Pathologic features of paraspinal muscle biopsies in patients with adolescent idiopathic scoliosis.
- Author:
Dan Feng ZHENG
1
;
Jun Yu LI
2
;
Jia Xi LI
3
;
Ying Shuang ZHANG
4
;
Yan Feng ZHONG
1
;
Miao YU
2
Author Information
1. Department of Pathology, School of Basic Medical Sciences Peking University/Peking University Third Hospital, Beijing 100191, China.
2. Departmant of Orthopaedics, Peking University Third Hospital, Beijing 100191, China.
3. School of Basic Medical Sciences, Peking University, Beijing 100191, China.
4. Departmant of Neurology, Peking University Third Hospital, Beijing 100191, China.
- Publication Type:Journal Article
- Keywords:
Adolescent;
Biopsy;
Dystrophin protein;
Paraspinal muscles;
Scoliosis
- MeSH:
Humans;
Adolescent;
Scoliosis/surgery*;
Paraspinal Muscles/pathology*;
Dystrophin;
Non-alcoholic Fatty Liver Disease/pathology*;
Kyphosis/pathology*;
Biopsy
- From:
Journal of Peking University(Health Sciences)
2023;55(2):283-291
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To characterize the paraspinal muscles of adolescent idiopathic scoliosis (AIS) patients, and to further explore its etiology.
METHODS:Clinical records and paraspinal muscle biopsies at the apex vertebra region during posterior scoliosis correction surgery of 18 AIS were collected from November 2018 to August 2019. Following standardized processing of fresh muscle tissue biopsy, serial sections with conventional hematoxylin-eosin (HE) and histochemical and immunohistochemical (IHC) with antibody Dystrophin-1 (R-domain), Dystrophin-2 (C-terminal), Dystrophin-3 (N-terminal), Dystrophin-total, Myosin (fast), major histocompatibility complex 1 (MHC-1), CD4, CD8, CD20, and CD68 staining were obtained. Biopsy samples were grouped according to the subjects' median Cobb angle (Cobb angle ≥ 55° as severe AIS group and Cobb angle < 55° as mild AIS group) and Nash-Moe's classification respectively, and the corresponding pathological changes were compared between the groups statistically.
RESULTS:Among the 18 AIS patients, 8 were in the severe AIS group (Cobb angle ≥55°) and 10 in the mild AIS group (Cobb angle < 55°). Both severe and mild AIS groups presented various of atrophy and degeneration of paraspinal muscles, varying degrees and staining patterns of immune-expression of Dystrophin-3 loss, especially Dystrophin-2 loss in severe AIS group with significant differences, as well as among the Nash-Moe classification subgroups. Besides, infiltration of CD4+ and CD8+ cells in the paraspinal muscles and tendons was observed in all the patients while CD20+ cells were null. The expression of MHC-1 on myolemma was present in some muscle fibers.
CONCLUSION:The histologic of paraspinal muscle biopsy in AIS had similar characteristic changes, the expression of Dystrophin protein was significantly reduced and correlated with the severity of scoliosis, suggesting that Dystrophin protein dysfunctions might contribute to the development of scoliosis. Meanwhile, the inflammatory changes of AIS were mainly manifested by T cell infiltration, and there seemed to be a certain correlation between inflammatory cell infiltration, MHC-1 expression and abnormal expression of Dystrophin. Further research along the lines of this result may open up new ideas for the diagnosis of scoliosis and the treatment of paraspinal myopathy.
