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Proinflammatory cytokines in cerebrospinal fluid and serum in patients with disc herniation and sciatica.

Journal article
Authors Helena Brisby
Kjell Olmarker
Karin Larsson
Magdalena Nutu
Björn Rydevik
Published in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Volume 11
Issue 1
Pages 62-6
ISSN 0940-6719
Publication year 2002
Published at Institute of Surgical Sciences, Department of Orthopaedics
Institute of Physiology and Pharmacology, Dept of Physiology
Pages 62-6
Language en
Keywords Adult, Biological Markers, Cytokines, blood, cerebrospinal fluid, Female, Humans, Interferon-gamma, blood, cerebrospinal fluid, Interleukin-1, blood, cerebrospinal fluid, Interleukin-6, blood, cerebrospinal fluid, Intervertebral Disk Displacement, blood, cerebrospinal fluid, immunology, Male, Middle Aged, Sciatica, blood, cerebrospinal fluid, immunology, Tumor Necrosis Factor-alpha, cerebrospinal fluid
Subject categories Biological Sciences, Microbiology in the medical area, Clinical immunology


Proinflammatory cytokines have been identified in herniated intervertebral discs in humans, and such cytokines have experimentally been demonstrated to be important in the pathophysiological mechanisms of disc herniation. Cerebrospinal fluid (CSF) and serum concentrations of interleukin (IL)-1beta IL-6, IL-8, interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha were investigated using the enzyme-linked immunosorbent assay (ELISA) technique in 39 patients with lumbar disc herniation and sciatica. Pain duration and pain intensity (visual analogue scale, VAS) were recorded at inclusion, and a clinical examination was performed evaluating neurological findings. The extent of disc herniation (protrusion or extrusion/sequestration) was evaluated perioperatively. Normal concentrations of IL-1beta, IL-6, IFN-gamma and TNF-alpha were present in CSF and serum in almost all patients with lumbar disc herniation. The concentrations of IL-8 in CSF were increased in 12 out of 39 patients, and these increased levels of IL-8 correlated to a short duration of pain and to more pronounced herniation (extrusion or sequestration). No relationship between IL-8 concentrations in CSF and pain intensity, positive neurological findings or a positive straight leg-raising (SLR) test was found. The observation of increased concentrations of IL-8 in CSF in patients with a short duration of symptoms supports the concept of the initial involvement of inflammatory mechanisms after a disc herniation. The finding that most of the patients with increased concentrations of IL-8 in CSF had an extrusion or a sequestration may suggest that the increase in IL-8 is related to mechanical nerve root compression, but may also indicate a biochemical effect exerted by the herniated disc on the surrounding tissue. Further studies on the potential role of IL-8 as a biomarker for disc herniation are warranted.

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