇集分析分别对GSE23130及GSE67567上调及下调基因进行生物信息学分析。结果:GSE23130及GSE67567各筛选出差异表达基因3182个和3017个,其中135个基因在上述两个基因表达谱数据中均存在差异表达。针对两组数据进行的KEGG PATHWAY分析发现TGF-beta signaling pathway和regulation of apoptosis等数个相同的生物学通路及DAVID功能注释簇集;此外,还发现了数个与GSE23130及GSE67567单独相关的DAVID功能注释簇集。结论:椎间盘退变过程中纤维环及髓核组织内基因表达情况存在差异,两种组织内发生的生物过程不尽相同。某些生物学过程在两种组织内均出现异常改变,这些生物学过程中的异常变化可能是椎间盘退变的关键环节,值得进行深入研究。     

The role of TGF‐β1/Smad2/3 pathway in platelet‐rich plasma in retarding intervertebral disc degeneration

Recent studies have suggested that platelet‐rich plasma (PRP) injections are an effective way to retard intervertebral disc degeneration, but the mechanism of action is unclear. Activated platelets release some growth factors, such as transforming growth factor‐β1 (TGF‐β1), which positively modulate the extracellular matrix of nucleus pulposus cells. The purpose of this study was to explore the mechanism underlying the PRP‐mediated inhibition of intervertebral disc degeneration. In an in vitro study, we found that the proliferation of nucleus pulposus cells was greatly enhanced with 2.5% PRP treatment. The TGF‐β1 concentration was much higher after PRP treatment. PRP administration effectively increased the collagen II, aggrecan and sox‐9 mRNA levels and decreased collagen X levels. However, Western blotting demonstrated that specifically inhibiting TGF‐β1 signalling could significantly prevent nucleus pulpous cellular expression of Smad2/3 and matrix protein. In a rabbit study, magnetic resonance imaging revealed significant recovery signal intensity in the intervertebral discs of the PRP injection group compared with the very low signal intensity in the control groups. Histologically, the PRP plus inhibitor injection group had significantly lower expression levels of Smad2/3 and collagen II than the PRP group. These results demonstrated that a high TGF‐β1 content in the platelets retarded disc degeneration in vitro and in vivo. Inhibiting the TGF‐β1/Smad2/3 pathway could prevent this recovery by inactivating Smad2/3 and down‐regulating the extracellular matrix. Therefore, the TGF‐β1/Smad2/3 pathway might play a critical role in the ability of PRP to retard intervertebral disc degeneration.     

Human disc degeneration is associated with increased MMP 7 expression.

During intervertebral disc (IVD) degeneration, normal matrix synthesis decreases and degradation of disc matrix increases. A number of proteases that are increased during disc degeneration are thought to be involved in its pathogenesis. Matrix metalloproteinase 7 (MMP 7) (Matrilysin, PUMP-1) is known to cleave the major matrix molecules found within the IVD, i.e., the proteoglycan aggrecan and collagen type II. To date, however, it is not known how its expression changes with degeneration or its exact location. We investigated the localization of MMP 7 in human, histologically graded, nondegenerate, degenerated and prolapsed discs to ascertain whether MMP 7 is up-regulated during disc degeneration. Samples of human IVD tissue were fixed in neutral buffered formalin, embedded in paraffin, and sections stained with hematoxylin and eosin to score the degree of morphological degeneration. Immunohistochemistry was performed to localize MMP 7 in 41 human IVDs with varying degrees of degeneration. We found that the chondrocyte-like cells of the nucleus pulposus and inner annulus fibrosus were MMP 7 immunopositive; little immunopositivity was observed in the outer annulus. Nondegenerate discs showed few immunopositive cells. A significant increase in the proportion of MMP 7 immunopositive cells was seen in the nucleus pulposus of discs classified as showing intermediate levels of degeneration and a further increase was seen in discs with severe degeneration. Prolapsed discs showed more MMP 7 immunopositive cells compared to nondegenerated discs, but fewer than those seen in cases of severe degeneration.     

