Chronic inflammation is believed to have a role in the development of lumbar disc herniation (LDH). Ceruloplasmin (CP), an acute phase protein, is known to limit inflammation.
OBJECTIVE:
To evaluate CP levels in patients with LDH.
METHODS:
Thirty-five patients with LDH and 35 healthy individuals were enrolled in the study. Participants were divided into two groups; group 1 (n = 35) consisted of patients with LDH, and group 2 (n = 35) consisted of healthy subjects. Surgery specimens were taken from all patients who underwent LDH-related surgery. CP levels were measured in both blood and tissue samples. Pain intensity was evaluated using a visual analog scale(VAS).
RESULTS:
There were no significant differences in gender, age, or body mass index between the control and LDH patients (p > 0.05 for all). Compared with the control patients, LDH patients had significantly higher serum CP levels (p < 0.001). In LDH patients, tissue CP levels were significantly higher than serum levels (p < 0.001). According to bivariate analysis, the serum CP levels were significantly correlated with the VAS score in group 1 (r = 0.491, p = 0.003).
CONCLUSIONS:
The present study showed that CP levels increased in both the serum and the tissues of patients with LDH compared to patients without LDH, possibly as a consequence of LDH-associated inflammation.
ChengL, FanW, LiuB, WangX, NieL. Th17 lymphocyte levels are higher in patients with ruptured than non-ruptured lumbar discs, and are correlated with pain intensity. Injury. 2013; 44: 1805-10.
2.
TufanK, SenO, CekinmezM, BolatFA, AlkanO, SaricaFB, et al. Comparison of E-selectin and the other inflammatory markers in lumbar disc herniation: a new promising therapeutical window for radicular pain. J Spinal Disord Tech. 2012; 25: 443-6.
3.
RathodTN, ChandanwaleA, LadkatKM, ChavanS, ChavanA, BhosalePB. High sensitive C-reactive protein-Effective tool in determining postoperative recovery in lumbar disc disease. Indian J Orthop. 2014; 48: 354-9.
4.
SenO, AydinMV, BagdatogluC, ErtorerME, BolatFA, YalcinO, et al. Can E-selectin be a reliable marker of inflammation in lumbar disc disease?Neurosurg Rev. 2005; 28: 214-7.
5.
TakahashiH, SuguroT, OkazimaY, MotegiM, OkadaY, KakiuchiT. Inflammatory cytokines in the herniated disc of the lumbar spine. Spine (Phila Pa 1976). 1996; 21: 218-24.
6.
EserI, UlasT, KurkcuogluIC, AydoganH, YalcinF, SakZH, et al. Evaluation of ceruloplasmin levels in patients with pulmonary cysticechinococcus. Clin Ter. 2013; 164: e89-92.
7.
DemirME, UlasT, DalMS, ErenMA, AydoganH, YalcinS, et al. Oxidative stress parameters and ceruloplasmin levels in patients with severe preeclampsia. Clin Ter. 2013; 164: e83-7.
GrönbladM, VirriJ, SeitsaloS, HabtemariamA, KaraharjuE. Inflammatory cells, motor weakness, and straight leg raising in transligamentous disc herniations. Spine (Phila Pa 1976). 2000; 25: 2803-7.
10.
VirriJ, GrönbladM, SeitsaloS, HabtemariamA, KääpäE, KaraharjuE. Comparison of the prevalence of inflammatory cells in subtypes of disc herniations and associations with straight leg raising. Spine (Phila Pa 1976). 2001; 26: 2311-5.
11.
AhnSH, Cho YW, AhnMW, JangSH, SohnYK, KimHS. mRNA expression of cytokines and chemokines in herniated lumbar intervertebral discs. Spine (Phila Pa 1976). 2002; 27: 911-7.
12.
BurkeJG, G WatsonRW, ConhyeaD, McCormackD, DowlingFE, WalshMG, et al. Human nucleus pulposis can respond to a pro-inflammatory stimulus. Spine (Phila Pa 1976). 2003; 28: 2685-93.
13.
ParkJB, ChangH, KimYS. The pattern of interleukin-12 and T-helper types 1 and 2 cytokine expression in herniated lumbar disc tissue. Spine (Phila Pa 1976). 2002; 27: 2125-8.
14.
WuertzK, HaglundL. Inflammatory mediators in intervertebral disk degeneration and discogenic pain. Global Spine J. 2013; 3: 175-84.
15.
