title: Identifying inflammatory targets for biologic therapies for spine pain.
abstract: The costs associated with treating spine-related conditions are enormous and are trending upward. Current methods employed to treat inflammatory-mediated pain are targeted at alleviating symptoms, rather than correcting the underlying cause of disease. It is clear that a biochemical basis for inflammatory-mediated intervertebral disk, facet joint, and nerve pain exists. Biologic therapies that address the underlying cause of pain could potentially decrease the costs associated with treating spine pathology. MMPs, IL-1, TNF- α, IL-6, NGF, bradykinin, prostaglandins, and nitric oxide are implicated in much of the catabolic effects seen in the pathogenesis of inflammatory-mediated pain and are good targets for inhibition. The anticatabolic and anabolic effects of TIMPs, BMPs, TGF- β, and IGF-1 are targets already shown to favorably impact disk matrix homeostasis. With rapid advances in biomedical technology, these interventions may be available for clinical use in the near future.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. jacobslj@upmc.edu
authors.forename: Lloydine J
authors.initials: LJ
authors.lastname: Jacobs
authors.forename: Nam
authors.initials: N
authors.lastname: Vo
authors.forename: James D
authors.initials: JD
authors.lastname: Kang
mesh_terms: D001688:Biological Products / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism*; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D010146:Pain / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D013122:Spinal Diseases / Q000150:complications / Q000188:drug therapy / Q000378:metabolism
chemical_list: D001688:Biological Products; D015415:Biomarkers; D016207:Cytokines