Human disc degeneration is associated with increased MMP 7 expression

During intervertebral disc (IVD) degeneration, normal matrix synthesis decreases and degradation of disc matrix increases. A number of proteases that are increased during disc degeneration are thought to be involved in its pathogenesis. Matrix metalloproteinase 7 (MMP 7) (Matrilysin, PUMP-1) is known to cleave the major matrix molecules found within the IVD, i.e., the proteoglycan aggrecan and collagen type II. To date, however, it is not known how its expression changes with degeneration or its exact location. We investigated the localization of MMP 7 in human, histologically graded, nondegenerate, degenerated and prolapsed discs to ascertain whether MMP 7 is up-regulated during disc degeneration. Samples of human IVD tissue were fixed in neutral buffered formalin, embedded in paraffin, and sections stained with hematoxylin and eosin to score the degree of morphological degeneration. Immunohistochemistry was performed to localize MMP 7 in 41 human IVDs with varying degrees of degeneration. We found that the chondrocyte-like cells of the nucleus pulposus and inner annulus fibrosus were MMP 7 immunopositive; little immunopositivity was observed in the outer annulus. Nondegenerate discs showed few immunopositive cells. A significant increase in the proportion of MMP 7 immunopositive cells was seen in the nucleus pulposus of discs classified as showing intermediate levels of degeneration and a further increase was seen in discs with severe degeneration. Prolapsed discs showed more MMP 7 immunopositive cells compared to nondegenerated discs, but fewer than those seen in cases of severe degeneration.     

Human disc degeneration is associated with increased MMP 7 expression

During intervertebral disc (IVD) degeneration, normal matrix synthesis decreases and degradation of disc matrix increases. A number of proteases that are increased during disc degeneration are thought to be involved in its pathogenesis. Matrix metalloproteinase 7 (MMP 7) (Matrilysin, PUMP-1) is known to cleave the major matrix molecules found within the IVD, i.e., the proteoglycan aggrecan and collagen type II. To date, however, it is not known how its expression changes with degeneration or its exact location. We investigated the localization of MMP 7 in human, histologically graded, nondegenerate, degenerated and prolapsed discs to ascertain whether MMP 7 is up-regulated during disc degeneration. Samples of human IVD tissue were fixed in neutral buffered formalin, embedded in paraffin, and sections stained with hematoxylin and eosin to score the degree of morphological degeneration. Immunohistochemistry was performed to localize MMP 7 in 41 human IVDs with varying degrees of degeneration. We found that the chondrocyte-like cells of the nucleus pulposus and inner annulus fibrosus were MMP 7 immunopositive; little immunopositivity was observed in the outer annulus. Nondegenerate discs showed few immunopositive cells. A significant increase in the proportion of MMP 7 immunopositive cells was seen in the nucleus pulposus of discs classified as showing intermediate levels of degeneration and a further increase was seen in discs with severe degeneration. Prolapsed discs showed more MMP 7 immunopositive cells compared to nondegenerated discs, but fewer than those seen in cases of severe degeneration.     

腰腹肌运动联合超声波对非特异性下腰痛的治疗效果及机制

为了解腰腹肌运动联合超声波治疗的效果,本研究对腰腹肌运动联合超声波治疗非特异性下腰痛进行了探讨。研究显示,治疗4周后,腰腹肌运动+超声波治疗组的疼痛评分(0.73)显著低于超声波治疗组(1.22)(p<0.05)。腰腹肌运动+超声波治疗组的立位体前屈活动幅度(2.35 cm)显著低于超声波治疗组(6.23 cm)(p<0.05)。腰腹肌运动+超声波治疗组的屈伸肌总功和屈伸肌峰值力矩比显著高于超声波治疗组(p<0.05)。腰腹肌运动+超声波治疗组的Oswestry功能障碍指数问卷表(ODI)评分显著低于超声波治疗组(p<0.05)。治疗4周后,腰腹肌运动+超声波治疗组的血清超氧化物歧化酶(SOD)和过氧化氢酶(CAT)水平显著高于超声波治疗组,而丙二醛(MDA)水平显著低于超声波治疗组(p<0.05)。为了进一步考察运动联合超声波疗法对下腰痛的治疗机制,本研究建立了完全弗氏佐剂诱导的腰椎间盘退变大鼠模型。采用阿利新蓝染色检测大鼠椎间盘纤维环区和髓核区蛋白多糖的水平,并采用免疫组化染色检测蛋白聚糖和Ⅱ型胶原的表达,发现运动联合超声波治疗可明显提高大鼠蛋白多糖、Ⅱ型胶原和蛋白聚糖水平。本研究表明,与超声波治疗相比,腰腹肌运动联合超声波治疗可更大程度地降低非特异性下腰痛患者的疼痛,提高肌肉功能和腰椎功能,增强血清抗氧化能力,并减少氧化应激损伤。此外,该联合疗法可明显提高腰椎间盘退变大鼠椎间盘中的蛋白多糖、Ⅱ型胶原和蛋白聚糖水平。     

