Expression Of IL-17 In Herniated Intervertebral Disc Tissue Of The Patients With Lumbar Disc Herniation

Objective:To observe histological and immunohistochemical characteristics of the disc specimens in patients with lumbar disc herniation(LDH) which contain injured disc herniation and degenerative disc herniation, and explore the interleukin-17 (IL-17) and chondrocytes in the role of the pathogenesis of lumbar disc herniation(LDH)with different types, further make out the essence between the two types of lumbar disc herniation.Methods:Fifty patients with LDH were eligible for surgery in the orthopedic department of the General Hospital of Tianjin Medical University and spinal surgery department of Tianjin Hospital, according to the clinical diagnostic criteria, imaging (CT and MRI) examination results, and operative findings, the patients were divided into two groups as follows:â‘ injured disc herniation (IDH) group:35 cases, prominent lesions of the posterior longitudinal ligament,the disruption of annulus fibrosus and separation between nucleus pulposus and maternal,soft and easily removed;â‘¡degenerative disc herniation (DDH) group:15 cases, annulus fibrosus was complete after shallow incision of posterior longitudinal ligament, hard and removed by equipment. All disc specimens were tested using HE staining, toluidine blue staining and immunohistochemical staining.ResuIts:Histological analysis using HE staining showed granulation tissue and neovascularization in the disc specimens of IDH group were more than those of the DDH group. The rate of neovascularization in IDH group was 88.6%, but that in DDH group was 13.3%; Histological examination using toluidine blue staining revealed chondrocyte proliferation(CP) and cartilage cells clusters were found in specimens of IDH group,chondrocyte proliferation in IDH group accounted for 74.3%, while chondrocyte proliferation in DDH group accounted for 6.7%. Analysis of immunohistochemical staining manifestated IL-17 positive cells in the specimens of IDH group were significantly higher than those in the DDH group.Conclusion:1.The pathological type of lumbar disc herniation should be divide into injured disc herniaton and degenerative disc herniation,the differences between the pathogenesis of LDH should be distinguished;2.Injured herniated disc causes the changes of disc-nerve root micro-enviroment such as granulation tissue formation and angiogenesis,which demonstrated that the exposure of nucleus pulposus induced the local inflammatory response;3.Chondrocyte proliferation and cartilage cell clusters might be some performances of self-healing response of intervertebral disc after the complete destruction of intervertebral disc;4.IL-17 found in the chondrocytes of injured herniated disc demonstrates that IL-17 could involve in the immune and inflammatory changes of disc nerve root microenvironment;5.Local inflammation and autoimmune response play important parts in the pathophysiology of LDH with injured disc herniation, chondrocyte could invovle in the process of disc repair after injury.