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巨噬细胞在椎间盘源性疼痛中的潜在调控作用

孙飞¹, 孙钰¹, 刘恩旭¹, 杨雷², 李兆勇², 杨少锋^2,*

¹湖南中医药大学，长沙 410208；²湖南中医药大学第一附属医院骨科，长沙 410208

摘要

椎间盘退变(intervertebral disc degeneration, IDD)是腰痛产生的主要原因。免疫细胞通过与髓核(nucleus pulposus, NP)细胞和细胞外基质(extracellular matrix, ECM)相互作用，在调节IDD的进展中发挥着极其重要的作用。健康的NP组织是一种无血管的免疫特权组织，通常不与巨噬细胞相互作用。然而，在受损椎间盘中新生血管的建立导致了NP与巨噬细胞之间产生广泛对话(cross-talk)，并依据不同的微环境刺激导致不同的结果。基于此，本综述回顾了IDD与腰痛的关联性，总结了巨噬细胞的来源及作用，探讨了巨噬细胞与椎间盘源性疼痛间的可能调控机制，最后还讨论了近年来靶向巨噬细胞延缓IDD的潜在治疗方式，旨在强调免疫学在IDD中的重要作用，为IDD的防治提供新方向。

关键词： 椎间盘退变; 巨噬细胞; 炎症; 免疫

Potential regulatory role of macrophages in discogenic pain

SUN Fei¹, SUN Yu¹, LIU En-Xu¹, YANG Lei², LI Zhao-Yong², YANG Shao-Feng^2,*

¹Hunan University of Chinese Medicine, Changsha 410208, China；²Department of Orthopedics, the First Hospital of Hunan University of Chinese Medicine, Changsha 410208, China

Abstract

Intervertebral disc degeneration (IDD) is the main cause of low back pain. Immune cells play an extremely important role in regulating the progression of IDD by interacting with nucleus pulposus (NP) cells and the extracellular matrix (ECM). Healthy NP tissue is a vascular-free and immune-privileged tissue that does not normally interact with macrophages. However, the establishment of neovascularization channels in damaged intervertebral discs has led to extensive cross-talk between NP and macrophages, with different results depending on microenvironmental stimuli. Based on this, this review reviewed the correlation between IDD and low back pain, summarized the source and function of macrophages, and discussed the possible regulatory mechanism between macrophages and discogenic pain. Finally, potential therapies targeting macrophages to delay IDD in recent years were also discussed, aiming to emphasize the important role of immunology in IDD and provide a new direction for the prevention and treatment of IDD.

Key words: intervertebral disc degeneration; Macrophage; inflammation; immunity

收稿日期：　　录用日期：

通讯作者：杨少锋　　E-mail:

DOI: 10.13294/j.aps.2025.0054

引用本文：

孙飞, 孙钰, 刘恩旭, 杨雷, 李兆勇, 杨少锋. 巨噬细胞在椎间盘源性疼痛中的潜在调控作用[J]. 生理学报 2025; 77 (5): 979-988.

SUN Fei, SUN Yu, LIU En-Xu, YANG Lei, LI Zhao-Yong, YANG Shao-Feng. Potential regulatory role of macrophages in discogenic pain. Acta Physiol Sin 2025; 77 (5): 979-988 (in Chinese with English abstract).