光生物调节对大鼠脊髓损伤结构性生物标志物的影响以及临床验证  

Effect of photobiomodulation on structural biomarkers of spinal cord injury in rats and clinical validation

作　　者：罗亮 张建新 左晓霜 张智昊 梁卓文 丁坦 胡学昱 王哲 LUO Liang;ZHANG Jianxin;ZUO Xiaoshuang;ZHANG Zhihao;LIANG Zhuowen;DING Tan;HU Xueyu;WANG Zhe(Graduate School,Xi'an Medical University,Xi'an 710021,China;Department of Orthopedics,Xijing Hospital,Air Force Medical University,Xi'an 710032,China;Department of Orthopedics,Weinan Central Hospital,Weinan 714099,China)

机构地区：[1]西安医学院研究生院,陕西西安710021 [2]空军军医大学西京医院骨科,陕西西安710032 [3]渭南市中心医院骨科,陕西渭南714099

出　　处：《空军军医大学学报》2024年第8期883-890,共8页Journal of Air Force Medical University

基　　金：国家自然科学基金(2018RCFC02);陕西省重点研发计划项目(2020ZDLSF02-05,2021ZDLSF02-10)。

摘　　要：目的探索光生物调节(PBM)对脊髓损伤(SCI)结构性生物标志物的影响,为后期SCI结构性生物标志物作为PBM疗效评估指标创造可能性。方法在动物实验中,将大鼠分为假手术组(Sham组)、SCI组、SCI+光照组(PBM组)3组,每组9只,在造模前与造模后1、3、7 d进行BBB评分并采集血清与脑脊液,利用酶联免疫法检测各组大鼠各时间点血清与脑脊液中结构性生物标志物(S100β、GFAP、TAU、MMPs、pNF-H、NSE)的浓度,对比分析其与大鼠BBB评分在PBM干预下的变化特征,并以此结果为基础,在临床展开验证。在临床实验中,根据纳入排除标准,将招募的SCI患者按照是否接受PBM治疗分为单纯减压手术+光照组(DP组)和单纯减压手术组(D组),在术前对两组患者进行ASIA评分,并于术前与术后1、3、7 d采集两组患者血清标本,检测并比较在动物实验中受PBM影响较大的结构性生物标志物(S100β、TAU、pNF-H、GFAP),在术后3个月随访时再次对患者进行ASIA评分,并与术前检查结果进行比较。结果在动物实验中,PBM组大鼠的BBB评分在造模后第3日开始高于SCI组,并于第7日显著高于SCI组(P<0.01)。PBM组与SCI组大鼠血清与脑脊液中的结构性生物标志物浓度均在造模后开始升高,并都在1~3 d内达到峰值,PBM组大鼠1、3、7 d血清中S100β、GFAP、TAU、pNF-H的浓度均显著低于SCI组(P<0.01),PBM组大鼠1、3、7 d脑脊液中的S100β、GFAP、TAU、MMPs、pNF-H、NSE浓度显著低于SCI组(P<0.01)。在临床实验中,DP组患者术后3、7 d血清中的TAU、pNF-H、GFAP浓度显著低于D组(P<0.01),并且随访发现,术后3个月DP组患者的ASIA针刺觉与轻触觉评分显著高于术前(P<0.05)。结论PBM在促进神经功能恢复的同时,可降低血清和脑脊液中SCI结构性生物标志物的浓度。Objective To explore the effect of photobiomodulation(PBM)on structural biomarkers of spinal cord injury(SCI),so as to create the possibility for structural biomarkers of SCI to be used as the efficacy evaluation index of PBM.Methods In animal experiments,rats were divided into Sham group,SCI group,and PBM group,with 9 rats in each group.BBB scores were performed and serum and cerebrospinal fluid were collected before and 1,3 and 7 d after modeling.The concentrations of structural biomarkers in serum and cerebrospinal fluid of rats at each time point in each group(S100β,GFAP,TAU,MMPs,pNF-H,and NSE)were detected by enzyme-linked immunosorbent assay,the change characteristics of these biomarkers and BBB scores of rats under the intervention of PBM were compared and analyzed,and based on these results,clinical verification was carried out.In clinical experiments,according to the inclusion and exclusion criteria,the recruited SCI patients were divided into simple decompression group+light exposure group and simple decompression group according to whether they were treated with PBM or not.ASIA scores were performed before operation in both groups,and serum samples of the two groups were collected before operation and 1,3 and 7 d after operation.The structural biomarkers(S100β,TAU,pNF-H,and GFAP)that were significantly affected by PBM in animal experiments were detected and compared.ASIA scores were performed again at 3 months post-operative follow-up and compared with preoperative results.Results In animal experiments,BBB scores of rats in PBM group were higher than those in SCI group on the 3rd day after modeling,and significantly higher than those in SCI group on the 7th day(P<0.01).The concentrations of structural biomarkers in serum and cerebrospinal fluid of rats in PBM and SCI groups began to increase after modeling and reached the peak within 1 to 3 d.The concentrations of S100β,GFAP,TAU and pNF-H in serum of rats in PBM group were significantly lower than those in SCI group at 1,3 and 7 d(P<0.01).The concen

关 键 词：脊髓损伤 光生物调节 血清 脑脊液 生物标志物 

分 类 号：R651.2[医药卫生—外科学]