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Proinflammatory cytokines in the cerebrospinal fluid of patients with lumbar radiculopathy

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Abstract

In pathologic radicular pain of lumbar spinal stenosis, cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukins (ILs) play a crucial role in the pathogenesis of nerve degeneration and pain. We investigated TNF-α and IL-6 levels in the cerebrospinal fluid (CSF) of patients with radicular pain caused by lumbar spinal stenosis (LSS). A total of 30 LSS patients and 10 age-matched controls were examined. CSF samples were obtained adjacent to the level of stenosis in 30 LSS patients, and at the L4–L5 level in the 10 control patients. TNF-α and IL-6 levels in the samples were analyzed using enzyme-linked immunosorbent assays (ELISA). We compared the amounts of TNF-α and IL-6 with severity of pain (low back and leg pain), walking ability, and severity of stenosis (cross-sectional area of dural space). The concentration of IL-6 was significantly higher in LSS patients than in controls, but TNF-α levels were beneath the limit of detection. There was no correlation between IL-6 levels and severity of pain or walking ability (p > 0.05). However, there was a significant correlation between IL-6 levels and severity of stenosis (p < 0.05). The current study showed that the increased CSF IL-6 levels in LSS patients with radicular pain were not correlated with pain severity; although not proven in this study, the increase in CSF IL-6 concentration could indicate pathological nerve damage or degeneration of lumbar radiculopathy represented by the severity of stenosis.

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References

  1. Brisby H, Olmarker K, Larsson K, Nutu M, Rydevik B (2002) Proinflammatory cytokines in cerebrospinal fluid and serum in patients with disc herniation and sciatica. Eur Spine J 11:62–66

    Article  PubMed  CAS  Google Scholar 

  2. Grönblad M, Virri J, Tolonen J, Seitsalo S, Kääpä E, Kankare J, Myllynen P, Karaharju EO (1994) A controlled immunohistochemical study of inflammatory cells in disc herniation tissue. Spine 19:2744–2751

    Article  PubMed  Google Scholar 

  3. Hoyland JA, Freemont AJ, Jayson MI (1989) Intervertebral foramen venous obstruction. A cause of periradicular fibrosis? Spine 14:558–568

    Article  PubMed  CAS  Google Scholar 

  4. Ito T, Ohtori S, Inoue G, Koshi T, Doya H, Ozawa T, Saito T, Moriya H, Takahashi K (2007) Glial phosphorylated p38 MAP kinase mediates pain in a rat model of lumbar disc herniation and induces motor dysfunction in a rat model of lumbar spinal canal stenosis. Spine 32:159–167

    Article  PubMed  Google Scholar 

  5. Konno S, Yabuki S, Sato K, Olmarker K, Kikuchi S (1995) A model for acute, chronic, and delayed graded compression of the dog cauda equina: presentation of the gross, microscopic, and vascular anatomy of the dog cauda equina and accuracy in pressure transmission of the compression model. Spine 20:2758–2764

    Google Scholar 

  6. Myers RR, Wagner R, Sorkin LS (1999) Hyperalgesic actions of cytokines on peripheral nerves. In: Watkins LR, Maier SF (eds) Cytokines and Pain. Switzerland, pp 133–157

  7. Nagashima H, Morio Y, Yamane K, Nanjo Y, Teshima R (2009) Tumor necrosis factor-α, interleukin-1β, and interleukin-6 in the cerebrospinal fluid of patients with cervical myelopathy and lumbar radiculopathy. Eur Spine J 18:1946–1950

    Article  PubMed  Google Scholar 

  8. Olmarker K, Larsson K (1998) Tumor necrosis factor α and nucleus-pulposus induced nerve root injury. Spine 23:2538–2544

    Article  PubMed  CAS  Google Scholar 

  9. Olmarker K, Rydevik B, Nordborg C (1993) Autologous nucleus pulposus induces neurophysiologic and histologic changes in porcine cauda equina nerve roots. Spine 18:1425–1432

    PubMed  CAS  Google Scholar 

  10. Olmarker K, Nutu M, Størkson R (2003) Changes in spontaneous behavior in rats exposed to experimental disc herniation are blocked by selective TNF-alpha inhibition. Spine 28:1635–1642

    PubMed  Google Scholar 

  11. Onda A, Murata Y, Rydevik B, Larsson K, Kikuchi S, Olmarker K (2004) Infliximab attenuates immunoreactivity of brain-derived neurotrophic factor in a rat model of herniated nucleus pulposus. Spine 29:1857–1861

    Article  PubMed  Google Scholar 

  12. Scuderi GJ, Brusovamik GV, Anderson DG, Dunham CJ, Vaccaro AR, Demeo RF, Hallab N (2006) Cytokine assay of the epidural space lavage in patients with lumbar intervertebral disk herniation and radiculopathy. J Spinal Disord Tech 19:266–269

    Article  PubMed  Google Scholar 

  13. Sekiguchi M, Kikuchi S, Myers RR (2004) Experimental spinal stenosis: relationship between degree of cauda equina compression, neuropathology, and pain. Spine 29:1105–1111

    Article  PubMed  Google Scholar 

  14. Shamash S, Reichert F, Rotshenker S (2001) The cytokine network of Wallerian degeneration: tumor necrosis factor-α, interleukin-1α, and interleukin-1β. J Neurosci 22:3052–3060

    Google Scholar 

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No funds were received in support of this study.

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Correspondence to Seiji Ohtori.

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S. Ohtori, M. Suzuki, and T. Koshi contributed equally to this work.

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Ohtori, S., Suzuki, M., Koshi, T. et al. Proinflammatory cytokines in the cerebrospinal fluid of patients with lumbar radiculopathy. Eur Spine J 20, 942–946 (2011). https://doi.org/10.1007/s00586-010-1595-3

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  • DOI: https://doi.org/10.1007/s00586-010-1595-3

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