文章摘要
黎清波,蔡磊,王正坤,等.脉冲电磁场对椎间盘退行性病变大鼠A2A腺苷受体及p38 MAPK信号通路的影响[J].中华物理医学与康复杂志,2023,45(9):769-775
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脉冲电磁场对椎间盘退行性病变大鼠A2A腺苷受体及p38 MAPK信号通路的影响
  
DOI:10.3760/cma.j.issn.0254-1424.2023.09.001
中文关键词: 脉冲电磁场  A2A腺苷受体  p38 MAPK  椎间盘退行性病变
英文关键词: Pulsed electromagnetic fields  A2A adenosine receptor  p38 MAPK  Intervertebral discs  Disc degeneration
基金项目:湖北省自然科学基金面上项目(2021CFB522);武汉市卫生和计划生育委员会一般项目(WX18D14);武汉市卫生和计划生育委员会一般项目(WX10C20)
作者单位
黎清波 武汉市第四医院脊柱科武汉 430030 
蔡磊 武汉市第四医院脊柱科武汉 430030 
王正坤 武汉市第四医院脊柱科武汉 430030 
方为志 武汉市第四医院脊柱科武汉 430030 
周传坤 武汉市第四医院脊柱科武汉 430030 
周逸驰 武汉市第四医院脊柱科武汉 430030 
姚智 华中科技大学同济医学院武汉 430030 
魏梦诚 华中科技大学同济医学院武汉 430030 
张诗爽 江汉大学医学院武汉 430056 
刘伟军 武汉市第四医院脊柱科武汉 430030 
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中文摘要:
      目的 观察脉冲电磁场(PEMF)对椎间盘退行性病变(IDD)大鼠A2A腺苷受体(A2AR)及p38 MAPK信号通路的影响。 方法 采用随机数字表法将40只SD大鼠分为对照组、IDD模型组(简称模型组)、PEMF组和PEMF联合CGS-21680治疗组(简称观察组)。将模型组、PEMF组及观察组大鼠制成IDD动物模型,PEMF组于制模后给予PEMF干预,观察组则给予PEMF干预并注射A2AR激动剂CGS-21680。于造模8周后采用番红O-快绿染色评估各组大鼠椎间盘病理改变,同时检测各组大鼠椎间盘A2AR、环磷酸腺苷(cAMP)、蛋白激酶A(PKA)、半胱氨酸天冬氨酸蛋白水解酶-3(Caspase-3)、Ⅱ型胶原(Col-Ⅱ)、基质金属蛋白酶-3(MMP3)表达水平。 结果 模型组大鼠髓核组织皱缩,纤维成分及软骨细胞增多,观察组大鼠髓核形态基本趋于正常,纤维环完整无破裂。模型组椎间盘组织A2AR蛋白表达及mRNA水平均高于对照组,观察组A2AR蛋白表达及mRNA水平均显著高于其他各组(P<0.05)。PEMF组和观察组椎间盘cAMP含量及PKA mRNA表达均较模型组增高,且观察组与模型组间差异具有统计学意义(P<0.05)。模型组大鼠椎间盘p38 MAPK、p-p38 MAPK含量及p-p38 MAPK/p38 MAPK比值均显著高于对照组(P<0.05),PEMF组和观察组p38 MAPK、p-p38 MAPK蛋白含量及p-p38 MAPK/p38 MAPK比值均有不同程度降低,且观察组上述指标数值均显著低于模型组(P<0.05),p-p38 MAPK蛋白含量及p-p38 MAPK/p38 MAPK比值亦显著低于PEMF组(P<0.05)。模型组大鼠Caspase-3蛋白含量及mRNA表达均显著高于对照组,PEMF组及观察组上述指标含量均较模型组明显降低(P<0.05)。模型组大鼠MMP3含量较对照组显著升高,Col-Ⅱ含量则明显下降;PEMF组、观察组MMP3含量均较模型组降低,Col-Ⅱ表达均较模型组增高,并且观察组上述指标含量与模型组间差异均具有统计学意义(P<0.05)。 结论 炎性因子刺激能活化p38 MAPK信号通路并诱导细胞凋亡,这也是促进IDD大鼠病变的重要原因之一。PEMF联合A2AR激动剂干预能激活A2AR/cAMP/PKA信号通路,进而抑制p38 MAPK磷酸化,减少髓核细胞凋亡,缓解IDD损伤。
英文摘要:
      Objective To explore any effect of pulsed electromagnetic field (PEMF) stimulation on intervertebral disc degeneration (IDD). Methods Forty Sprague-Dawley rats were randomly divided into a control group, an IDD model group, a PEMF group and an observation group. An IDD model was induced in all except those in the control group. Both the PEMF and observation groups were given PEMF stimulation, while the latter was additionally injected with the A2AR agonist CGS-21680. Eight weeks after the modelling any pathological changes in the morphology of the rats′ intervertebral disc tissues were evaluated using saffron solid green staining. The expression of A2AR, cyclic adenosine phosphate (cAMP),protein kinase A (PKA),cysteine aspartate proteolytic enzyme-3 (Caspase-3), type II collagen (COL-II) and matrix metalloproteinase-3 (MMP3) in the intervertebral discs were evaluated. Results The nucleus pulposus had shrunk, while fibrous tissues and chondrocytes had increased in the IDD model group. In the observation group the nucleus pulposus was intact and of basically normal shape. A2AR mRNA and protein levels were higher in the intervertebral disc tissue of the model group than among the control group, on average, while the levels in the observation group were significantly higher than in the other groups. In the PEMF and observation groups cAMP and PKA mRNA were significantly higher than in the IDD model group. The p38 MAPK and P-P38 MAPK levels of the IDD model group and its average P-P38 MAPK/p38 MAPK ratio were significantly higher than in the control group. In the PEMF and observation groups those indices had decreased to varying degrees, with those of the observation group significantly lower than among the model and PEMF groups on average, except for the p38 MAPK values. Caspase-3 and its mRNA were significantly higher in the model group than in the control group, on average, and those values were significantly lower in the PEMF and observation groups than in the IDD model group. The average MMP3 contents of the IDD model group had increased significantly compared with the control group, while the Col-Ⅱ level had decreased significantly. Compared with the IDD model group, the MMP3 level had decreased but Col-Ⅱ expression had increased in both the PEMF and observation groups, with significant differences between the IDD model and observation groups. Conclusions The activation of the p38 MAPK signaling pathway by inflammatory factors to induce apoptosis is one of the important reasons for the aggravation of IDD lesions. PEMF combined with A2AR agonists can activate the A2AR/cAMP/PKA signaling pathway, inhibit p38 MAPK phosphorylation, reduce apoptosis of nucleus pulposus cells, and relieve IDD damage.
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