Comparison of E-selectin and the other inflammatory markers in lumbar disc herniation: a new promising therapeutical window for radicular pain.
METHODS
Histopathologic and immunohistochemical analysis of the herniated disc specimens obtained from 50 patients who had unilateral persistent radicular pain or unilateral radicular motor paresis.


OBJECTIVE
The aim of this study was to investigate the prevalence of inflammatory cells in lumbar disc herniations (LDH) and compare the prevalence of leukocyte adhesion protein "E-selectin" with other inflammatory cells such as T cells, B cells, and macrophages.


BACKGROUND
Studies on inflammatory cells and biochemical mediators of inflammation have suggested that these factors may play an important role in pathophysiology of radicular pain, and the medical therapy was formed against to block these cells and inflammatory cytokines.


METHODS
The herniated disc specimens obtained from 50 patients who had unilateral persistent radicular pain or unilateral radicular motor paresis were microscopically examined after staining with monoclonal antibodies of CD20, CD45, CD68, and E-selectin. Relative risk assessment of the straight-leg raising (SLR) test positivity or negativity with CD20, CD45, CD68, and E-selectin staining was investigated.


RESULTS
Our data emphasize that, the cases with positive SLR test had higher rates of immunostaining with E-selectin and CD45. There were no statistically significant relationship between SLR positivity and CD20 and CD68.


CONCLUSIONS
We suggest that E-selectin is as valuable as the other well-known inflammatory markers in the pathogenesis of LDH. In our opinion, beside the well-known nonsteroidal anti-inflammatory drugs, antagonists targeting E-selectin can be potentially effective therapeutics for controlling inflammation in LDH.
Department of Neurosurgery, Baskent University, Ankara, Turkey. kadirtufan@hotmail.com
Kadir
K
Tufan
Orhan
O
Sen
Melih
M
Cekinmez
Filiz Aka
FA
Bolat
Ozlem
O
Alkan
Feyzi Birol
FB
Sarica
Hakan
H
Caner
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015703:Antigens, CD / Q000032:analysis; D018951:Antigens, CD20 / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D015415:Biomarkers; D015299:Discitis / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D019040:E-Selectin / Q000032:analysis*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D017493:Leukocyte Common Antigens / Q000032:analysis; D008159:Lumbar Vertebrae; D016131:Lymphocyte Subsets / Q000473:pathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D008349:Manipulation, Orthopedic; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology; D010291:Paresis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011446:Prospective Studies; D011843:Radiculopathy / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D018570:Risk Assessment; D012585:Sciatica / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013126:Spinal Nerve Roots; D000097382:CD68 Molecule
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015703:Antigens, CD; D018951:Antigens, CD20; D015214:Antigens, Differentiation, Myelomonocytic; D015415:Biomarkers; D019040:E-Selectin; D017493:Leukocyte Common Antigens; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C516769:PTPRC protein, human