Histological analysis of nucleus pulposus tissue from patients with lumbar disc herniation after condoliase administration

IF 3.4 3区医学 Q1 ORTHOPEDICS

JOR Spine Pub Date : 2024-04-03 DOI:10.1002/jsp2.1328

Yuka Minamisawa, Taiichi Shirogane, Ippei Watanabe, Akira Dezawa

{"title":"Histological analysis of nucleus pulposus tissue from patients with lumbar disc herniation after condoliase administration","authors":"Yuka Minamisawa, Taiichi Shirogane, Ippei Watanabe, Akira Dezawa","doi":"10.1002/jsp2.1328","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Condoliase is an enzyme used as a treatment for lumbar disc herniation (LDH). This enzyme degrades chondroitin sulfate (CS) in the nucleus pulposus of the intervertebral disc (IVD). However, there are cases in which symptoms do not improve, despite condoliase administration. This study reports histological analysis of lumbar disc tissue of LDH patients who underwent surgery because condoliase had no therapeutic effect.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Between March 2019 and August 2019, 12 LDH patients who underwent full endoscopic spine surgery (FESS) discectomy at the Dezawa Akira PED Clinic were the subjects of the study. There are two study groups: six cases underwent FESS after condoliase administration, while six underwent FESS without condoliase administration. The average duration from drug administration to surgery was 152 days. Herniated disc removed at surgery was evaluated by histological staining including immunohistochemistry by anti-CS antibodies.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Multiple large clusters (40–120 μm in diameter) were observed in the nucleus pulposus of those who received condoliase, but no clusters were observed in those who did not. The lumbar disc tissues, including the nucleus pulposus of recipients, were stained with anti-CS antibodies that recognize the CS unsaturated disaccharide, but non-administration tissue was not stained. These findings suggest that the enzyme acted on the nucleus pulposus, even in cases where symptoms were not improved by condoliase administration. Furthermore, there was no histological difference between stained images of the extracellular matrix in those who did or did not receive condoliase, suggesting that condoliase acted specifically on CS in the nucleus pulposus.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>We demonstrated that CS in the nucleus pulposus was degraded in patients in whom condoliase did not have a therapeutic effect. Moreover, condoliase acts in human IVD without causing necrosis of chondrocytes and surrounding tissues.</p>\n </section>\n </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jsp2.1328","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JOR Spine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jsp2.1328","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Condoliase is an enzyme used as a treatment for lumbar disc herniation (LDH). This enzyme degrades chondroitin sulfate (CS) in the nucleus pulposus of the intervertebral disc (IVD). However, there are cases in which symptoms do not improve, despite condoliase administration. This study reports histological analysis of lumbar disc tissue of LDH patients who underwent surgery because condoliase had no therapeutic effect.

Methods

Between March 2019 and August 2019, 12 LDH patients who underwent full endoscopic spine surgery (FESS) discectomy at the Dezawa Akira PED Clinic were the subjects of the study. There are two study groups: six cases underwent FESS after condoliase administration, while six underwent FESS without condoliase administration. The average duration from drug administration to surgery was 152 days. Herniated disc removed at surgery was evaluated by histological staining including immunohistochemistry by anti-CS antibodies.

Results

Multiple large clusters (40–120 μm in diameter) were observed in the nucleus pulposus of those who received condoliase, but no clusters were observed in those who did not. The lumbar disc tissues, including the nucleus pulposus of recipients, were stained with anti-CS antibodies that recognize the CS unsaturated disaccharide, but non-administration tissue was not stained. These findings suggest that the enzyme acted on the nucleus pulposus, even in cases where symptoms were not improved by condoliase administration. Furthermore, there was no histological difference between stained images of the extracellular matrix in those who did or did not receive condoliase, suggesting that condoliase acted specifically on CS in the nucleus pulposus.

Conclusions

We demonstrated that CS in the nucleus pulposus was degraded in patients in whom condoliase did not have a therapeutic effect. Moreover, condoliase acts in human IVD without causing necrosis of chondrocytes and surrounding tissues.

Abstract Image

查看原文本刊更多论文

给腰椎间盘突出症患者注射髓核酸酶后髓核组织的组织学分析

背景 Condoliase 是一种用于治疗腰椎间盘突出症（LDH）的酶。这种酶能降解椎间盘（IVD）髓核中的硫酸软骨素（CS）。然而，在一些病例中，尽管使用了冷凝酶，但症状并没有得到改善。本研究报告了因使用冷凝酶无治疗效果而接受手术治疗的 LDH 患者腰椎间盘组织的组织学分析。方法 2019年3月至2019年8月期间，在出泽明PED诊所接受全内窥镜脊柱手术（FESS）椎间盘切除术的12例LDH患者为研究对象。研究分为两组：6 例患者在使用冷凝酶后接受了 FESS 手术，6 例患者在未使用冷凝酶的情况下接受了 FESS 手术。从用药到手术的平均时间为 152 天。对手术切除的椎间盘进行组织学染色评估，包括抗CS抗体的免疫组化。结果在接受冷凝酶治疗的患者髓核中观察到多个大团（直径 40-120 μm），而未接受冷凝酶治疗的患者髓核中未观察到大团。用识别 CS 不饱和二糖的抗 CS 抗体对腰椎间盘组织（包括接受治疗者的髓核组织）进行染色，但未接受治疗者的组织未被染色。这些研究结果表明，即使在使用髓核酸酶后症状未得到改善的病例中，髓核酸酶也能发挥作用。此外，接受或未接受冷凝酶治疗的患者细胞外基质的染色图像在组织学上没有差异，这表明冷凝酶专门作用于髓核中的CS。结论我们的研究表明，在没有使用冷凝酶治疗的患者中，髓核中的 CS 发生了降解。此外，冷凝酶作用于人类 IVD 不会导致软骨细胞和周围组织坏死。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