Expression of interleukin-1 beta, interleukin-6 and cyclooxygenase 2 in cervical intervertebral disc of cervical spondylosis patients with different clinical symptoms

doi:10.3969/j.issn.2095-4344.2016.35.015

Abstract

Abstract:

BACKGROUND: During degeneration of cervical spine, biochemical changes appeared in intervertebral disc cells. During this process, a variety of inflammatory cytokines may lead to disc herniation, which stimulates the production of a variety of inflammatory factors from surrounding adjacent tissue.

OBJECTIVE: To explore the expression and significance of interleukin-1β, interleukin-6 and cyclooxygenase 2 in patients with different clinical symptoms of cervical spinal cord oppression.

METHODS: Protrusion of the intervertebral disc or disc of responsibility among patients with anterior disc resection and internal fixation were divided into three groups according to clinical symptoms: myelopathic symptom group, nerve root symptom group and cervical spine trauma group. Intervertebral disc received hematoxylin-eosin staining and immunohistochemical staining for morphological observation. Positive cells were counted according to the result of immunohistochemical staining.
RESULTS AND CONCLUSION: (1) Hematoxylin-eosin staining results showed visible inflammatory cell infiltration and new blood vessel formation in the myelopathic symptom group and nerve root symptom group. No remarkable inflammatory cell infiltration or new blood vessel formation was seen in cervical spine trauma group. (2) Immunohistochemical staining interleukin-1β-, interleukin-6-positive cells were seen in the myelopathic symptom group. Cytoplasm was stained tan. Cyclooxygenase 2-positive cells showed a low number. The numbers of interleukin-1β-, interleukin-6- and cyclooxygenase 2-positive cells were significantly more in the nerve root symptom group than in the myelopathic symptom group. The numbers of interleukin-1β-, interleukin-6- and cyclooxygenase 2-positive cells were small in the cervical spine trauma group. (3) Expression rate and IA value of interleukin-1β, expression rate and IA value of interleukin-6 were significantly higher in the myelopathic symptom group and nerve root symptom group than in the cervical spine trauma group (P < 0.05). Expression rate and IA value of cyclooxygenase 2 were significantly higher in the nerve root symptom group than in the cervical spine trauma group. (4) These results suggested that interleukin-1β, interleukin-6 and cyclooxygenase 2 expression could be found in the cervical intervertebral disc after protrusion, and played a role in early degeneration of cervical intervertebral disc. The expressions of these inflammatory factors were significantly different in patients with different clinical symptoms of cervical spinal cord compression.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Cervical Vertebrae, Intervertebral Disk, Inflammatory Factor, Tissue Engineering

CLC Number:

R318

Hu Wei, Ma Xin-long, Yuan Jian-jun, Zhang Ren-zan, Peng Bing, Zhang Xue-li. Expression of interleukin-1 beta, interleukin-6 and cyclooxygenase 2 in cervical intervertebral disc of cervical spondylosis patients with different clinical symptoms[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(35): 5270-5276.

Figures/Tables 3

2.1 参与者数量分析纳入患者60例，分为3组，试验过程中无脱落，全部进入结果分析。 2.2 三组患者基线资料分析见表1。3组患者性别、年龄、颈髓损伤节段比较差异无显著性意义。 2.3 形态学观察结果 2.3.1 苏木精-伊红染色髓型症状组和根性症状组苏木精-伊红染色在突出颈椎间盘周围的炎性肉芽组织中可见炎细胞浸润以及新生血管形成。阳性细胞以成纤维纽胞、软骨细胞及淋巴细胞为主。颈椎外伤组未见明显炎细胞浸润以及新生血管形成。 2.3.2 免疫组织化学染色髓型症状组中切片镜下在突出间盘周围的炎性肉芽组织周围可见白细胞介素1β、白细胞介素6表达阳性的细胞，同时于椎间盘髓核及纤维环亦可见散在分布。其胞浆主要呈棕黄色着色，环氧化酶2表达阳性的细胞稀少。根性症状组中可见白细胞介素1β、白细胞介素6、环氧化酶2表达阳性的细胞，在椎间盘周围的炎性肉芽组织中、椎间盘髓核及纤维环内均可见阳性表达，阳性细胞数量多于髓型症状组。颈椎外伤组中免疫组织化学染色白细胞介素1β、白细胞介素6、环氧化酶2表达阳性细胞表达稀。 2.3.3 阳性细胞计数髓型症状组及根性症状组中白细胞介素1β阳性表达率及IA值均显著高于颈椎外伤组，髓型症状组及根性症状组中白细胞介素1β阳性表达率差异无显著性意义，IA值比较差异有显著性意义(表2)。髓型症状组及根性症状组中白细胞介素6阳性表达率及IA值均显著高于颈椎外伤组，髓型症状组及根性症状组中白细胞介素6阳性表达率差异无显著性意义，IA值比较差异无显著性意义(表3)。根性症状组中环氧化酶2阳性表达率及IA值均显著高于髓型症状组及颈椎外伤组，髓型症状组及颈椎外伤组中环氧化酶2阳性表达率差异无显著性意义，IA值比较差异有显著性意义(表4)。"

2.4 典型病例介绍例1，患者女，38岁，主因“四肢麻木无力2年，加重伴双手精细动作减退，行走不稳2个月”入院，入院诊断为颈椎病(脊髓型)，术前MRI检查T2像可见C3/4水平间盘突出，脊髓受压(图1A)，完善术前准备，行颈前路C4椎体次全切除，C3-5钛网植入内固定术。颈间盘组织苏木精-伊红染色可见炎细胞浸润以及新生血管形成(图1B)；椎间盘免疫组织化学染色切片镜下可见白细胞介素1β(图1Ca)、白细胞介素6(图1Cb)表达阳性的细胞，主要集中在突出间盘周围的炎性肉芽组织中，椎间盘髓核及纤维环中亦可见散在分布。其胞浆为棕黄色着色为主，环氧化酶2表达阳性的细胞稀少(图1Cc)。例2，患者男，47岁，主因“左上肢放射痛伴麻木无力1年加重3个月”入院。入院诊断为颈椎病(神经根型)，术前MRI检查T2像可见C6椎体后缘间盘突出，脊髓受压(图2A)，完善术前准备，行颈前路C6椎体次全切除，C5-7钛网植入内固定术。颈间盘组织标本苏木精-伊红染色可见炎细胞浸润以及新生血管形成(图2B)；颈间盘组织行免疫组织化学染色，椎间盘切片镜下可见白细胞介素1β(图2Ca)、白细胞介素6(图2Cb)、环氧化酶2(图2Cc)表达阳性的细胞，在间盘周围的炎性肉芽组织、椎间盘髓核及纤维环中均可见阳性表达。例3，患者男，26岁，主因外伤致颈部活动受限3h入院，入院诊断颈椎外伤，无骨折脱位。术前MRI检查T2像可见C6椎体高信号(图3A)，完善术前检查，行C6 椎体次全切除，C5-7钛网植入内固定术。颈间盘组织标本苏木精-伊红染色未见炎细胞浸润以及新生血管形成(图3B)；颈间盘组织标本免疫组织化学染色，椎间盘切片镜下可见白细胞介素1β(图3Ca)、白细胞介素6(图3Cb)、环氧化酶2(图3Cc)表达阳性细胞表达稀少。"

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