γδ T Cell Infiltration Predicts the Prognosis of Lumbar Disc Herniation.

Lumbar disc herniation (LDH) is a common degenerative spinal disorder traditionally attributed to mechanical compression. However, growing evidence suggests that the immune system plays a crucial role in its pathogenesis. The role of alterations in the T cell receptor (TCR) clonal repertoire in LDH and their correlation with neurological recovery was investigated in this study. Immunohistochemical analysis was performed to assess T cell infiltration in nucleus pulposus tissue from patients with LDH, while TCR immune repertoire sequencing was conducted on peripheral blood mononuclear cells to examine TCR clonal diversity and gene rearrangement patterns. The results revealed a significant reduction in TCR clonal diversity in patients with LDH, with selective expansion of specific V, J, and VDJ gene segments indicating abnormal clonal proliferation of certain T cell subsets. Furthermore, local CD3⁺ (r = 0.5193; p = 0.0039) and TCRγδ⁺ (r = 0.6137; p < 0.001) T cell densities were positively correlated with Japanese Orthopaedic Association (JOA) scores, whereas white blood cell (r = -0.3861; p = 0.0351) and neutrophil counts (r = -0.4243; p = 0.0194) were negatively correlated with JOA scores. This study highlights the immunological characteristics of TCR repertoire alterations in LDH and suggests that TCR clonal profiling could serve as a potential biomarker for personalized immunotherapy.