title: Chemokine profile of disc degeneration with acute or chronic pain.
abstract: OBJECTIVE
  Disc-related disorders such as herniation and chronic degenerative disc disease (DDD) are often accompanied by acute or chronic pain. Different mediators have been identified in the development of radicular pain and DDD. Previous studies have not analyzed individual cytokine profiles discriminating between acute sciatic and chronic painful conditions, nor have they distinguished between different anatomical locations within the disc. The aim of this study was to elucidate the protein biochemical mechanisms in DDD.
  
  
  METHODS
  The authors determined expression levels of matrix metalloproteinase-3, transforming growth factor-β (TGF-β), tumor necrosis factor-α, interleukin-1α, and pro-substance P using enzyme-linked immunosorbent assay and Western blot analyses in patients suffering from DDD (n = 7), acute back pain due to herniated discs with radiculopathy (n = 7), and a control group (n = 7). Disc tissue samples from the anulus fibrosus (AF) and nucleus pulposus (NP) were analyzed. Statistical analysis was performed using nonparametric tests.
  
  
  RESULTS
  A distinct distribution of cytokines was found in different anatomical regions of intervertebral discs in patients with DDD and herniated NP. Increased TGF-β levels were predominantly found in DDD. Matrix metalloproteinase-3 was increased in acute herniated disc material. Increased levels of substance P were found in patients suffering from DDD but not in patients with disc herniation. The data showed significantly higher levels of proinflammatory cytokines in the AF and NP of patients with DDD, and the expression levels in the AF were even higher than in the NP, suggesting that the inflammatory response initiates from the AF.
  
  
  CONCLUSIONS
  These results highlight the complex mechanisms involved during disc degeneration and the need to distinguish between acute and chronic processes as well as different anatomical regions, namely the AF and NP. They also highlight potential problems in disc nucleus replacement therapies because the results suggest a biochemical link between AF and NP cytokine expression.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg 20246, Germany. m.schroeder@uke.de
authors.forename: Malte
authors.initials: M
authors.lastname: Schroeder
authors.forename: Lennart
authors.initials: L
authors.lastname: Viezens
authors.forename: Christian
authors.initials: C
authors.lastname: Schaefer
authors.forename: Barbara
authors.initials: B
authors.lastname: Friedrichs
authors.forename: Petra
authors.initials: P
authors.lastname: Algenstaedt
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rüther
authors.forename: Lothar
authors.initials: L
authors.lastname: Wiesner
authors.forename: Nils
authors.initials: N
authors.lastname: Hansen-Algenstaedt
mesh_terms: D059787:Acute Pain / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D018925:Chemokines / Q000096:biosynthesis / Q000378:metabolism*; D059350:Chronic Pain / Q000201:enzymology / Q000378:metabolism*; D005260:Female; D006801:Humans; D053582:Interleukin-1alpha / Q000096:biosynthesis; D055959:Intervertebral Disc Degeneration / Q000201:enzymology / Q000378:metabolism*; D007405:Intervertebral Disc Displacement / Q000201:enzymology / Q000378:metabolism*; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000096:biosynthesis; D008875:Middle Aged; D013373:Substance P / Q000096:biosynthesis; D016212:Transforming Growth Factor beta / Q000096:biosynthesis; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis; D055815:Young Adult
chemical_list: D018925:Chemokines; D053582:Interleukin-1alpha; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha; D013373:Substance P; D019278:Matrix Metalloproteinase 3