Macrophage infiltration and polarization during lumbar intervertebral disc herniation (LDH) have attracted increased attention but their role remains unclear. To explore macrophage polarization in herniated nucleus pulposus (NP) tissue of patients with LDH and investigate the association between cell frequency and different clinical characteristics or symptoms, we conducted a retrospective study by analyzing NP tissue samples from 79 patients. Clinical features and symptoms, using the visual analog scale (VAS) and Oswestry disability index (ODI), were collected. The macrophage markers CD68, CCR7, CD163, and CD206; pro‐inflammatory cytokine TNF‐α; and anti‐inflammatory factor IL‐4 were analyzed by immunohistochemistry. The frequency of polarized macrophages and positivity rate of pro‐ and anti‐inflammatory cytokines showed significant differences in some of clinical characteristics. Specifically, higher CCR7+ and TNF‐α + proportions were identified in the high‐intensity zone (HIZ) and the type of extrusion and sequestration NP tissue than in non‐HIZ and protrude NP tissue. Higher CD206+ and IL‐4+ proportion were detected in Modic changes. However, no differences in gender, age, smoking status, Pfirrmann grade, analgesic use, leg pain duration, and segments were found between groups. CD68+, CCR7+, and CD206+ cell proportions, and TNF‐α and IL‐4 showed positive associations with VAS scores preoperation. Associations between ODI and the macrophages markers were weak/insignificant. Our results indicated that macrophage polarization or macrophage‐like cells contribute to LDH pathological features. Macrophage populations displaying significant associations with VAS score reflected continuous M1/M2 transition contributing to pain during LDH. These findings may contribute to enhanced/personalized pharmacological interventions for patients with LDH considering pain heterogeneity.

纤维环损伤与椎间盘退行性疾病(IVDD)的发病密切相关,也是导致椎间盘术后疗效不佳的重要因素,恢复纤维环结构和功能的完整性对缓解甚至逆转IVDD有重要意义.传统的椎间盘纤维环修复策略仅完成物理修复而不能恢复纤维环的生物力学特性,并不是理想的修复方式.近年来,应用生物学方法来修复纤维环取得了一些进展.本文综述了目前对椎间盘纤维环损伤的认识,并介绍了包括细胞移植、纤维环组织工程以及基因治疗在内的各种生物疗法在椎间盘纤维环再生策略方面的最新进展,以期为未来的研究方向选择提供帮助.

Hypertropohy of ligamentum flavum (HLF) can lead tolumbar spinal stenosis (LSS), and then cause a series of clinical symptoms such as limb pain and walking disorder. Inflammation is an important cause of HLF, and macrophages play an important role in inflammation. Studies on human specimens, animal models and cell experiments have confirmed that there is macrophage infiltration in HLF, but the specific mechanism of its role in HLF is still unclear. This article mainly introduces the research progress on the role of macrophages and their polarization in HLF at home and abroad, in order to provide new insights and research directions for the etiology of HLF.