Hypertrophy of the lumbar ligamentum flavum is associated with inflammation-related TGF-β expression.
Summary of "Hypertrophy of the lumbar ligamentum flavum is associated with inflammation-related TGF-β expression."
BACKGROUND:
Despite the significance of hypertrophy of the ligamentum flavum (HLF) in the disease progress of neurogenic claudication, the cellular mechanisms underlying the gradual fibrotic thickening of the ligamentum flavum remain poorly understood. The aim of our study was to get insight into the contribution of inflammatory mechanisms to the development of hypertrophy.
METHODS:
Specimens of hypertrophied ligamenta flava were obtained at surgery from 20 patients with acquired lumbar osteoligamentous spinal canal stenosis from the central part of the ligament. Paraffin sections were stained with hematoxylin and eosin and Elastica van Gieson to evaluate extracellular matrix architecture, and immunohistochemistry was performed to characterize the inflammatory reaction and the sources of transforming growth factor beta (TGF-β) expression. Sections of normal ligamenta flava obtained from corresponding anatomical sites and stained in parallel served as a control.
RESULTS:
HLF was characterized by a considerable distortion of the elastic matrix and fibrotic transformation by extracellular collagen deposition. All specimens showed highly inflammatory cellular infiltrates confined to regions exhibiting marked degeneration of the elastic matrix composed mainly of macrophages, scattered T lymphocytes, and neovascularization, thus representing a chronic inflammation. Surprisingly, macrophages as well as vascular endothelial cells but not fibroblasts showed a strong expression of TGF-β, a strong inducer of extracellular collagen deposition.
CONCLUSIONS:
Macrophages were identified as a major cellular source of TGF-β in advanced HLF and may perpetuate further hypertrophy. This finding suggests that modulating the immune response locally or systemically could prove to be effective for impeding the disease progress.
Affiliation
Department of General Neurosurgery, University Hospital of Cologne, Kerpener Strasse 62, 50924, Cologne, Germany, loehr.m@nch.uni-wuerzburg.de.
Journal Details
This article was published in the following journal.
Name: Acta neurochirurgica
ISSN: 0942-0940
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20960015
- DOI: http://dx.doi.org/10.1007/s00701-010-0839-7
Medical and Biotech [MESH] Definitions
Ligamentum Flavum
The paired bands of yellow elastic tissue that connect adjoining laminae of the vertebrae. With the laminae, it forms the posterior wall of the spinal canal and helps hold the body erect.
Brevibacterium Flavum
A species in the genus CORYNEBACTERIUM, family Corynebacteriaceae, which is used for industrial production of the amino acid LYSINE. It is closely related to Corynebacterium glutamicum.
Spinal Puncture
Tapping of the subarachnoid space in the lumbar region, usually between the third and fourth lumbar vertebrae.
Longitudinal Ligaments
Two extensive fibrous bands running the length of the vertebral column. The anterior longitudinal ligament (ligamentum longitudinale anterius; lacertus medius) interconnects the anterior surfaces of the vertebral bodies; the posterior longitudinal ligament (ligamentum longitudinale posterius) interconnects the posterior surfaces. The commonest clinical consideration is OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT. (From Stedman, 25th ed)
Cardiomyopathy, Hypertrophic
A form of CARDIAC MUSCLE disease, characterized by left and/or right ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR; HYPERTROPHY, RIGHT VENTRICULAR), frequent asymmetrical involvement of the HEART SEPTUM, and normal or reduced left ventricular volume. Risk factors include HYPERTENSION; AORTIC STENOSIS; and gene MUTATION; (FAMILIAL HYPERTROPHIC CARDIOMYOPATHY).
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