Inhibiting tumor necrosis factor‐alpha at time of induced intervertebral disc injury limits long‐term pain and degeneration in a rat model

• DOI: 10.1002/jsp2.1014
• Publication Date: 2018-05-21T09:29:30Z
• Authors: Thomas W. Evashwi...; Alon Lai; Hironobu Watanabe; Jonathan M. Salandra; Beth A. Winkelstein; Samuel K. Cho; Andrew C. Hecht; James C. Iatridis
• Keywords: Degeneration (medical); Intervertebral Disc; Back Pain

Painful intervertebral disc (IVD) degeneration has tremendous societal costs and few effective therapies. Intradiscal tumor necrosis factor-alpha (TNFα) is commonly associated with low back pain, but the direct relationship remains unclear.Treatment strategies for pain require improved understanding of complex relationships between intradiscal pro-inflammatory cytokines, structural IVD degeneration. A rat in vivo lumbar puncture model was used to 1) determine role TNFα initiating painful degeneration, 2) identify statistical behavior, cytokine expression.Lumbar IVDs were punctured anteriorly injected TNFα, anti-TNFα, or saline compared sham naive controls. Hindpaw mechanical hyperalgesia assayed weekly over time. 6-weeks post-surgery, animals sacrificed, height, interleukin-1 beta (IL-1β) expressions assayed.Intradiscal injection increased whereas anti-TNFα alleviated level. Multivariate step-wise linear regression identified threshold predicted by expression. Pain also linearly height loss IL-1β.The significant associations loss, inflammation, behavior highlight multifactorial nature challenges diagnose treat a specific underlying factor. We concluded that an initiator its early inhibition can mitigate following injury may warrant investigation potential alter downstream processes.