The paravertebral lymphatic system is involved in the resorption of the herniated nucleus pulposus and the regression of inflammation associated with disc herniation

IF 7.2 2区医学 Q1 ORTHOPEDICS

Osteoarthritis and Cartilage Pub Date : 2024-08-28 DOI:10.1016/j.joca.2024.08.007

Yuanfei Fu , Zhiming Lan , Ning Li , Lianping Xing , Luying Yuan , Juyi Lai , Hualong Feng , Lin Cong , Yongjun Wang , Shenghua He , Qianqian Liang

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引用次数: 0

Abstract

Objective

To investigate the role of the paravertebral lymphatic system in the nucleus pulposus herniation (NPH) resorption and the inflammation regression.

Design

Clinical specimens (n = 10) from patients with lumbar disc herniation (LDH) were collected, C57BL/6 (n = 84) and conditional Vegfr3 knockout mice (n = 14) were used. Immunofluorescence staining detected lymphatic vessels (LVs) and NP cells. Near-infrared imaging assessed lymphatic drainage function, and Alcian Blue/Orange determined inflammation.

Results

Lymphangiogenesis was observed in the herniated NP of patients with LDH, and the proportion of capillary LVs was higher than that of collecting LVs (mean 68.2% [95% confidence interval: 59.4, 77.1]). In NPH mice, NP cells were detected in paravertebral tissue (38.6 [32.0, 45.2]) and draining lymph nodes (dLN) at 4 h (76.9 [54.9, 98.8]). A significant increase of NP cells in dLNs was observed at 24 h (157.1 [113.7, 200.6]). Most of the herniated NP cells were cleared in paravertebral tissue after 1 week (7.5 [4.4, 10.6]), but disc inflammation peaked at 1 week (19.9% [14.7, 25.1]), along with persistent lymphangiogenesis (9.5 [7.2, 11.8]). However, conditional Vegfr3 knockout mice exhibited impaired lymphangiogenesis (5.7 [4.4, 7.0]) and herniated NP cell clearance (6.1 [1.8, 10.5]) during NPH, leading to exacerbated disc inflammation (23.7% [19.3, 28.2]).

Conclusion

The paravertebral lymphatic system is involved in the NPH resorption and inflammation regression. Promoting lymphangiogenesis may be a novel strategy for facilitating NPH resorption and inflammation regression in patients with LDH.

查看原文本刊更多论文

椎旁淋巴系统参与椎间盘突出髓核的吸收以及与椎间盘突出相关的炎症消退。

目的研究椎旁淋巴系统在髓核突出症（NPH）吸收和炎症消退中的作用：收集腰椎间盘突出症（LDH）患者的临床标本（n = 10），使用C57BL/6（n = 84）和条件性Vegfr3基因敲除小鼠（n = 14）。免疫荧光染色检测淋巴管（LV）和NP细胞。近红外成像评估淋巴引流功能，阿尔新蓝/橙色测定炎症情况：结果：在 LDH 患者疝出的 NP 中观察到淋巴管生成，毛细淋巴管的比例高于集合淋巴管（平均 68.2% [95% 置信区间：59.4, 77.1]）。在 NPH 小鼠中，4 小时后在椎旁组织（38.6 [32.0, 45.2]）和引流淋巴结（dLN）（76.9 [54.9, 98.8]）中检测到 NP 细胞。24 小时后，观察到 dLN 中的 NP 细胞明显增加（157.1 [113.7, 200.6]）。1 周后，椎旁组织中的大部分疝出的 NP 细胞被清除（7.5 [4.4, 10.6]），但椎间盘炎症在 1 周后达到高峰（19.9 % [14.7, 25.1]），同时淋巴管生成持续存在（9.5 [7.2, 11.8]）。然而，条件性 Vegfr3 基因敲除小鼠在 NPH 期间淋巴管生成（5.7 [4.4, 7.0]）和疝出的 NP 细胞清除（6.1 [1.8, 10.5]）受损，导致椎间盘炎症加剧（23.7% [19.3, 28.2]）：结论：椎旁淋巴系统参与了 NPH 吸收和炎症消退。促进淋巴管生成可能是促进 LDH 患者 NPH 吸收和炎症消退的一种新策略。

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来源期刊

Osteoarthritis and Cartilage 医学-风湿病学

CiteScore

11.70

自引率

7.10%

发文量

802

审稿时长

52 days

期刊介绍： Osteoarthritis and Cartilage is the official journal of the Osteoarthritis Research Society International. It is an international, multidisciplinary journal that disseminates information for the many kinds of specialists and practitioners concerned with osteoarthritis.