Abstract
Epidural fibrosis is the main cause of failed back surgery syndrome. To investigate the role of miR-146 in the diagnosis and development of epidural fibrosis. Lumbar disc tissues were collected from 72 lumbar disc herniation patients (45 developed epidural fibrosis and 27 did not). The expression of miR-146 in collected tissues and isolated epidural fibroblasts was detected by RT-qPCR. The relative levels of pro-inflammatory cytokines were analyzed by ELISA. The effect of miR-146 on the proliferation of fibroblasts was evaluated by MTT assay. miR-146 was significantly upregulated in epidural fibrosis patients compared with control patients. The expression of miR-146 was closely associated with the location, lower limb symptom and duration of disease of epidural fibrosis patients, and was positively correlated with the relative levels of pro-inflammatory cytokines. Moreover, miR-146 could discriminate epidural fibrosis patients from control patients. In isolated epidural fibroblasts, the overexpression of miR-146 dramatically enhanced its proliferation and the inflammatory response. miR-146 serves as a diagnostic biomarker for the early detection of epidural fibrosis. The upregulation of miR-146 enhanced the fibroblasts proliferation and inflammatory response in epidural fibrosis. This study provides a novel potential therapeutic target for epidural fibrosis.
Highlights
Laminectomy is a routine surgical procedure in the treatment of lumbar disc herniation, lumbar spinal stenosis, and other spine diseases, which can relieve pain in the waist and lower extremities and promote the recovery of patients (Alkalay et al, 2003)
It was found that miR-146 was significantly upregulated in patients that developed epidural fibrosis compared with the expression in the control group (P < 0.001, Figure 1)
Postoperative epidural scar adhesion is the major cause of failed back surgery syndrome, which mainly resulted from epidural fibrosis (Xie et al, 2017)
Summary
Laminectomy is a routine surgical procedure in the treatment of lumbar disc herniation, lumbar spinal stenosis, and other spine diseases, which can relieve pain in the waist and lower extremities and promote the recovery of patients (Alkalay et al, 2003). Postoperative epidural scar formation, called epidural fibrosis, is the body’s response to trauma after spinal surgery, especially in laminectomy (Manchikanti and Singh, 2002). The inflammatory response and hematoma formation after laminectomy are the main factors that result in the proliferation of fibroblasts, the accumulation of collagens, and the formation of a fibrous scar, lead to epidural fibrosis (Slipman et al, 2002; Gambardella et al, 2005). An investigation on the role of miR-519d-3p in postoperative epidural scar formation and found that the overexpression of miR-519d-3p promoted the proliferation of fibroblasts and the expression of type I collagen, which are important factors in epidural fibrosis (Yang L et al, 2019). MiR-146 was speculated to play roles in epidural fibrosis of patients undergoing laminectomy
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