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腰椎间盘突出症伴坐骨神经痛患者的腰椎间盘内白细胞介素-1β和白细胞介素-6水平升高。

Elevated IL-1β and IL-6 levels in lumbar herniated discs in patients with sciatic pain.

机构信息

Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.

出版信息

Eur Spine J. 2013 Apr;22(4):714-20. doi: 10.1007/s00586-012-2502-x. Epub 2012 Sep 27.


DOI:10.1007/s00586-012-2502-x
PMID:23014739
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3631043/
Abstract

PURPOSE: Previous experimental models have shown that proinflammatory cytokines modulate peripheral and central nociception. However, the direct correlation between inflammation and pain in patients remains unclear. Our aim is to correlate the levels of inflammation in the spine with pre- and postoperative pain scores after discectomy. METHODS: Paravertebral muscle, annulus fibrosus (AF) and nucleus pulposus (NP) biopsies were intraoperatively collected from ten lumbar disc hernia (LDH) patients suffering from chronic sciatic pain and, as painless controls, five scoliosis patients. IL-1β and IL-6 expressions in these biopsies were assessed by qPCR and western blot. The amount of pain, indicated on a 0-10 point visual analogue scale (VAS), was assessed 1 day before surgery and 6 weeks and 1 year after surgery. For analysis purposes, LDH patients were grouped into painful (VAS ≥ 3.5) and non-painful (VAS < 3.5). LDH painful patient group showed a onefold increased mRNA expression of IL-1β in the NP, and IL-6 in the AF and NP (p < 0.05 vs. controls). RESULTS: By western blot analysis, both cytokines were clearly visible in all LDH biopsies, but not in controls. However, cytokine expression of the painful patient group did not differ from those of the non-painful patient group. In addition, there was no correlation between VAS scores and either marker. CONCLUSIONS: These findings support the idea that LDH is accompanied by a local inflammatory process. Yet, the lack of correlation between IL-1β or IL-6 expression and the severity pain suggests that these cytokines may not play a leading role in maintaining a pain generating network.

摘要

目的:先前的实验模型表明,促炎细胞因子可调节外周和中枢痛觉。然而,患者的炎症与疼痛之间的确切相关性尚不清楚。我们的目的是将脊柱炎症水平与椎间盘切除术后的术前和术后疼痛评分相关联。

方法:从 10 例患有慢性坐骨神经痛的腰椎间盘突出症(LDH)患者和 5 例无疼痛的脊柱侧凸患者的手术中收集椎旁肌肉、纤维环(AF)和髓核(NP)活检组织。通过 qPCR 和 Western blot 评估这些活检组织中的 IL-1β 和 IL-6 表达。在手术前 1 天、术后 6 周和 1 年使用 0-10 分视觉模拟量表(VAS)评估疼痛程度。为了分析目的,将 LDH 患者分为疼痛(VAS≥3.5)和非疼痛(VAS<3.5)两组。与对照组相比,LDH 疼痛患者的 NP 中 IL-1β 和 AF 及 NP 中 IL-6 的 mRNA 表达均增加了 1 倍(p<0.05)。

结果:通过 Western blot 分析,所有 LDH 活检标本中均可见两种细胞因子,但在对照组中不可见。然而,疼痛组和非疼痛组的细胞因子表达无差异。此外,VAS 评分与两种标志物均无相关性。

结论:这些发现支持 LDH 伴有局部炎症过程的观点。然而,IL-1β 或 IL-6 表达与疼痛严重程度之间缺乏相关性表明,这些细胞因子可能在维持疼痛产生网络中不起主要作用。

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本文引用的文献

[1]
Tumor necrosis factor-α levels correlate with postoperative pain severity in lumbar disc hernia patients: opposite clinical effects between tumor necrosis factor receptor 1 and 2.

Pain. 2011-9-14

[2]
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Neurol Sci. 2011-5-11

[3]
Human nucleus pulposus cells react to IL-6: independent actions and amplification of response to IL-1 and TNF-α.

Spine (Phila Pa 1976). 2011-4-15

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Eur Spine J. 2010-10-17

[5]
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Pain. 2010-10-13

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Arthritis Res Ther. 2010-10-11

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Pain. 2010-7-6

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Neurology. 2010-6-1

[9]
Sciatica.

Best Pract Res Clin Rheumatol. 2010-4

[10]
Elevated levels of tumor necrosis factor-alpha in periradicular fat tissue in patients with radiculopathy from herniated disc.

Spine (Phila Pa 1976). 2008-9-1

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