The Presence And Role Of Macrophage, Mast Cell And Monocyte Chemoattractant Protein-1 In Lumbar Disc Herniation

[Objective] To investigate the expression of macrophage,mast cell and monocyte chemoattractant protein-1(MCP-1) in lumbar disc herniation and explore their significance in the pathogenesis of intervertebral disc degeneration and lumbar disc hernaiton. Furthermore, to study the association between the expression of macrophage and sciatica ; To supply the theoretical support for treating the degenerative disc disease and sciatica.[Methods] The experimental group consisted of 48 cases of the fresh pulpy nucleus tissue which were obtained from patients with lumbar disc herniation by surgical intervention(22 external anulus intact,26 external anulus rupture) .The specimens were obtained from the zone of hernia tissue,which were adjioning nerve root ,and the area was less than 5 cm. 10 cases of the fresh pulpy nucleus tissue were harvested by operation for fracture of lumbar vertebrae acted as control group. Patients, sciatica pain were evaluated with Oswestry Disability Index preoperatively.The protein expression of macrophage and mast cell in specimens were detected with immunohistochemical technique;By quantitatively analyzing all the sections with graph analysis meter,the correlation between the expression of macrophage and patients, sciatica pain was explored.The mRNA and protein expression of MCP-1 in all specimens were detected by semi-quantitative RT-PCR and immunohistochemical staining .[Results] (1)Macrophage and MCP-1were overexpressed in LDH group compare with those in control group (P<0.01).In different types of herniation,the expression of macrophage and MCP-1were higher in external anulus intact type as compared with external anulus rupture type (P<0.01) .(2)Two different types of LDH have different ODI score of sciatica statistically (P<0.01).The ODI pain score of sciatica were positive correlated with the expression of macrophage in LDH group (r=0.748,P<0.01).(3)Mast cell were observed in a minority of disc herniations after immunohistochemical staining;The expression of mast cell were not different in different types of herniation and control group(P>0.05).[Conclusion] Macrophage and MCP-1 were involved in the pathogenesis of lumbar disc degeneration and lumbar disc herniation. Macrophage and MCP-1 play critical role in the development of lumbar disc degeneration and herniation;The intervertebral disc cell have the potential to express MCP-1. In our study,a statistically significant correlation between inflammatory changes in the herniated lumbar disc specimen and clinical symptom could be demonstrated;Our study suggests that it is improbable that mast cells or mediators released from them ,have any major clinical relevance in disc herniation inflammation.