The value of TGF-β1, Smad2 and Smad3 in the diagnosis and efficacy evaluation of spinal tuberculosis

English Keywords:Spinal tuberculosis  TGF-β1  Smad2  Smad3  Diagnosis and efficacy evaluation

English Abstract:

  【Abstract】 Objectives: To study the value of transforming growth factor-β1(TGF-β1), Smad2 and Smad3 in the diagnosis and efficacy evaluation of spinal tuberculosis. Methods: Thirty-five patients diagnosed with spinal tuberculosis and treated in General Hospital of Ningxia Medical University from September 2018 to June 2019 were enrolled in the experimental group, and another thirty-five patients diagnosed with degenerative intervertebral disc and treated in the same hospital during the same period were enrolled in the control group. The clinical information of patients in both groups were analyzed, and diseased tissues of intervertebral disc of each group of patients were collected. Besides, 35 specimens of peripheral blood of patients in the experimental group were collected before operation(group A), 6 months after operation(group B) and 1 year after operation(group C). And 35 specimens of preoperative peripheral blood in the control group were also collected. The RNA from tissues of intervertebral disc and specimens of peripheral blood were extracted, then the concentration of mRNA of TGF-β1, Smad2 and Smad3 was amplified via PCR, and the mRNA expression levels in intervertebral disc were detected via immunohistochemical staining while the expression levels of protein in blood were measured via ELISA. At last, the intragroup and intergroup differences in expressions were analyzed through t test, the value of independent indexes and their combined value with ESR and CRP in the diagnosis of spinal tuberculosis were analyzed by ROC curve, and the correlations of the three indexes with clinical data of patients were evaluated by curve regression. Results: The mRNA of TGF-β1, Smad2 and Smad3 in experimental group was higher than that of control group from the disc(P<0.05). TGF-β1, Smad2 and Smad3 were positively expressed in the experimental group, and negatively expressed in the control group at the level of intervertebral disc protein. In the peripheral blood, mRNA of TGF-β1 and Smad3 in group A was higher than that in the control group, and it in group B was lower than that in group A(P<0.01), in group C it was lower than that in group B(P＜0.05), but Smad2 had no difference within groups(P>0.05). At the protein level, TGF-β1 in group A was higher than that in the control group(P<0.01), and it in group B was lower than that in group A(P<0.01), and which was lower in group C than that in group B(P＜0.05), but Smad2 and Smad3 had no difference within groups(P>0.05). The AUC of TGF-β1 mRNA, TGF-β1 protein and Smad3 mRNA in blood alone and combined with ESR or CRP respectively were 0.7800, 0.8000, 0.8352, 0.8219, 0.8705, 0.8819, 0.7410, 0.7552 and 0.8000, the sensitivity were 93.33%, 73.33%, 86.67%, 70.00%, 90.00%, 80.00%, 46.67%, 46.67% and 80.00%, respectively, the specificity were 54.29%, 80.00%, 80.00%, 91.43%, 88.57%, 94.29%, 100.00%, 100.00% and 85.71%(P<0.01), respectively. The mRNA of TGF-β1 and Smad3 had positive correlation(R2=0.8534, P<0.01), but it was not correlated with age, course of disease, number of diseased vertebrae, ESR and CRP. Conclusions: The TGF-β1/Smads pathway participates the onset of spinal tuberculosis, and TGF-β1/Smad3 may play a major role. The detection of TGF-β1 and Smad3 mRNA in peripheral blood and intervertebral disc tissue can be used to assist the diagnosis and efficacy evaluation of spinal tuberculosis. The expression of TGF-β1 protein in peripheral blood is highly expressed and related to prognosis. It can be used as an index for the diagnosis and efficacy evaluation of spinal tuberculosis, and it′s more valuable when combined with CRP.