细胞因子IL-1a、IL -6、TNF-a、MMP3与颈椎间盘退变机制的相关性研究

目的]探讨细胞因子在颈椎间盘退变机制中的作用及其与神经功能的相关性.方法]实验组椎间盘组织取自46例颈椎病患者,根据术前颈椎MRI及术中椎间盘突出情况分为两组:退变组(24例)和突出组(22例).对照组椎间盘组织取自15例无颈椎病病史的颈椎外伤患者.根据颈椎病患者术前JOA评分分为三组:轻度组(17例),中度组(15例)和重度组(14例).采用酶联免疫吸附法(ELISA法)分别检测不同退变程度颈椎间盘中IL-1a、IL -6、TNF -a和MMP3的表达水平.结果]对照组、退变组和突出组三组之间比较,IL -1a、IL -6、TNF-a和MMP3的表达有统计学意义(P＜0.05),其表达水平与颈椎间盘退变呈正相关趋势;轻度组、中度组和重度组三组之间比较,MMP3、TNF -a的表达有统计学意义(P＜0.05),其表达水平与JOA评分呈负相关趋势.结论]IL -1、IL -6、TNF -a和MMP3与颈椎间盘退变密切相关,其表达水平与椎间盘退变呈正相关趋势;TNF -a与神经功能有关,可能在神经损伤中起主导作用;MMP3与椎间盘突出有关,对TNF -a的神经功能损伤可能起促进作用.

Correlation between inflammatory cytokines IL-1a,IL-6,TNF-a and MMP3 levels versus cervical intervertebral disc degeneration mechanism

Objective]To investigate the effects of inflammatory cytokines on cervical intervertebral disc degeneration(IVD) mechanism and the correlation between inflammatory cytokines and nerve function.Methods]Cervical intervertebral discs of experimental group were obtained from 46 patients with cervical spondylotic myelopathy(CSM).According to preoperative cervical MRI and whether the nucleus pulposus was free at operation,46 patients were divided non-randomly into two groups: uncontained IVD herniation group(n=24) and contained IVD herniation group(n=22).Cervical intervertebral discs of control group were obtained from 15 young cervical trauma patients who had no CSM history.According to the preoperative Japanese Orthopedic Association(JOA) scoring system,46 patients with CSM were divided into three groups: mild group(n=17),moderate group(n=15) and severe group(n=14).The expression levels of IL-1a,IL-6,TNF-a and MMP3 were assessed respectively using enzyme-linked immunosorbent assay(ELISA) method.Results]There was significant difference among contral group,uncontained IVD herniation group and contained IVD herniation group for IL-1a,IL-6,TNF-a and MMP3 expression levels(P<0.05),and cytokine expression levels showed positive correlation trends with cervical intervertebral disc degeneration.There was significant difference between mild group,moderate group and severe group for MMP3 and TNF-a expression levels(P<0.05).MMP3 and TNF-a expression levels showed negative correlation trends with JOA scoring system.Conclusion]IL-1,IL-6,TNF-a and MMP3 have close correlations with cervical intervertebral disc degeneration,and their expression levels show positive correlation trends with intervertebral disc degeneration.TNF-a are closely related to spinal cord function,and may play a dominant role in nerve injury.MMP3 are closely related to cervical intervertebral disc herniation,and may facilitate the nerve injury function of TNF-a.