Exploration of the pathology of lumbar spinal canal stenosis associated with Diabetes

2016 Fiscal Year Final Research Report

• Project/Area Number: 26462251
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Orthopaedic surgery
• Research Institution: Keio University
• Principal Investigator: Watanabe Kota 慶應義塾大学, 医学部(信濃町), 講師 (60317170)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Keywords: 糖尿病 / 腰部脊柱管狭窄症 / アルドース還元酵素阻害剤

Outline of Final Research Achievements

The pathomechanism of the ligamentum flavum (LF) hypertrophy in diabetic patients with lumbar spinal canal stenosis (LSCS) remains unclear. We found that the LF of diabetic patients exhibited significantly higher levels of sorbitol and pro-inflammatory cytokines. The high glucose-cultured fibroblasts exhibited significantly higher levels of sorbitol, pro-inflammatory factors, and TGF-β1 compared to the low glucose-cultured cells, and these levels were dose-dependently reduced by treatment with the aldose reductase inhibitor. Taken together, our data suggests that increased sorbitol levels in the LF of diabetic patients results in increased production of pro-inflammatory and fibrogenic factor, which contribute to LF hypertrophy, and could increase the susceptibility of diabetic patients to LSCS. Furthermore, aldose reductase inhibition effectively reduced the levels of sorbitol and sorbitol-induced pro-inflammatory factor expression in high glucose-cultured fibroblasts.

Free Research Field

脊椎外科