Abstract
ABSTRACT Objective: To define histological scores for intervertebral disc degeneration that would enable the definition of morphological characteristics of disease, besides improving knowledge of the lumbar degenerative disc disease by means of immunohistochemical markers. Methods: Hematoxylin and Eosin, Alcian/PAS, Masson Trichrome and Safranin O/FCF staining was used on the intervertebral disc degeneration sections of patients with lumbar degenerative disc disease. The protein markers defined in immunohistochemistry were cell proliferation (Ki-67) and apoptosis (p53). Results: The study data enabled the determination of Safranin O/FCF stain as the most effective one for evaluating parameters such as area, diameter, and number of chondrocyte clusters. The importance of using stains in association, such as Safranin O/FCF, Masson Trichrome, Alcian/PAS and Hematoxylin and Eosin, was also determined, as they are complementary for the histopathological verification of intervertebral disc degeneration. By expressing proteins using the immunohistochemistry technique, it was possible to consider two stages of disc degeneration: cell proliferation with chondrocyte cluster formation, and induction of apoptosis. Conclusion: This study enabled the histological and immunohistochemical characterization to be determined for lumbar degenerative disc disease, and its degrees of evolution, by determining new disc degeneration scores.
Highlights
The intervertebral disc (IVD) is the spine structure responsible for the daily absorption of load and impact on the human body
Hematoxylin and Eosin, Alcian/PAS, Masson Trichrome and Safranin O/FCF staining was used on the intervertebral disc degeneration sections of patients with lumbar degenerative disc disease
The present study showed that the Safranin O/FCF stain was best one for histopathological evaluations involving lumbar degenerative disc disease (LDD), because it allows greater accuracy of the results, as it is easy to delimit the chondrocyte clusters in the nucleus pulposus (NP)
Summary
The intervertebral disc (IVD) is the spine structure responsible for the daily absorption of load and impact on the human body. When the number of chondrocytes in adult cells of the NP increases, they may modify the notochord phenotype and trigger a cell reduction due to the high levels of apoptosis.[8,9] The mature NP in the presence of lumbar degenerative disc disease (LDD) provokes a hyaline formation in the cartilage, expressing high levels of markers for the chondrocytes, which enable the verification and follow-up of disc degeneration.[10,11] The painful symptoms of disc degeneration are a result of loss of functionality and mechanical integrity of the disc These are direct consequences of qualitative and quantitative histological changes of the proteoglycans, collagens, proportion of water, cell proliferation, and increase in dead cells.[5,12,13]
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