正常椎间盘胶原的研究

腰椎间盘突出症是引起腰腿痛常见的原因。胶原作为椎间盘结构的主要成分,构成椎间盘的纤维框架,其类型与分布直接决定着椎间盘结构的强度和功能的稳定。本文利用溴化氰消化椎间盘胶原产生多肽,借助于梯度层析。SDS-PAGE及光密度定量扫描等对正常人椎间盘胶原进行了研究。结果表明:正常人椎间盘含Ⅰ型及Ⅱ型两种胶原,它们的分布呈明显而特征性的移行性变化:纤维环外层边缘以Ⅰ型胶原为主(83％),由外向内Ⅰ型胶原逐渐移行为Ⅱ型胶原,靠近髓核处以Ⅱ型胶原为主(72％);髓核中心含有Ⅱ型胶原。此为椎间盘的一个结构特性,以满足椎间盘的特殊功能的需要。     

NF-κB信号通路参与高糖在椎间盘退行性变中影响及其作用的研究

目的:近来研究发现,椎间盘退变与代谢性疾病,尤其是与糖尿病具有明显的相关性,但具体机制尚未有深入研究。本实验拟探究高糖微环境诱导椎间盘退行性变及其对NF-κB信号通路的影响,为进一步揭示高糖诱导椎间盘髓核细胞退变的机制提供研究基础,为延缓、阻止糖尿病椎间盘退变和治疗糖尿病相关腰痛疾病带来新的策略和方法。方法:1、高糖微环境与IVDD的关系:使用5.5 mmol/L、15 mmol/L、30 mmol/L、100 mmol/L不同浓度葡萄糖培养基培养髓核细胞,RT-PCR检测髓核细胞MMP-3、MMP-13、Aggrecan、CollagenII的表达;2、NF-κB信号通路参与高糖微环境调控IVDD进展:Bay11-7082抑制NF-κB信号通路激活,再使用RT-PCR、Western Blot检测髓核细胞MMP-3、MMP-13、Aggrecan、CollagenII和NF-κB的表达。结果:RT-PCR检测显示,在不同葡萄糖浓度下,Aggrecan、CollagenII随浓度升高表达减少,MMP-3、MMP-13随浓度升高表达增加。RT-PCR、Western Blot检测显示,使用Bay11-7082可使高糖组中Aggrecan、CollagenII表达增加,MMP-3、MMP-13表达减少。结论:高糖微环境诱导椎间盘退行性变发病,且NF-κB信号通路参与高糖微环境诱导椎间盘退行性变发病。     

Immunolocalization of type X collagen in human lumbar intervertebral discs during ageing and degeneration

 Type X collagen has so far not been reported to occur in human intervertebral discs. The objective of this study was therefore to investigate the occurrence of type X collagen in human lumbar intervertebral discs during ageing and degeneration. Ninety intervertebral discs with adjacent endplates were excised in toto from individuals (0–86 years) without known spinal disease and were processed for routine decalcified histology. Appropriate slices of each disc were processed for immunohistochemistry using a type-spec ific, monoclonal antibody raised against human type X collagen. Each intervertebral disc was examined for macroscopic and histomorphological features of disc degeneration. Immunohistochemically, a positive specific type X staining was observed in the hypertrophic zone of the growth plate and only in the interstitial matrix of juvenile (<2 years) nucleus pulposus. In adult discs, type X collagen could be localized in conjunction with advanced disc degeneration and first occurred in the disc matrix (i.e., pericellular region) of a 47-year-old specimen. Positive type X staining of the disc matrix was more frequently found in senile (>70 years) discs with end stages of disc degeneration. This study provides the first evidence for the occurrence of type X collagen in human lumbar intervertebral discs and it appears that type X collagen is re-expressed in late stages of disc degeneration. Accepted: 24 April 1997