Expression of Sigma-Class Glutathione-S-Transferase in Fetal and Pediatric Filum Terminale Samples: A Comparative Study.

Cahit Kural,Pınar Kaygın,Gülçin Güler Şimşek,Ozkan Tehli,Servet Guresci,Serpil Oguztuzun,Yusuf Izci,Soner Yasar

doi:10.3390/medicina55050133

Abstract

Background and objectives: The pathophysiology of tethered cord syndrome (TCS) in children is not well elucidated. An inelastic filum terminale (FT) is the main factor underlying the stretching of the spinal cord in TCS. Our study aimed to investigate the expression of glutathione-S-transferase (GST) in children and fetal FT samples in order to understand the relationship between this enzyme expression and the development of TCS. Materials and Methods: FT samples were obtained from ten children with TCS (Group 1) and histological and immunohistochemical examinations were performed. For comparison, FT samples from fifteen normal human fetuses (Group 2) were also analyzed using the same techniques. Statistical comparison was made using a Chi-square test. Results: Positive GST-sigma expression was detected in eight (80%) of 10 samples in Group 1. The positive GST-sigma expression was less frequent in nine (60%) of 15 samples from Group 2. No statistically significant difference was detected between the two groups (p = 0.197). Conclusions: Decreased FT elasticity in TCS may be associated with increased GST expression in FT. More prospective studies are needed to clarify the mechanism of the GST–TCS relationship in children.

Highlights

Tethered cord syndrome (TCS) is a functional disorder of the spinal cord which is secondary to stretching of the spinal cord
Fibrosis was observed in 8 samples in Group 2 (Table 2), while it was observed in all ten of the filum terminale (FT) samples from Group
The FT consists of the filum terminale internum (FTI) and the filum terminale externum (FTE) [8]

Summary

Introduction

Tethered cord syndrome (TCS) is a functional disorder of the spinal cord which is secondary to stretching of the spinal cord. Progressive neurological and urological dysfunctions and orthopedic deformities secondary to fixation or tethering of the distal spinal cord are the main characteristics of TCS. This syndrome is often seen in children, and both the diagnosis and treatment are controversial and can be difficult for neurosurgeons. Cutting of the FT and release of the spinal cord is the main strategy of surgical treatment for TCS [9,10,11] This procedure can be performed either by open surgery or an endoscopic approach [9,11].

Objectives

Methods

Results

Discussion

Conclusion