Skip to main content
SpringerLink
Log in

Concomitant immunocytochemical study of macrophage cells and blood vessels in disc herniation tissue

  • Original Articles
  • Published:
European Spine Journal Aims and scope Submit manuscript

Summary

Twenty disc herniations (DH) were studied immunocytochemically for macrophages and blood vessels. Serial thin frozen sections were immunostained with an antibody specific for tissue macrophages (monoclonal antibody to CD68 antigen) and the endothelium of blood vessels (polyclonal antibody to von Willebrand factor). With this method, blood vessels, often abundant, were observed in as many as 16/20 (80%) of the DH studied, 12 disc extrusions and 8 sequestrated discs, whereas abundant macrophages were noted in 11/20 (55%) of the DH. Macrophages were present only in areas with blood vessels and had presumably infiltrated the tissue from them. As has been noted previously, some blood vessels are apparently newly formed as a result of tissue injury, whereas others were present in the disc prior to herniation. This is suggested by the lack of a clear correlation between the presence or absence of blood vessels and the preoperative duration of radicular pain. In areas of the DH where cartilage fragments occurred, both macrophages and blood vessels were particularly abundant.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ashton IK, Roberts S, Jaffray DC, Polak J (1992) Immunochemical demonstration of innervation and neurotransmitters in the human intervertebral disc. Presented at the Annual Meeting of the International Society for the Study of the Lumbar Spine, Chicago, Illinois

  2. Bogduk N, Tynan W, Wilson AS (1981) The innervation of the human lumbar intervertebral discs. J Anat 132:39–56

    PubMed  Google Scholar 

  3. Bogduk N, Windsor M, Inglis A (1989) The innervation of the cervical intervertebral discs. Spine 13:2–8

    Google Scholar 

  4. Coppes MIL, Marani E, Thomeer RT, Oudega M, Groen GJ (1990) Innervation of annulus fibrosus in low back pain (Letter). Lancet 336:189–190

    Google Scholar 

  5. Cordell JL, Falini B, Ether WN et al (1984) Immunoenzymatic labeling of monoclonal antibodies using immune complexes of alkaline phosphatase and monoclonal anti-alkaline phosphatase (APAAP complexes). J Histochem Cytochem 32:219–229

    PubMed  Google Scholar 

  6. Grönblad M, Weinstein JN, Santavirta S (1991) Immunohistochemical observations on spinal tissue innervation: a review of hypothetical mechanisms of back pain. Acta Orthop Scand 62:614–622

    PubMed  Google Scholar 

  7. Grönblad M, Virri J, Tolonen J et al (1994) A controlled immunohistochemical study of proinflammatory cells in disc herniation tissue. Spine (in press)

  8. Guyton AC (1969) The blood cells. In: Function of the human body, 3rd edn. WB Saunders, Philadelphia, pp 85–98

    Google Scholar 

  9. Hardy MA (1989) The biology of scar formation. Phys Ther 69:1014–1024

    PubMed  Google Scholar 

  10. Hirsch C, Schajowicz F (1953) Studies on structural changes in the lumbar annulus fibrosus. Acta Orthop Scand 22:184–231

    PubMed  Google Scholar 

  11. Hirsch C, Ingelmark BE, Miller M (1963) The anatomical basis for low back pain. Acta Orthop Scand 33:1–17

    PubMed  Google Scholar 

  12. Hsu S-M, Raine L, Fanger H (1981) Use of avidin-biotin-peroxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabeled antibody (PAP) procedures. J Histochem Cytochem 29:577–580

    PubMed  Google Scholar 

  13. Jackson HC, Winkelmann RK, Bickel WH (1966) Nerve endings in the human lumbar spinal column and related structures. J Bone Joint Surg [Am] 48:1272–1281

    Google Scholar 

  14. Kelly PMA, Bliss E, Morton JA, Burns J, McGee JOD (1988) A monoclonal antibody (EBM 11) with high cellular specificity for human macrophages. J Clin Pathol 41:510–515

