A Study Of The Relationship Between Lumbar Disc Degeneration Disease And Peripheral Blood Lymphocyte Subsets

Background and ObjectiveThe serious low back and leg pain caused by lumbar disc degenerative disease(LDDD)is the most crippling spinal disease.Previous studies suggested that the main causes of LDDD are aging,mechanical load change,trauma,metabolic disorder and adverse genetic factors,but the role of autoimmune factors in the process of LDDD is not clear.Lymphocyte is the most important immune cell in human body.Observe the changes of peripheral blood lymphocyte subsets and the pain degree of lumbar disc degeneration,determine the relationship between the degree of lumbar disc degeneration,pain degree and peripheral blood lymphocyte subsets,and provide theoretical basis for the study of the autoimmune mechanism of lumbar disc degeneration.MethodsThe LDDD group included 76 patients diagnosed with lumbar disc degeneration,compared with 56 healthy volunteers in the control group.Peripheral blood of the two groups of subjects was extracted,and the percentage of lymphocyte subsets in peripheral blood,including CD3+T cells,CD4+T cells,CD8+T cells,CD 19+B cells,CD3’CD16+CD56+NK cells,was detected by flow cytometry,and the CD4+/CD8+ratio was calculated.Lumbar MRI was performed on all subjects,and the grade and severity of lumbar disc degeneration were assessed using the Pfirrmann grading criteria.The visual analogue scale(VAS)was used to assess the pain degree of low back and leg pain in LDDD group of 76 patients with lumbar disc degeneration disease.The above data were statistically analyzed to evaluate the correlation between peripheral blood lymphocyte subsets and the degree of lumbar disc degeneration and the VAS score of low back and leg pain.Results(1)The degree of lumbar disc degeneration(2.94±0.62)in LDDD group was significantly higher than that in the control group(1.57±0.32),and the difference between the two groups was statistically significant(P<0.05).(2)The percentage of CD4+T cells(46.08±6.82)and NK cells(14.20±7.36)in LDDD group were significantly higher than those in control group(37.94±6.80),and the ratio of CD4+/CD8+in LDDD group(2.27±0.95)was significantly higher than those in control group(1.35±0.41).The difference between groups was statistically significant(P<0.05).The percentage of CD8+T cells(22.68±6.69)was significantly lower than that of the control group(29.501±6.25),the difference between the two groups was statistically significant(P<0.05);the percentage of CD3+T cells(73.47±7.63)in LDDD group was not significantly different from that in the control group(73.10±6.90)(P>0.05),and the percentage of CD19+B cells(12.60±4.61)in LDDD group was not significantly different from that in the control group(13.00±4.60)(P>0.05).(3)The degree of lumbar disc degeneration in the control group was not correlated with CD3+T cells percentage,CD4+T cells percentage,CD8+T cells percentage,CD19+B cells percentage,NK cells percentage,and CD4+/CD8+ratio(r=-0.161,P=0.234;r=0.037,P=0.789;r=0.063,P=0.643;r=0.085,P=0.534;r=0.057,P=0.677;r=-0.036,P=0.793).The degree of lumbar disc degeneration in LDDD group was positively correlated with the percentage of CD4+T cells,the ratio of CD4+/CD8+and the percentage of NK cells(r=0.412,P=0.000;r=0.715,P=0.000;r=0.494,P=0.000),negatively correlated linearly with CD8+T cells percentage(r=-0.737,P=0.000),and had no correlation with CD3+T cells percentage and CD19+B cells percentage(r=-0.202,P=0.081;r=-0.017,P=0.887).(4)The VAS score of low back and leg pain in LDDD group was positively correlated with the percentage of CD4+T cells,the ratio of CD4+/CD8+and the percentage of NK cells(r=0.350,P=0.002;r=0.644,P=0.000;r=0.487,P=0.000),negatively correlated with the percentage of CD8+T cells(r=-0.685,P=0.000),and negatively correlated with the percentage of CD3+T cells and the percentage of CD 19+B cells was not correlated(r=-0.182,P=0.115;r=-0.076,P=0.516).ConclusionsOur results show that lumbar disc degeneration will lead to the change of peripheral blood lymphocyte subsets,which provides further clinical evidences for the autoimmune theory of lumbar disc degeneration.In addition,the change of immune system aggravates the development of symptoms of lumbar disc degeneration to a certain extent.The more peripheral blood CD4+T cells and NK cells,the higher the ratio of CD4+/CD8+,the more serious the degeneration of lumbar disc,the more serious the symptoms of low back and leg pain.Peripheral blood lymphocyte subsets can be used as an auxiliary examination item of lumbar disc degeneration,which provides a new starting point for further study of the pathogenesis,diagnosis indexes and treatment methods of lumbar disc degeneration.The immune system is expected to be a new target for the prevention and treatment of lumbar disc degeneration disease.