组织蛋白酶L与人腰椎间盘退变关系的研究  

Involvement of cathepsin L in the pathomechanism of lumbar intervertebral disc degeneration.

作　　者：智春升[1] 谢林[2] 

机构地区：[1]沈阳市骨科医院,沈阳110044 [2]中国医科大学附属第一医院,沈阳110001

出　　处：《中国矫形外科杂志》2008年第5期365-368,共4页Orthopedic Journal of China

摘　　要：[目的]探讨Cathepsin L与人腰椎间盘退变的关系。[方法]实验组标本来源于腰间盘突出症的患者,在外科手术过程中取得的退变间盘组织,并根据术中所见将腰间盘突出分为非包含型组和包含型组;对照组间盘来源于胸腰段骨折行前路手术患者手术中切除的间盘组织,以上标本采用HE染色组织学观察椎间盘的退变特征,免疫组织化学S-P法和逆转录-聚合酶链式反应(RT-PCR)法检测人腰椎间盘细胞Cathepsin L蛋白表达。[结果]HE染色组织学观察在退变组间盘中,各标本均表现出一定的退变特征:纤维环板层结构紊乱,软骨细胞巢状增生,纤维环粘液瘤样变,髓核软骨细胞减少,纤维细胞增生,玻璃样变及纤维化,髓核毛细血管的侵入,炎性细胞的浸润等。在未包含型组与包含型组比较显示了更多的髓核毛细血管侵入和炎性细胞浸润,髓核及纤维环退变更严重,纤维细胞增生及瘢痕形成。免疫组织化学染色显示组织蛋白酶L阳性率在退变组(90.68±7.61)%明显高于对照组(10.00±8.69)%,并且在非包含型组(95.45±4.63)%明显高于包含型组(86.93±7.49)%。RT-PCR结果显示组织蛋白酶L的mRNA表达水平在退变组(1.445±0.206)%较对照组(0.526±0.378)%明显上调,并且在非包含型组(1.608±0.044)%明显高于包含型组(1.282±0.166)%。以上结果均经统计分析证实组间差异有统计学意义。[结论]Cathepsin L与人腰椎间盘退变有关。[Objective] To determine the involvement of cathepsin L in the pathomechanism of lumbar intervertebral disc degeneration. [Method] Experimental group were made from 25 cases with lumbar disc protrusion disease and control group were made from 5 cases of thoracic - lumber broken. The thirty disc specimens collected at the time of surgery were classified into degenerated group and control group, and the degenerated group were further classified into contained discs and noncontained discs depending on the findings of operation. Paraffin - embedded sections of all intervertebral disc tissue were stained by Hematoxylin and Erosin, and then immunohistochemically stained with monoclonal antibodies for Cathepsin L Furthermore, mRNA of cathepsin L from all the specimens was detected by RT - PCR. [ Result] Hematoxylin and eosin staining revealed obvious signs of degeneration characterized by disorganization of the oriented lamellar structure of the anulus fibrosus, formation of fissures, cystic or myxomatous change, cloning of chondrocyte - like cells, cartilaginous metaplasia of the anulus, vascular invasion in outer anulus. Cathepsin L was immunolocalized in disc cells at various sites exhibiting degeneration. And Cathepsin L - positive cell ratio ohserved in degenerated group （90. 68 ± 7.61 ） % was significantly higher than that in control group （ 10. 00 ± 8. 69） % and in noncontained group lumbar intervertebral discs （95.45 ±4. 63 ） % was higher than that in contained discs （ 86. 93±7.49） %. Furthermore, mRNA of cathepsin L was up regulated in degenerated disc tissue （ 1. 445±0. 206） % compared to the control disc tissue （0. 526±0. 378） % detected by RT - PCR , and also was higher in noncontained discs （ 1. 608±0. 044） % than the contained discs （ 1. 282±0. 166） %. [ Conclusion] Cathepsin L is involved in the pathomechanism of lumbar intervertebral disc degeneration.

关 键 词：椎间盘 退变 组织蛋白酶 

分 类 号：R681.53[医药卫生—骨科学]