Department of Biomedical Engineering, Duke University, 136 Hudson Hall, Box 90281, Durham, NC, USA.
Arthritis Res Ther. 2011 Aug 26;13(4):R137. doi: 10.1186/ar3451.
Tumor necrosis factor-α (TNFα) has received significant attention as a mediator of lumbar radiculopathy, with interest in TNF antagonism to treat radiculopathy. Prior studies have demonstrated that TNF antagonists can attenuate heightened nociception resulting from lumbar radiculopathy in the preclinical model. Less is known about the potential impact of TNF antagonism on gait compensations, despite being of clinical relevance. In this study, we expand on previous descriptions of gait compensations resulting from lumbar radiculopathy in the rat and describe the ability of local TNF antagonism to prevent the development of gait compensations, altered weight bearing, and heightened nociception.
Eighteen male Sprague-Dawley rats were investigated for mechanical sensitivity, weight-bearing, and gait pre- and post-operatively. For surgery, tail nucleus pulposus (NP) tissue was collected and the right L5 dorsal root ganglion (DRG) was exposed (Day 0). In sham animals, NP tissue was discarded (n = 6); for experimental animals, autologous NP was placed on the DRG with or without 20 μg of soluble TNF receptor type II (sTNFRII, n = 6 per group). Spatiotemporal gait characteristics (open arena) and mechanical sensitivity (von Frey filaments) were assessed on post-operative Day 5; gait dynamics (force plate arena) and weight-bearing (incapacitance meter) were assessed on post-operative Day 6.
High-speed gait characterization revealed animals with NP alone had a 5% decrease in stance time on their affected limbs on Day 5 (P ≤0.032). Ground reaction force analysis on Day 6 aligned with temporal changes observed on Day 5, with vertical impulse reduced in the affected limb of animals with NP alone (area under the vertical force-time curve, P <0.02). Concordant with gait, animals with NP alone also had some evidence of affected limb mechanical allodynia on Day 5 (P = 0.08) and reduced weight-bearing on the affected limb on Day 6 (P <0.05). Delivery of sTNFRII at the time of NP placement ameliorated signs of mechanical hypersensitivity, imbalanced weight distribution, and gait compensations (P <0.1).
Our data indicate gait characterization has value for describing early limb dysfunctions in pre-clinical models of lumbar radiculopathy. Furthermore, TNF antagonism prevented the development of gait compensations subsequent to lumbar radiculopathy in our model.
肿瘤坏死因子-α(TNFα)作为腰椎神经根病的介质受到了广泛关注,人们对 TNF 拮抗剂治疗神经根病产生了兴趣。先前的研究表明,TNF 拮抗剂可以减轻临床前模型中腰椎神经根病引起的痛觉过敏。尽管具有临床相关性,但人们对 TNF 拮抗剂对步态代偿的潜在影响知之甚少。在这项研究中,我们扩展了之前在大鼠腰椎神经根病中描述的步态代偿,并描述了局部 TNF 拮抗作用预防步态代偿、改变承重和痛觉过敏发展的能力。
18 只雄性 Sprague-Dawley 大鼠在术前和术后进行机械敏感性、承重和步态评估。对于手术,收集尾核髓核(NP)组织并暴露右侧 L5 背根神经节(DRG)(第 0 天)。在假手术动物中,丢弃 NP 组织(n = 6);对于实验动物,将自体 NP 放置在 DRG 上,或与 20 μg 可溶性 TNF 受体 II 型(sTNFRII)一起放置(每组 n = 6)。术后第 5 天在开放场中评估时空步态特征(高速步态特征)和机械敏感性(von Frey 纤维);术后第 6 天在力板场中评估步态动力学(承重)和步态动力学(承重)。
高速步态特征显示,仅 NP 动物在第 5 天其受影响肢体的站立时间减少了 5%(P ≤0.032)。第 6 天的地面反作用力分析与第 5 天观察到的时间变化一致,仅 NP 动物的受影响肢体的垂直冲量减少(垂直力-时间曲线下面积,P <0.02)。与步态一致,仅 NP 动物在第 5 天也有一些受影响肢体机械性痛觉过敏的证据(P = 0.08),并且第 6 天受影响肢体的承重减少(P <0.05)。在 NP 放置时给予 sTNFRII 可改善机械过敏、不平衡的重量分布和步态代偿(P <0.1)。
我们的数据表明,步态特征对于描述腰椎神经根病的临床前模型中的早期肢体功能障碍具有价值。此外,TNF 拮抗剂可预防我们模型中腰椎神经根病后步态代偿的发展。