Quantitative Assessment of Human Proteinases as Agents for Chemonucleolysis

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Abstract
A rabbit model system is described. It allows accurate measurement of the dose-dependent loss of glycosamlnoglycan from the nucleus pulposus of lumbar intervertebral discs after Injection of a protelnase. At the dose equivalent to that of chymopapaln used In human Chemonucleolysis, two human serlne protelnases, cathepsln G and chymotrypsin, were as effective as chymopapaln In removing up to 80% of the glycosamlnoglycan from the disc. A cystelne protelnase, cathepsln B released no more than 45% of glycosamlnoglycan. X-ray films clearly showed narrowing of the disc space when 30–40% of glycosamlnoglycan was removed. The degradation of the nucleus pulposus was seen hlstologlcally as loss of toluldlne blue metachromasia.

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