非血瘀证腰椎间盘突出症非手术治疗的血清蛋白质组学分析

摘要

背景:蛋白质组学是一项较成熟的实验技术,目前应用于腰椎间盘突出症非手术治疗的研究报道较少.目的:通过蛋白质组学相关技术筛选非血瘀证腰椎间盘突出症患者经非手术治疗前后的差异表达蛋白.方法:选取非血瘀证腰椎间盘突出症患者60例,予非手术综合治疗4周,应用iTRAQ联合LC-MS/MS筛选和鉴定患者治疗前后的血清差异表达蛋白,并对鉴定出的蛋白质进行相关生物信息学分析,同时观察患者临床疗效.结果与结论:①患者治疗后较治疗前的目测类比评分明显降低(P ＜ 0.05),JOA评分明显升高(P ＜ 0.05),疗效优良率达95.0%;②质谱共筛选出有意义差异蛋白300个,并鉴定到25个显著性差异蛋白(P ＜ 0.05),生物信息学分析发现其中9个差异蛋白富集至15条KEGG信号通路;③结果提示,采用西医非手术综合疗法治疗非血瘀证腰椎间盘突出症可取得较满意的疗效;补体 C1qA、cDNA(FLJ60724)蛋白、补体 C4B 移码突变、cDNA(FLJ53025)蛋白、甘露糖结合蛋白C、载脂蛋白B、血红蛋白α-1珠蛋白链变体、血红蛋白β亚基及cDNA(FLJ76254)蛋白可能为非手术综合治疗腰椎间盘突出症非血瘀证的血清标志蛋白.%BACKGROUND: Proteomics is a well studied research method, but its application in the non-surgical treatment of lumbar intervertebral disc protrusion (LIDP) is little reported. OBJECTIVE: To screen the differentially expressed proteins in patients with LIDP but without blood stasis before and after non-surgical treatment by proteomics. METHODS: Sixty patients with LIDP but without blood stasis were selected, and treated with non-surgical treatment for 4 weeks. The differentially expressed proteins were screened and identified by iTRAQ combined with LC-MS/MS. The bioinformatics analysis of the identified proteins was carried out, and the curative effectiveness was investigated. RESULTS AND CONCLUSION: Compared with those before treatment, the Visual Analogue Scale scores were significantly (P ＜ 0.05), the Japanese Orthopedic Association scores were significantly increased decreased (P ＜ 0.05), and the excellent and good rate reached 95.0% post-treatment. A total of 300 differentially expressed proteins were screened and 25 significantly expressed proteins were identified (P ＜0.05). Bioinformatics analysis revealed that nine of the significantly expressed proteins were enriched to 15 KEGG signaling pathways. These results suggest that the use of Western medicine non-surgical treatment for the LIDP without blood stasis can achieve satisfactory results. Besides, complement C1qA, cDNA protein (FLJ60724), complement C4B frameshift mutation, cDNA protein (FLJ53025), mannose binding protein C, apolipoprotein B, hemoglobin α-1 globin chain variant, hemoglobin β subunit and cDNA protein (FLJ76254) may be the potential serum markers of the non-surgical treatment for the LIDP without non-blood stasis.