Serum Levels of the Inflammatory Cytokines in Patients with Lumbar Radicular Pain Due to Disc Herniation.
10.4184/asj.2016.10.5.843
- Author:
Bo ZU
1
;
Hong PAN
;
Xiao Jun ZHANG
;
Zong Sheng YIN
Author Information
1. Department of Orthopaedics, Anhui Medical University, Hefei, China.
- Publication Type:Original Article
- Keywords:
Interleukins;
Tumor necrosis factor-α;
Pain;
Cytokines
- MeSH:
Cohort Studies;
Cytokines*;
Enzyme-Linked Immunosorbent Assay;
Follow-Up Studies;
Humans;
Hyperalgesia;
Interleukin-4;
Interleukins;
Radiculopathy;
Tumor Necrosis Factor-alpha;
Visual Analog Scale
- From:Asian Spine Journal
2016;10(5):843-849
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: Cohort study. PURPOSE: This study primarily aimed to evaluate the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-4 in patients with lumbar radiculopathy 1 and 12 months after microdiscectomy. OVERVIEW OF LITERATURE: Lumbar radiculopathy is possibly caused by inflammatory changes in the nerve root. The intraneural application of pro-inflammatory cytokines induces behavioral signs associated with pain. Anti-inflammatory cytokine treatment effectively reduces hyperalgesia. METHODS: The role of TNF-α and IL-4 in long-lasting lumbar radiculopathy was addressed. A total of 262 patients were recruited from Anqing Hospital, Anhui Medical University. During inclusion at 1 and 12 months, serum concentrations of TNF-α and IL-4 were analyzed by enzyme-linked immunosorbent assay, and pain intensity was reported on a 0–10 cm visual analog scale (VAS). RESULTS: Sixty six patients had VAS <3 and 196 patients had VAS ≥3. Serum concentrations of pro-inflammatory TNF-α and anti-inflammatory IL-4 in patients with lumbar radiculopathy related to disc herniation were measured at 1- and 12-month follow-up. TNF-α decreased in both VAS groups with time. In contrast, IL-4 increased in both groups at 1 month and then decreased gradually until month 12. The changes in serum levels of TNF-α and IL-4 over time between the VAS ≥3 and VAS <3 groups were significantly different. CONCLUSIONS: Chronic lumbar radiculopathy may be associated with high level of pro-inflammatory substances, such as TNF-α, in serum after disc herniation, and elevated anti-inflammatory cytokine in patients with lumbar radiculopathy may indicate a favorable outcome.
