Angiogenesis and inflammatory cell infiltration in lumbar disc herniation.
METHODS
Immunohistochemical study of the angiogenesis and inflammatory cell invasion in lumbar disc herniation. OBJECTIVES To observe the blood vessel formation within the extracellular matrix in lumbar disc herniation, and to elucidate the role of angiogenesis in the natural shrinking of hernias.


BACKGROUND
There have been few reports of detailed observation of blood vessel formation within the extracellular matrix, and the role that angiogenesis plays in the natural shrinking of hernias has not been elucidated.


METHODS
Twenty tissue samples surgically removed from 17 patients with herniated discs were studied (9 men, 8 women, 23-58 years old, 11 extrusion type, 9 sequestration type). In the immunohistochemical study, an anti-CD34 antibody for vascular endothelial cells, an anti-CD68 for macrophages, and an anti-vascular endothelial growth factor antibody was used for vascular endothelial growth factor.


RESULTS
Many spindle-shaped cells expressing vascular endothelial growth factor were seen inside granulation tissue infiltrating the cartilage matrix, and the number of vascular endothelial growth factor-positive cells and the number of CD34+ cells were positively correlated (R = 0.73, P < 0.001). In the area surrounding CD34+ cells that had formed a lumen, many CD68+ cells were observed, and the number of CD34+ cells and the number of CD68+ cells were positively correlated (R = 0.66, P < 0.001).


CONCLUSIONS
The results suggest that the vascular endothelial growth factor produced by the spindle-shaped cells acts to promote angiogenesis inside granulation tissue infiltrating the cartilage matrix, and that new blood vessels play an important role as a passage for macrophages into the degenerated matrix.
Koike
Yoichi
Y
Department of Orthopaedics, Tohoku University School of Medicine, Japan. yokoike@mail.cc.tohoku.ac.jp
Uzuki
Miwa
M
Kokubun
Shoichi
S
Sawai
Takashi
T
D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D018952:Antigens, CD34 / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007403:Intervertebral Disc / Q000737:chemistry / Q000276:immunology / Q000473:pathology; D007405:Intervertebral Disc Displacement / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D008264:Macrophages / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000503:physiopathology*; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis; D000097382:CD68 Molecule
D015703:Antigens, CD; D018952:Antigens, CD34; D015214:Antigens, Differentiation, Myelomonocytic; D042461:Vascular Endothelial Growth Factor A; C067980:CD68 antigen, human; D000097382:CD68 Molecule