M-CSF在青少年特发性脊柱侧凸患者成骨细胞中的表达及意义

目的从成骨细胞（osteoblast,OB）水平探讨巨噬细胞集落因子（macrophage colony stimulating factor,MCSF）与青少年特发性脊柱侧凸（adolescent idiopathic scoliosis,AIS）患者骨量降低的关系。方法AIS患者27例,其中男25例,女2例;年龄12～18岁,平均14.9岁;Cobb角40°～94°,平均57.3°。将所有AIS患者分为两组：A组14例,为骨量正常患者;B组13例,为骨量减低患者。正常对照组8例（定为C组）,年龄12～18岁,平均15.3岁。3组均采用双能X线吸收测量仪（dual-energy X-ray absorptiometry,DEXA）测量骨密度（bone mineral density,BMD）,测量部位包括非优势侧股骨近端及腰椎。所有受试者术中取适量髂前上嵴的松质骨,运用植块法培养成骨细胞。培养至P3代后行表型鉴定,用RT-PCR检测AIS组和正常对照组中M-CSF mRNA的表达水平。结果B组中M-CSFmRNA的表达量均较A组（P〈0.05）和C组高（P〈0.05）,A组与C组M-CSFmRNA的表达量无显著统计学差异（P〉0.05）。结论M-CSF在OB水平mRNA表达强度的异常可能与AIS骨量降低的分子机制相关。

Abnormal expression and significance of M-CSF in osteoblasts of adolescent idiopathic scoliosis patients

Objective：To investigate the possible relationship between M-CSF and the low bone mass of adolescent idiopathic scoliosis patients at the osteoblast（OB） level.Method：This study involved 27 AIS patients,with mean age 14.9 years old（range from 12 to 18）,with a mean Cobb angle of 57.1°（range from 40°to 94°）.They were divided into two groups.Patients in group A maintained normal bone mineral density（BMD）.Patients in group B sustained osteopenia. Normal group,including 8 patients,were age-matched non-scoliosis adolescents who underwent spinal surgery,with mean age 15.1 years old（range from 12 to 18）.BMD of the lumbar spine and proximal femur was measured using dual energy X-ray absorptiometry in there groups.Small cancellous bone samples were harvested from the iliac crest during the operation. The chipped explants were cultured to obtain the osteoblasts.P2 generation osteoblasts were analyzed to confirm the cell phenotype.Expression of mRNA of M-CSF was detected by using RT-PCR using P2 generation osteoblasts from three groups.Results：The mRNA expression of M-CSF of OBs had increased obviously in group B compared with group A and group C（P0.05）.However,there was no significant difference between group A and group C（P0.05）.Conclusions： The abnormal mRNA expression of M-CSF of OBs may be responsible for the low bone mass of adolescent idiopathic scoliosis patients.