PDF(Pubmed)
Abstract：
UNASSIGNED: Condoliase is an enzyme used as a treatment for lumbar disc herniation (LDH). This enzyme degrades chondroitin sulfate (CS) in the nucleus pulposus of the intervertebral disc (IVD). However, there are cases in which symptoms do not improve, despite condoliase administration. This study reports histological analysis of lumbar disc tissue of LDH patients who underwent surgery because condoliase had no therapeutic effect.
UNASSIGNED: Between March 2019 and August 2019, 12 LDH patients who underwent full endoscopic spine surgery (FESS) discectomy at the Dezawa Akira PED Clinic were the subjects of the study. There are two study groups: six cases underwent FESS after condoliase administration, while six underwent FESS without condoliase administration. The average duration from drug administration to surgery was 152 days. Herniated disc removed at surgery was evaluated by histological staining including immunohistochemistry by anti-CS antibodies.
UNASSIGNED: Multiple large clusters (40-120 μm in diameter) were observed in the nucleus pulposus of those who received condoliase, but no clusters were observed in those who did not. The lumbar disc tissues, including the nucleus pulposus of recipients, were stained with anti-CS antibodies that recognize the CS unsaturated disaccharide, but non-administration tissue was not stained. These findings suggest that the enzyme acted on the nucleus pulposus, even in cases where symptoms were not improved by condoliase administration. Furthermore, there was no histological difference between stained images of the extracellular matrix in those who did or did not receive condoliase, suggesting that condoliase acted specifically on CS in the nucleus pulposus.
UNASSIGNED: We demonstrated that CS in the nucleus pulposus was degraded in patients in whom condoliase did not have a therapeutic effect. Moreover, condoliase acts in human IVD without causing necrosis of chondrocytes and surrounding tissues.
UNASSIGNED: Between March 2019 and August 2019, 12 LDH patients who underwent full endoscopic spine surgery (FESS) discectomy at the Dezawa Akira PED Clinic were the subjects of the study. There are two study groups: six cases underwent FESS after condoliase administration, while six underwent FESS without condoliase administration. The average duration from drug administration to surgery was 152 days. Herniated disc removed at surgery was evaluated by histological staining including immunohistochemistry by anti-CS antibodies.
UNASSIGNED: Multiple large clusters (40-120 μm in diameter) were observed in the nucleus pulposus of those who received condoliase, but no clusters were observed in those who did not. The lumbar disc tissues, including the nucleus pulposus of recipients, were stained with anti-CS antibodies that recognize the CS unsaturated disaccharide, but non-administration tissue was not stained. These findings suggest that the enzyme acted on the nucleus pulposus, even in cases where symptoms were not improved by condoliase administration. Furthermore, there was no histological difference between stained images of the extracellular matrix in those who did or did not receive condoliase, suggesting that condoliase acted specifically on CS in the nucleus pulposus.
UNASSIGNED: We demonstrated that CS in the nucleus pulposus was degraded in patients in whom condoliase did not have a therapeutic effect. Moreover, condoliase acts in human IVD without causing necrosis of chondrocytes and surrounding tissues.
摘要：
■Condoliase是一种用于治疗腰椎间盘突出症（LDH）的酶。该酶降解椎间盘（IVD）髓核中的硫酸软骨素（CS）。然而,有些情况下症状没有改善，尽管有condoliase管理。这项研究报告了由于condoliase没有治疗作用而接受手术的LDH患者的腰椎间盘组织的组织学分析。
在2019年3月至2019年8月之间，在DezawaAkiraPED诊所接受全内窥镜脊柱手术（FESS）椎间盘切除术的12例LDH患者是研究对象。有两个研究组：6例患者在服用condoliase后接受FESS，而6人接受了FESS，没有服用condoliase。从药物施用到手术的平均持续时间为152天。通过组织学染色(包括通过抗CS抗体的免疫组织化学)来评估在手术中移除的突出椎间盘。
■在接受condoliase的人的髓核中观察到多个大的簇（直径40-120μm），但在那些没有观察到的人中没有观察到集群。腰椎间盘组织，包括接受者的髓核，用识别CS不饱和二糖的抗CS抗体染色，但非给药组织未染色。这些发现表明酶作用于髓核，即使在症状没有改善的情况下，通过condoliase管理。此外，在接受或未接受condoliase的患者中，细胞外基质的染色图像之间没有组织学差异，表明condoliase特异性作用于髓核中的CS。
■我们证明，在不具有治疗作用的患者中，髓核中的CS降解。此外，condoliase在人IVD中起作用而不会引起软骨细胞和周围组织的坏死。
在2019年3月至2019年8月之间，在DezawaAkiraPED诊所接受全内窥镜脊柱手术（FESS）椎间盘切除术的12例LDH患者是研究对象。有两个研究组：6例患者在服用condoliase后接受FESS，而6人接受了FESS，没有服用condoliase。从药物施用到手术的平均持续时间为152天。通过组织学染色(包括通过抗CS抗体的免疫组织化学)来评估在手术中移除的突出椎间盘。
■在接受condoliase的人的髓核中观察到多个大的簇（直径40-120μm），但在那些没有观察到的人中没有观察到集群。腰椎间盘组织，包括接受者的髓核，用识别CS不饱和二糖的抗CS抗体染色，但非给药组织未染色。这些发现表明酶作用于髓核，即使在症状没有改善的情况下，通过condoliase管理。此外，在接受或未接受condoliase的患者中，细胞外基质的染色图像之间没有组织学差异，表明condoliase特异性作用于髓核中的CS。
■我们证明，在不具有治疗作用的患者中，髓核中的CS降解。此外，condoliase在人IVD中起作用而不会引起软骨细胞和周围组织的坏死。