HawkerGA, MianS, KendzerskaT, FrenchM. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011; 63(11): 240-52.
16.
MarshallLL, TrethewieER, CurtainCC. Chemical radiculitis. A clinical, physiological and immunological study. ClinOrthopRelat Res. 1977; 129: 61-7.
17.
OlmarkerK, BlomquistJ, StrömbergJ, NannmarkU, ThomsenP, RydevikB. Inflammatogenic properties of nucleus pulposus. Spine (Phila Pa 1976). 1995; 20: 665-9.
18.
PedersenLM, SchistadE, JacobsenLM, RøeC, GjerstadJ. Serum levels of the pro-inflammatory interleukins 6 (IL-6) and -8 (IL-8) in patients with lumbar radicular pain due to disc herniation: A 12-month prospective study. Brain Behav Immun. 2015; 46: 132-6.
19.
KangJD, Stefanovic-RacicM, McIntyreLA, GeorgescuHI, EvansCH. Toward a biochemical understanding of human intervertebral disc degeneration and herniation. Contributions of nitric oxide, interleukins, prostaglandin E2, and matrix metalloproteinases. Spine (Phila Pa 1976). 1997; 22: 1065-73.
20.
BurkeJG, WatsonRW, McCormackD, DowlingFE, WalshMG, FitzpatrickJM. Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators. J Bone Joint Surg Br. 2002; 84: 196-201.
21.
RandN, ReichertF, FlomanY, RotshenkerS. Murine nucleus pulposus-derived cells secrete interleukins-1-beta, -6, and -10 and granulocyte-macrophage colony-stimulating factor in cell culture. Spine (Phila Pa 1976). 1997; 22: 2598-601.
22.
IgarashiT, KikuchiS, ShubayevV, MyersRR. 2000 Volvo Award winner in basic science studies: Exogenous tumor necrosis factor-alpha mimics nucleus pulpous-induced neuropathology. Molecular, histologic, and behavioral comparisons in rats. Spine (Phila Pa 1976). 2000; 25: 2975-80.
23.
OlmarkerK, RydevikB. Selective inhibition of tumor necrosis factor-alpha prevents nucleus pulposus-induced thrombus formation, intraneural edema, and reduction of nerve conduction velocity: possible implications for future pharmacologic treatment strategies of sciatica. Spine (Phila Pa 1976). 2001; 26: 863-9.
24.
HabtemariamA, GrönbladM, VirriJ, SeitsaloS, RuuskanenM, KaraharjuE. Immunocytochemical localization of immunoglobulins in disc herniations. Spine (Phila Pa 1976). 1996; 21: 1864-9.
25.
HabtemariamA, GrönbladM, VirriJ, SeitsaloS, KaraharjuE. A comparative immunohistochemical study of inflammatory cells in acute-stage and chronic-stage discherniations. Spine (Phila Pa 1976). 1998; 23: 2159-65.
26.
GrönbladM, VirriJ, TolonenJ, SeitsaloS, KääpäE, KankareJ, et al. A controlled immunohistochemical study of inflammatory cells in disc herniation tissue. Spine (Phila Pa 1976). 1994; 19: 2744-51.
27.
BrisbyH, OlmarkerK, LarssonK, NutuM, RydevikB. Proinflammatory cytokines in cerebrospinal fluid and serum in patients with disc herniation and sciatica. Eur Spine J. 2002; 11: 62-6.
28.
BlouinCC, PagéEL, SoucyGM, RichardDE. Hypoxic gene activation by lipopolysaccharide in macrophages: implication of hypoxia-inducible factor 1alpha. Blood. 2004; 103: 1124-30.
29.
MukhopadhyayCK, MazumderB, FoxPL. Role of hypoxia-inducible factor-1 in transcriptional activation of ceruloplasmin by iron deficiency. J Biol Chem. 2000; 275: 21048-54.
30.
MartinF, LindenT, KatschinskiDM, OehmeF, FlammeI, MukhopadhyayCK, et al. Copper-dependent activation of hypoxia-inducible factor (HIF)-1: implications for ceruloplasmin regulation. Blood. 2005; 105: 4613-9.
31.
BuyukhatipogluH, SezenY, YildizA, GuntekinU, BasM, PolatM, et al. Effects of statin use on total oxidant and antoxidant capacity and ceruloplasmin activity. Clin Invest Med. 2010; 33: E313-20.
32.
PercivalSS. Copper and immunity. Am J ClinNutr. 1998; 67: 1064S-8S.
