臨床整形外科57巻11号

2022年11月発行

特集 腰椎椎間板ヘルニアのCutting Edge

椎間板ヘルニアと炎症

著者： 大場哲郎¹ 波呂浩孝¹

所属機関： ¹山梨大学医学部医学科整形外科学講座

ページ範囲：P.1289 - P.1294

椎間板ヘルニアの自然退縮メカニズムは，無血管領域にある髄核が血行にさらされて自己免疫反応が惹起されることに伴って起こる炎症性反応をトリガーとすることが知られている．そこでわれわれは，椎間板の炎症・変性における免疫性の炎症に着目して研究を継続してきた．TNFファミリー分子であるTNF-like weak inducer of apoptosis(TWEAK)が椎間板に恒常的に発現しており，慢性的で比較的弱い炎症反応を誘導することで，軟骨基質生成の抑制およびmatrix metalloproteinases(MMPs)の産生誘導を通じて椎間板変性に関与している．また，アレルギー性疾患で免疫寛容の破綻時に炎症を誘導するthymic stromal lymphopoietin(TSLP)は，椎間板ヘルニアにおいても同様に，免疫担当細胞の遊走を惹起していることを解明した．

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