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. 2017 Jun;11(3):472-477.
doi: 10.4184/asj.2017.11.3.472. Epub 2017 Jun 15.

Correlation among Inflammatory Cytokine Expression Levels, Degree of Disk Degeneration, and Predominant Clinical Symptoms in Patients with Degenerated Intervertebral Discs

Takeshi Sainoh  1 , Kazuhide Inage  2 , Sumihisa Orita  2 , Masao Koda  2 , Takeo Furuya  2 , Kazuyo Yamauchi  2 , Miyako Suzuki  2 , Yoshihiro Sakuma  3 , Go Kubota  2 , Yasuhiro Oikawa  4 , Jun Sato  2 , Kazuki Fujimoto  2 , Yasuhiro Shiga  2 , Koki Abe  2 , Hirohito Kanamoto  2 , Masahiro Inoue  2 , Hideyuki Kinoshita  2 , Masaki Norimoto  2 , Tomotaka Umimura  2 , Kazuhisa Takahashi  2 , Seiji Ohtori  2
Affiliations

Correlation among Inflammatory Cytokine Expression Levels, Degree of Disk Degeneration, and Predominant Clinical Symptoms in Patients with Degenerated Intervertebral Discs

Takeshi Sainoh et al. Asian Spine J. 2017 Jun.

Abstract

Study design: Observational study.

Purpose: To assess the correlation among inflammatory cytokine expression levels, degree of intervertebral disk (IVD) degeneration, and predominant clinical symptoms observed in degenerative disk disease (DDD).

Overview of literature: Low back pain (LBP) is associated with inflammatory cytokine expression levels, including those of tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), and nerve growth factor (NGF). However, the association between cytokine expression levels and the physiological mechanisms of disk degeneration and clinical pain remain controversial.

Methods: Using the enzyme-linked immunosorbent assay, TNF-α, IL-6, and NGF expression levels were analyzed in 58 IVD samples that were harvested from patients with lumbar DDD. Patient samples were grouped according to the degree of IVD degeneration using the Pfirrmann grading system and magnetic resonance imaging, and the correlations between the disease groups and each cytokine expression level were assessed. In addition, on the basis of their predominant preoperative symptoms, the patients were assigned to either an LBP or leg pain group to determine the correlation among these disease manifestations and individual cytokine expression levels.

Results: A gradual increase in TNF-α (R=0.391) and IL-6 (R=0.388) expression levels correlated with the degree of IVD degeneration, whereas NGF (R=0.164) expression levels exhibited a minimal decrease with disease progression. Regarding the predominant clinical manifestation, only the LBP group exhibited a significant increase in TNF-α expression levels (p=0.002).

Conclusions: These results suggested that TNF-α and IL-6 play an important role in the pathophysiology of IVD degeneration at any stage, whereas NGF plays an important role during the early disease stages. Moreover, because TNF-α expression levels were significantly high in the LBP group, we propose that they are involved in LBP onset or progression.

Keywords: Intervertebral disk; Intervertebral disk degeneration; Low back pain.

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Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Correlation between cytokine expression levels and the degree of intervertebral disk (IVD) degeneration according to the Pfirrmann grading system and magnetic resonance imaging. A gradual increase in the tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) expression levels was observed with the progression of IVD degeneration. The nerve growth factor (NGF) exhibited a minimal decrease. NS, not significant. *p <0.05.
Fig. 2
Fig. 2. Correlation between cytokine expression levels and predominant clinical symptoms. Tumor necrosis factor-alpha (TNF-α) expression levels were significantly higher in the low back pain (LBP) group than in the leg pain group. IL-6, interleukin 6; NGF, nerve grCowth factor; NS, not significant.
See this image and copyright information in PMC

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