title: Importance of IL-6, MMP-1, IGF-1, and BAX Levels in Lumbar Herniated Disks and Posterior Longitudinal Ligament in Patients with Sciatic Pain.
abstract: OBJECTIVE
  The aim of this study was to evaluate prognostic importance of interleukin-6 (IL-6), matrix metalloproteinase (MMP)-1, insulin-like growth factor (IGF)-1, and Bcl-2-associated X protein (BAX) levels in biopsy specimens taken from the intervertebral disk specimens and the posterior longitudinal ligaments of patients with sciatic pain.
  
  
  METHODS
  The specimens of the intervertebral disk and the posterior longitudinal ligament were obtained from 52 patients undergoing herniectomy and diskectomy at the Neurosurgery Department of the Abant Izzet Baysal University Izzet Baysal Training and Research Hospital between April 2012 and February 2014. The immunohistochemical expressions of IL-6, MMP-1, IGF-1, and BAX were evaluated in three categories: mild, moderate, and intense.
  
  
  RESULTS
  The IL-6 expression in the intervertebral disk specimens was intense in the sequestration group when compared with that of the "protrusion" and "extrusion" groups. The intervertebral disk specimens in "extrusion" and "sequestration" groups were stained intensely for MMP-1. The IGF-1 expression was stained intensely in the intervertebral disk tissue of the extrude group patients. For the "extrusion" and "sequestration" groups, the intervertebral disk specimens were stained intensely for BAX compared with the protrude group. The IL-6 expression in the posterior longitudinal ligament specimens was more intense in the "sequestration" and "extrusion" groups when compared with that of the protrude group. The MMP-1 expressions were milder in the sequestration group when compared with that of the "extrusion" and "protrusion" groups.
  
  
  CONCLUSIONS
  Our findings suggest that the cytokines, enzymes, growth factors, and proapoptotic proteins, such as IL-6, MMP-1, IGF-1, and BAX, may be critical factors in the pathophysiology of the degeneration of the intervertebral disks in patients with symptomatic degenerative disk disease.
authors.affiliation: Department of Neurosurgery, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey. Electronic address: dagistanyasar@hotmail.com.
authors.forename: Yasar
authors.initials: Y
authors.lastname: Dagistan
authors.affiliation: Department of Pathology, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey.
authors.forename: Selma
authors.initials: S
authors.lastname: Cukur
authors.affiliation: Department of Radiology, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Dagistan
authors.affiliation: Department of Neurosurgery, Abant Izzet Baysal University Medical School, Izzet Baysal Training and Research Hospital, Bolu, Turkey.
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Gezici
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D015850:Interleukin-6 / Q000032:analysis*; D007405:Intervertebral Disc Displacement; D017846:Longitudinal Ligaments / Q000378:metabolism* / Q000473:pathology; D008159:Lumbar Vertebrae; D008297:Male; D020781:Matrix Metalloproteinase 1 / Q000032:analysis*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012585:Sciatica / Q000378:metabolism* / Q000473:pathology; D014421:Turkey; D051028:bcl-2-Associated X Protein / Q000032:analysis*
chemical_list: C494826:BAX protein, human; D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D051028:bcl-2-Associated X Protein; D007334:Insulin-Like Growth Factor I; D020781:Matrix Metalloproteinase 1
keywords: Degeneration; Herniated disk; Immunohistochemistry; Insulin-like growth factor-1; Interleukin-6; Intervertebral disk