Resorption Mechanisms Related with Neo-Vascularization for the Lomber Disc Herniation

Abstract

Lomber disk herniasyonu (LDH) bel agrisi ve siyatigin onemli bir nedenidir. LDH'nin magnetik rezonans goruntuleme (MRG) ile incelenmesi neo-vaskularizasyonla iliskili rezorbsiyon mekanizmasini ortaya cikarmistir. Aktive makrofajlarin disk dokusuyla etkilesimlerinin infamatuvar sitokinlerin uretimine yol actigi gosterilmistir. Buna ek olarak tumor nekrozis faktor-α (TNF-α) gibi infamatuvar sitokinler, vaskuler endotelyal growt faktor (VEGF) gibi anjiogenezi uyaran faktorlerin induksiyonu icin gereklidir. VEGF endotel hucresine ozgu bir mitojendir ve yeni kan damarlarinin olusumunda esasli bir rolu vardir. Yeni olusmus kan damarlari ve makrofaj infiltrasyonu LDH rezorbsiyonu sirasinda onemli bir rol oynarlar. Bu derlemede LDH'da rezorbsiyon mekanizmalari hakkindaki guncel bilgiler ozetlendi. Lomber disc herniation (LDH) is a major cause of low back pain and sciatica. MRI investigation of LDH has revealed a resorption mechanism related with neo-vascularization. It has shown that the interaction of activated macrophages with disc tissues leads to the generation of inflammatory cytokines. In addition, inflammatory cytokines such as tumor necrosis factor-α (TNF-α) is required for the induction of angiogenesis stimulating factors such as vascular endothelial growth factor (VEGF). VEGF is an endothelial cell-specific mitogen, and it has an essential role in the formation of new blood vessels. The newly formed vessels and infiltrating macrophages play an important role during LDH resorption. In this review, recent knowledge on the resorbtion mechanisms of LDH is summerized.