Asian Spine J.  2016 Oct;10(5):843-849. 10.4184/asj.2016.10.5.843.

Serum Levels of the Inflammatory Cytokines in Patients with Lumbar Radicular Pain Due to Disc Herniation

• Zu B
• Pan H
• Zhang XJ
• Yin ZS

• KMID: 2354807
• DOI: http://doi.org/10.4184/asj.2016.10.5.843

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.

Keyword

Interleukins; Tumor necrosis factor-α; Pain; Cytokines

MeSH Terms

Cohort Studies
Cytokines*
Enzyme-Linked Immunosorbent Assay
Follow-Up Studies
Humans
Hyperalgesia
Interleukin-4
Interleukins
Radiculopathy
Tumor Necrosis Factor-alpha
Visual Analog Scale
Cytokines
Interleukin-4
Interleukins
Tumor Necrosis Factor-alpha