    PubMed  Google Scholar 

  15. Kääpä E, Grönblad M, Holm S, Liesi P, Murtomäki S, Vanharanta H (1994) Neural elements in the normal and experimentally injured porcine intervertebral disc. Eur Spine J 3:137–142

    PubMed  Google Scholar 

  16. Lindahl O (1962) Pain: a chemical explanation. Acta Rheum Scand 8:161–169

    PubMed  Google Scholar 

  17. Mason DY (1985) Immunocytochemical labeling of monoclonal antibodies by the APAAP immunoalkaline phosphatase technique. In: Bullock GR, Petrusz P (eds) Techniques in immunocytochemistry. Academic Press, New York, pp 25–42

    Google Scholar 

  18. Maves TJ, Pechman PS, Gebhart GF, Meller ST (1993) Possible chemical contribution from chronic gut sutures produces disorders of pain sensation like those seen in man. Pain 54:57–69

    PubMed  Google Scholar 

  19. Payan DG (1989) Neuropeptides and inflammation: the role of substance P. Annu Rev Med 40:341–352

    PubMed  Google Scholar 

  20. Petersen M, LaMotte RH (1993) Effect of protons on the inward current evoked by capsaicin in isolated dorsal root ganglion cells. Pain 54:37–42

    PubMed  Google Scholar 

  21. Reeh PW, Steen KH, Hanisch AE (1991) A dominant role of acid pH in inflammatory excitation of nociceptors in rat skin. Soc Neurosci Abstr 17:214–215

    Google Scholar 

  22. Sehested M, Hou-Jensen K (1981) Factor VIII-related antigen as an endothelial cell marker in benign and malignant diseases. Virchows Arch [A] 391:217–225

    Google Scholar 

  23. Steen KH, Reeh PW, Anton F, Handwerker HO (1992) Protons selectively induce lasting excitation and sensitization to mechanical stimulation of nociceptors in rat skin in vitro. J Neurosci 12:86–95

    PubMed  Google Scholar 

  24. Tolonen J, Grönblad M, Virri J, Seitsalo S, Rytömaa T, Karaharju E (1993) Fibroblast growth factor in disc herniation tissue. An immunohistochemical study. Presented at the Annual Meeting of the International Society for the Study of the Lumbar Spine, Marseilles, France

  25. Weinstein J, Claverie W, Gibson S (1988) The pain of discography. Spine 13:1341–1348

    Google Scholar 

  26. Yasuma T, Makino E, Saito S, Inui M (1986) Clinicopathological study on lumbar intervertebral disc herniation. 3. Comparison between surgical materials and clinical data. Orthop Trauma 29:1817–1826

    Google Scholar 

  27. Yasuma T, Arai K, Yamauchi Y (1993) The histology of lumbar intervertebral disc herniation. Spine 18:1761–1765

    PubMed  Google Scholar 

  28. Yoshizawa H, O'Brian JP, Thomas-Smith W, Trumper M (1980) The neuropathology of intervertebral discs removed for low back pain. J Pathol 132:95–104

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Spine Research Unit and Department of Orthopaedics and Traumatology, Clinical Research Institute, Helsinki University Central Hospital, Haartmaninkatu 4, SF-00290, Helsinki, Finland

    J. Virri, S. Sikk, M. Grönblad, J. Tolonen, S. Seitsalo, J. Kankare & E. O. Karaharju

Authors
  1. J. Virri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Sikk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Grönblad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Tolonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Seitsalo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. Kankare
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. E. O. Karaharju
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Supported in part by grants from the Yrjb Jahnsson Foundation and the Memorial Foundation of Dorothea Olivia, Jarl Walter and Karl Walter Perklen, Helsinki, Finland

Visiting Research Student, University of Tartu, Estonia

Rights and permissions

Reprints and permissions

About this article

Cite this article

Virri, J., Sikk, S., Grönblad, M. et al. Concomitant immunocytochemical study of macrophage cells and blood vessels in disc herniation tissue. Eur Spine J 3, 336–341 (1994). https://doi.org/10.1007/BF02200147

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02200147

Key words

Search

Navigation