title: Fractalkine receptor chemokine (CX3CR1) influences on cervical and lumbar disc herniation.
abstract: BACKGROUND
  Herniation of nuclear or disc material along with, inflammatory chemokines such as prostaglandin E2, interleukin-6, matrix metalloproteinase and nitric oxide has definite correlation, possibly they are over produced. CX3CL1 and its receptor (CX3CR1) are part of chemokine system involved in leukocyte recruitment and adhesion in chronic inflammatory disease, but its role in spinal herniated nucleus pulposus (HNP) is unknown. We evaluated the expression of CX3CL1 and CX3CR1 in patients with disc herniation to clarify the role of CX3CL1 and CX3CR1 in the disc degeneration and to compare between cervical and lumbar HNP.
  
  
  METHODS
  The mRNA concentrations of CX3CL1/CX3CR1 chemokine were analyzed in the surgically obtained disc specimens from C-HNP (n = 13) and L-HNP (n = 13) by real-time polymerase chain reaction (PCR). The localization of CX3CL1/CX3CR1 chemokine in the disc of C-HNP and L-HNP patients was determined using immunohistochemical study. Blood samples from patients with C-HNP and L-HNP patients were stained for CX3CR1 with flow cytometric analysis.
  
  
  RESULTS
  The CX3CL1 positive cell ratio in the discs was observed in both groups by immunohistochemical study. CX3CR1 was strongly expressed on endothelial cells in C-spine disc, but sparely expressed in L-spine disc. There was greater CX3CR1 mRNA expression in C-HNP patients than in L-HNP patients as quantified by reversal transcription-PCR (P = 0.010). CX3CR1 positive cell frequencies and CX3CR1 expression levels were increased in CD4 (+) T-cells and natural killer (NK) cells from patients with C-HNP (P = 0.210 and P = 0.040).
  
  
  CONCLUSIONS
  This study identified that increases in CX3CL1 and CX3CR1-expressing cells are significantly related to pathomechanism of HNP for the first time. Especially, CD4 (+) T-cells and NK cells expressing CX3CR1 may play an important role in developing C-HNP.
authors.affiliation: Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, Seoul, South Korea.
authors.forename: In-Soo
authors.initials: IS
authors.lastname: Oh
authors.affiliation: Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, Seoul, South Korea.
authors.forename: Dong-Whan
authors.initials: DW
authors.lastname: Suh
authors.affiliation: Department of Orthopaedic Surgery, Incheon St. Mary's Hospital, Seoul, South Korea.
authors.forename: Sung-Ryeoll
authors.initials: SR
authors.lastname: Park
authors.affiliation: Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Kee-Yong
authors.initials: KY
authors.lastname: Ha
keywords: Lumbar; Lumbar disc; cervical; chemokine; disc; fractalkine receptor; herniated; herniated nucleus pulposus; receptors