J Korean Soc Spine Surg.  2002 Mar;9(1):8-13. 10.4184/jkss.2002.9.1.8.

Phospholipase A2 in Herniated Lumbar Discs: Its Relevance to Pain

• Moon SH
• Park MS
• Kim H
• Kim HS
• Lee HM

• KMID: 1897084
• DOI: http://doi.org/10.4184/jkss.2002.9.1.8

Abstract

STUDY DESIGN: A prospective study.
OBJECTIVE
To determine whether phospholipase A2(PLA2) activity in herniated lumbar disc is correlated with clinical, radiographic and anatomic signs of the patients with herniated nucleus pulposus. SUMMARY OF LITERATURE REVIEW: Several studies have suggested inflammation around nerve root as a mechanism of sciatica and PLA2 emerges as a key enzyme of the inflammation. However, consensus about association between PLA2 and sciatica has been lacking. In addition, there has been no report that investigated the relationship between cytosolic and membrane PLA2 in herniated disc and patient's symptoms.
MATERIALS AND METHODS
Human intervertebral disc materials were obtained from 33 patients who underwent discectomy for HNP. The information was noted about smoking history, medication of NSAID, symptom duration, pain score on a visual analog scale(VAS), positive angle of straight leg raising test (SLR), neurologic deficits, Thompson grade of herniated disc, volume of herniation shown by the MRI and type of herniation based on the operative record. These data were matched to the PLA2 a ctivity in herniated disc measured using Western blotting analysis. PLA2 activity was expressed as the relative percentage compared to that of a 33-year-old female disc obtained during an operation for spinal fracture. The analysis was carried out using Mann-Whitney test, Pearson correlation analysis, simple linear regression analysis. A value of p<0.05 was considered significant.
RESULTS
Cytosolic and membrane PLA2 activity showed no statistical relationship to clinical, radiographic and anatomic characteristics of herniated disc. However, membrane PLA2(active form) activity was correlated with the pain score on VAS(p=0.013, r=0.481), while cytosolic PLA2(latent form) showed no statistically significant correlation with the pain score.
CONCLUSION
This study demonstrates that membrane PLA2 activity is correlated with the pain score. It also suggests that selective PLA2 inhibitors could be used for the alternative treatment modality of HNP.

Keyword

Herniated lumbar disc; Phospholipase A2; Clinical relevance

MeSH Terms

Adult
Blotting, Western
Consensus
Cytosol
Diskectomy
Female
Humans
Inflammation
Intervertebral Disc
Intervertebral Disc Displacement
Leg
Linear Models
Magnetic Resonance Imaging
Membranes
Neurologic Manifestations
Phospholipases A2*
Phospholipases*
Prospective Studies
Sciatica
Smoke
Smoking
Spinal Fractures
Phospholipases
Phospholipases A2
Smoke

Figure

• 

  Fig. 1. Comparison of disc PLA2 activity as Thompson grade. p value > 0.05

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  Fig. 2. Comparison of disc PLA2 activity as volume of disc herniation. p value > 0.05

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  Fig. 3. Comparison of disc PLA2 activity as type of disc herniation. p value > 0.05

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  Fig. 4. Correlation between cytosolic disc PLA2 activity and the patient's pain score on a visual analog scale. Cytosolic PLA 2 activity showed no statistical relationship to the patient's pain score. Fig. 5. p value > 0.05

• 

  Fig. 5. Correlation between membrane disc PLA2 activity and the patient's pain score on a visual analog scale. Membrane PLA2 activity was correlated with the patient's pain score on a visual analog scale. Fig. 5. r=0.481, p=0.013

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