Lumbar disc extrusions reduce faster than bulging discs due to an active role of macrophages in sciatica

Djuric, Niek; Yang, Xiaoyu; Barzouhi, Abdelilah el; Ostelo, Raymond; Duinen, Sjoerd G. van; Nijeholt, Geert J. Lycklama à; Kallen, Bas F.W. van der; Peul, Wilco C.; Vleggeert-Lankamp, Carmen

doi:10.1007/s00701-019-04117-7

Cited by 15 publications

(21 citation statements)

References 29 publications

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“…First, the presence of MC was tested against the dichotomized histological findings and against the type of disc herniation using Chi-square tests for categorical data. The association between disc type and inflammation was previously reported [4]. For the clinical analysis at both baseline and follow-up, patients were first grouped based on the type of herniation, Subsequently, the main effects of inflammation and MC, and their interaction effect were tested against the clinical baseline scores (RDQ, VAS leg pain and VAS back pain).…”

Section: Discussionmentioning

confidence: 99%

“…Macrophages may subsequently induce a resorption process by excreting matrix metalloproteases [2], inducing apoptosis and degrading collagen fibres [3]. This so-called functional inflammation response can explain spontaneous regression in herniation size [4]. On the other hand, they can also excrete pro-inflammatory cytokines such as IL-6, IL8 and TNF-alpha, which have been associated with exacerbation of the pain symptoms, the so-called painful inflammation response [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, the degree of inflammation can be influenced by specific characteristics of the disc. For example, extruded discs, which are more exposed to the systemic circulation, tend to have a higher degree of inflammation as compared to bulging discs [4]. Therefore, the type of disc herniation should not be neglected when the characteristics of disc inflammation are studied.…”

Section: Introductionmentioning

confidence: 99%

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Disc inflammation and Modic changes show an interaction effect on recovery after surgery for lumbar disc herniation

et al. 2019

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Purpose To study the interaction between Modic changes (MC) and inflammation by macrophages in the disc, in relation to clinical symptoms before and after discectomy for lumbar disc herniation. Methods Disc tissue was embedded in paraffin and stained with haematoxylin and CD68. Subsequently, tissue samples were categorized for degree of inflammation. Type of MC was scored on MRI at baseline. Roland Disability Questionnaire (RDQ) score and visual analogue scale for back pain and leg pain separately were considered at baseline and 1-year followup post-surgery. Main and interaction effects of MC and inflammation were tested against clinical outcome questionnaires. In addition, this analysis was repeated in bulging and extruded discs separately. Results Disc material and MRI's of 119 patients were retrieved and analysed. Forty-eight patients demonstrated mild inflammation, 45 showed moderate inflammation, and 26 showed considerable inflammation. In total, 49 out of 119 patients demonstrated MC. Grade of disc inflammation did not associate with the presence of MC. At baseline, no main or interaction effects of MC and inflammation were found on the clinical scores. However, during follow-up after discectomy, significant interaction effects were found for RDQ score: Only in patients with MC at baseline, patients remained significantly more disabled (3.2 points p = 0.006) if they showed considerable disc inflammation compared to patients with mild inflammation. The additional analysis showed similar results in extruded discs, but no significant effects in bulging discs. Conclusions An interaction effect of MC and disc inflammation by macrophages is present. Only in patients with MC, those with considerable inflammation recover less satisfactory during follow-up after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Disc inflammation and Modic changes show an interaction effect on recovery after surgery for lumbar disc herniation

et al. 2019

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“…Sciatica is a kind of combined pain caused by stimulation and compression of various factors, such as lumbar disk herniation, lumbar degenerative disease and sciatic neuritis, which leads to the pain of stabbing, burning and blunt pain along the line of sciatica nerve walking, as well as the surrounding area, and brings great physiological and psychological pain to patients [1][2][3]. The mechanism of sciatica is very complex, which is often caused by the protrusion of lumbar disk [4].…”

Section: Introductionmentioning

confidence: 99%

Interaction between piperine and genes associated with sciatica and its mechanism based on molecular docking technology and network pharmacology

2020

Mol Divers

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Piperine is the main active component of Piper longum L., which is also the main component of anti-sciatica Mongolian medicine Naru Sanwei pill. It has many pharmacological activities such as anti-inflammatory and immune regulation. This paper aims to preliminarily explore the potential mechanism of piperine in the treatment of sciatica through network pharmacology and molecular docking. TCMSP, ETCM database and literature mining were used to collect the active compounds of Piper longum L. Swiss TargetPrediction and SuperPred server were used to find the targets of compounds. At the same time, CTD database was used to collect the targets of sciatica. Then the above targets were compared and analyzed to select the targets of anti-sciatica in Piper longum L. The Go (gene ontology) annotation and KEGG pathway of the targets were enriched and analyzed by Metascape database platform. The molecular docking between the effective components and the targets was verified by Autodock. After that, the sciatica model of rats was established and treated with piperine. The expression level of inflammatory factors and proteins in the serum and tissues of rat sciatic nerve were detected by ELISA and Western blot. HE staining and immunohistochemistry were carried out on the sciatica tissues of rats. The results showed that Piper longum L. can regulate the development of sciatica and affect the expressions of PPARG and NF-kB1 through its active ingredient piperine, and there is endogenous interaction between PPARG and NF-kB1.Jiu-wang Yu and Hong-wei Yuan have contributed equally to this work.

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“…Colleagues from the Netherlands have investigated the role of macrophages in sciatica, using a retrospective observational histological study [1]. They looked for associations between the size and type of lumbar disc herniation on MRI, Modic changes in the vertebral endplates, and the degree of macrophage infiltration in a group of 119 patients.…”

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confidence: 99%

Insights into the inflammatory process of lumbar discopathy

Demetriades

2019

Acta Neurochir

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Lumbar disc extrusions reduce faster than bulging discs due to an active role of macrophages in sciatica

Cited by 15 publications

References 29 publications

Disc inflammation and Modic changes show an interaction effect on recovery after surgery for lumbar disc herniation

Disc inflammation and Modic changes show an interaction effect on recovery after surgery for lumbar disc herniation

Interaction between piperine and genes associated with sciatica and its mechanism based on molecular docking technology and network pharmacology

Insights into the inflammatory process of lumbar discopathy

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