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Chick CN, Inoue T, Mori N, Tanaka E, Kawaguchi M, Takahashi T, Hanakita J, Minami M, Kanematsu R, Usuki T. LC-MS/MS analysis of elastin crosslinker desmosines and microscopic evaluation in clinical samples of patients with hypertrophy of ligamentum flavum. Bioorg Med Chem 2023; 82:117216. [PMID: 36842401 DOI: 10.1016/j.bmc.2023.117216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
Ligamentum flavum (LF) pathologies often lead to severe myelopathy or radiculopathy characterized by reduced elasticity, obvious thickening, or worsened ossification. Elastin endows critical mechanical properties to tissues and organs such as vertebrae and ligaments. Desmosine (DES) and isodesmosine (IDES) are crosslinkers of elastin monomers called tropoelastin. These crosslinkers are potential biomarkers of chronic obstructive pulmonary disease. As a biological diagnostic tool that supplements existing symptomatic, magnetic resonance imaging scanning or radiological imaging diagnostic measures for LF hypertrophy and associated pathologies, an isotope-dilution liquid chromatography-tandem mass spectrometry method with selected reaction monitoring mode for the quantitation of DESs in human plasma, urine, cerebrospinal fluid (CSF), and yellow ligamentum was investigated. Isotopically labeled IDES-13C3,15N1 was used as an internal standard (ISTD) for DES quantitation for the first time. The samples plus ISTD were hydrolyzed with 6 N hydrochloric acid. Analytes and ISTD were extracted using a solid phase extraction cellulose cartridge column. The assays were repeatable, reproducible, and accurate with % CV ≤ 7.7, ISTD area % RSD of 7.6, and % AC ≤ (101.2 ± 3.90) of the calibrations. The ligamentum samples gave the highest average DES/IDES content (2.38 μg/mg) on a dry-weight basis. A high percentage of the CSF samples showed almost no DESs. Urine and plasma samples of patients showed no significant difference from the control (p-value = 0.0519 and 0.5707, respectively). Microscopy of the yellow ligamentum samples revealed dark or blue-colored zones of elastin fibers that retained the hematoxylin dye and highly red-colored zones of collagen after counterstaining with van Gieson solution. Thus, we successfully developed a method for DES/IDES quantitation in clinical samples.
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Affiliation(s)
- Christian Nanga Chick
- Department of Materials and Life Sciences, Faculty of Science and Technology, Sophia University, 7-1 Kioicho, Chiyoda-ku, Tokyo 102-8554, Japan
| | - Tomoo Inoue
- Department of Materials and Life Sciences, Faculty of Science and Technology, Sophia University, 7-1 Kioicho, Chiyoda-ku, Tokyo 102-8554, Japan; Department of Neurosurgery, Saitama Red Cross Hospital, 1-5 Shintoshin, Chuo-ku, Saitama 330-8553, Japan; Spinal Disorders Center, Fujieda Heisei Memorial Hospital, 123-1 Mizukami, Fujieda, Shizuoka 426-8662, Japan.
| | - Natsuki Mori
- Department of Materials and Life Sciences, Faculty of Science and Technology, Sophia University, 7-1 Kioicho, Chiyoda-ku, Tokyo 102-8554, Japan
| | - Eri Tanaka
- Department of Materials and Life Sciences, Faculty of Science and Technology, Sophia University, 7-1 Kioicho, Chiyoda-ku, Tokyo 102-8554, Japan
| | - Mari Kawaguchi
- Department of Materials and Life Sciences, Faculty of Science and Technology, Sophia University, 7-1 Kioicho, Chiyoda-ku, Tokyo 102-8554, Japan
| | - Toshiyuki Takahashi
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, 123-1 Mizukami, Fujieda, Shizuoka 426-8662, Japan
| | - Junya Hanakita
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, 123-1 Mizukami, Fujieda, Shizuoka 426-8662, Japan
| | - Manabu Minami
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, 123-1 Mizukami, Fujieda, Shizuoka 426-8662, Japan
| | - Ryo Kanematsu
- Spinal Disorders Center, Fujieda Heisei Memorial Hospital, 123-1 Mizukami, Fujieda, Shizuoka 426-8662, Japan
| | - Toyonobu Usuki
- Department of Materials and Life Sciences, Faculty of Science and Technology, Sophia University, 7-1 Kioicho, Chiyoda-ku, Tokyo 102-8554, Japan.
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Aleksić V, Todorović J, Miladinović N, Aleksić N, Bogosavljević V, Đurović M, Kocić S, Aleksić R, Joković M. Ligamentum flavum analysis in patients with lumbar discus hernia and lumbar spinal stenosis. Sci Rep 2023; 13:3804. [PMID: 36882487 PMCID: PMC9992359 DOI: 10.1038/s41598-023-30928-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
The normal ligamentum flavum (LF) is a well-defined elastic structure with specific innervation. Several studies investigated LF in patients with lumbar spinal stenosis (LSS) and used lumbar discus hernia (LDH) patients as control group, only on the presumed thesis that LF in this patients have normal morphology. In patients with LSS thickening of the LF is the main cause of stenosis, which is most often presented with neurogenic claudication, whose pathophysiological mechanism is not completely understood. We conducted observational cohort study of 60 operated patients divided into two groups. The first group of 30 patients underwent micro-discectomy (LSH group), and second group with 30 patients underwent decompression, after which analysis of harvested LF was performed. Patients from the LDH group and LSS group differed significantly in the frequencies of chief complaints, duration of symptoms, physical examination, and specific morphological/radiological parameters. The LF analysis showed that the groups differed significantly in the amount of collagen and elastic fibers, as well as in the histological appearance/architectonics of elastic fibers. Also, groups differ in the presence of LF nerve fibers. Our findings speak in favor of the recently postulated inflammatory theory in the origin of spinal neurogenic claudication's.
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Affiliation(s)
- Vuk Aleksić
- Department of Neurosurgery, Clinical Hospital Center Zemun, Belgrade, Serbia.
| | - Jovana Todorović
- Institute for Social Medicine, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nenad Miladinović
- Department of Pathology, Clinical Hospital Center Zemun, Belgrade, Serbia
| | - Nemanja Aleksić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Cardiac Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Vojislav Bogosavljević
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Neurosurgery Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Marko Đurović
- Neurosurgery Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Svetlana Kocić
- Department of Radiology, Clinical Hospital Center Zemun, Belgrade, Serbia
| | - Radmila Aleksić
- Department of Neurosurgery, Clinical Hospital Center Zemun, Belgrade, Serbia
| | - Miloš Joković
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Neurosurgery Clinic, Clinical Center of Serbia, Belgrade, Serbia
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