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Exploring macrophage differentiation and its relation to Modic changes in human herniated disc tissue

N Djuric1,2, G C M Lafeber1,2, W Li1,2

  • 1University Neurosurgical Center Holland, the Netherlands.

Brain & Spine
|January 6, 2023
PubMed
Abstract

Insights

Macrophage infiltration influences disc herniation symptoms. This study found anti-inflammatory M2 macrophages dominate in herniated discs, with CD163 being a key marker, while Modic changes showed no direct link to macrophage types.

Area of Science:

  • Immunology
  • Orthopedics
  • Pathology

Background:

  • Macrophage infiltration is implicated in cervical and lumbosacral radiculopathy caused by disc herniation.
  • Vertebral endplate changes, such as Modic changes (MC), may correlate with the disc's inflammatory state.

Purpose of the Study:

  • To assess immunohistochemical markers for differentiating M1 (pro-inflammatory) and M2 (anti-inflammatory) macrophages in herniated disc tissue.
  • To investigate the association between macrophage differentiation patterns and Modic changes in the vertebral endplates.

Main Methods:

  • Analyzed 45 herniated disc samples from patients with radiculopathy using immunohistochemistry.
  • Stained for macrophage markers (CD68), M1 markers (CD40, iNOS, CD192), M2 markers (CD163, Arg1, CD209), T-cells (CD3), and neutrophils (CD15).

Main Results:

  • CD68+ cells were present; M2 markers (CD163, CD209) showed higher expression than M1 markers (CD192).
  • Lumbar samples exhibited greater iNOS and Arg1 expression than cervical samples.
  • Modic changes correlated with higher CD68+ cell density, but not significantly with specific M1/M2 marker expression.

Conclusions:

  • CD192 and CD163 are suitable markers for M1 and M2 macrophages, respectively.
  • Symptomatic disc herniations show a predominance of anti-inflammatory M2 macrophages.
  • Further large-scale studies are needed to clarify the relationship between macrophage differentiation and Modic changes in radiculopathy.
Keywords:
CervicalInflammationIntervertebral disc herniationLumbarM1M2MacrophageModic changes

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