Proinflammatory cytokines in the cerebrospinal fluid of patients with lumbar radiculopathy.
In pathologic radicular pain of lumbar spinal stenosis, cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukins (ILs) play a crucial role in the pathogenesis of nerve degeneration and pain. We investigated TNF-α and IL-6 levels in the cerebrospinal fluid (CSF) of patients with radicular pain caused by lumbar spinal stenosis (LSS). A total of 30 LSS patients and 10 age-matched controls were examined. CSF samples were obtained adjacent to the level of stenosis in 30 LSS patients, and at the L4-L5 level in the 10 control patients. TNF-α and IL-6 levels in the samples were analyzed using enzyme-linked immunosorbent assays (ELISA). We compared the amounts of TNF-α and IL-6 with severity of pain (low back and leg pain), walking ability, and severity of stenosis (cross-sectional area of dural space). The concentration of IL-6 was significantly higher in LSS patients than in controls, but TNF-α levels were beneath the limit of detection. There was no correlation between IL-6 levels and severity of pain or walking ability (p > 0.05). However, there was a significant correlation between IL-6 levels and severity of stenosis (p < 0.05). The current study showed that the increased CSF IL-6 levels in LSS patients with radicular pain were not correlated with pain severity; although not proven in this study, the increase in CSF IL-6 concentration could indicate pathological nerve damage or degeneration of lumbar radiculopathy represented by the severity of stenosis.
Ohtori
Seiji
S
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. sohtori@faculty.chiba-u.jp
Suzuki
Munetaka
M
Koshi
Takana
T
Takaso
Masashi
M
Yamashita
Masaomi
M
Inoue
Gen
G
Yamauchi
Kazuyo
K
Orita
Sumihisa
S
Eguchi
Yawara
Y
Kuniyoshi
Kazuki
K
Ochiai
Nobuyasu
N
Kishida
Shunji
S
Nakamura
Junichi
J
Aoki
Yasuchika
Y
Ishikawa
Tetsuhiro
T
Arai
Gen
G
Miyagi
Masayuki
M
Kamoda
Hiroto
H
Suzuki
Miyako
M
Toyone
Tomoaki
T
Takahashi
Kazuhisa
K
D000368:Aged; D006801:Humans; D015850:Interleukin-6 / Q000134:cerebrospinal fluid*; D017116:Low Back Pain / Q000134:cerebrospinal fluid* / Q000209:etiology; D008159:Lumbar Vertebrae; D008875:Middle Aged; D010147:Pain Measurement; D011843:Radiculopathy / Q000134:cerebrospinal fluid* / Q000209:etiology; D012720:Severity of Illness Index; D013130:Spinal Stenosis / Q000134:cerebrospinal fluid* / Q000150:complications; D014409:Tumor Necrosis Factor-alpha / Q000134:cerebrospinal fluid*
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha