1. Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Anesthesiology, Yuquan Hospital, Medical Center, Tsinghua University, Beijing 100049, China
Effects of degenerative autologous nucleus pulposus on the lumbar sympathetic trunk: Sympathetic inflammation in rats
1. Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Anesthesiology, Yuquan Hospital, Medical Center, Tsinghua University, Beijing 100049, China
摘要 Objective: We have reported the presence of discogenic visceral pain secondary to anterior herniation of the lumbar disc. The aim of this study was to observe the inflammatory response of the sympathetic trunk to an autologous degenerative nucleus pulposus (NP) injection under fluoroscopy. Methods: A total of 72 rats were used. In 24 rats, the autologous NP suspension was injected into the right sympathetic trunk. Next, food intake and body weight of each rat were monitored for 14 days. Fourteen days after the injection, the right lumbar sympathetic trunk was harvested for histological assessment, and protein levels of IL-1 β, IL-6, and TNF-α were quantified via ELISA. Results: In the NP-treated group, endoneural hyperemia and intensive infiltration of inflammatory cells could be identified in sections of the sympathetic trunk by the hematoxylin and eosin (H&E) stain. Meanwhile, elevated concentrations of IL-1 β, IL-6, and TNF-α were determined in the sympathetic trunk of the NP group as compared to that of the naïve and control groups, which indicated the development of an inflammatory response. Furthermore, food intake and body weight of rats in the NP group decreased significantly. Conclusions: The results indicated that an inflammatory response in the sympathetic trunk can be caused by anterior herniation of the lumbar disc, which can generate a sympathetic inflammatory pain response.
Abstract: Objective: We have reported the presence of discogenic visceral pain secondary to anterior herniation of the lumbar disc. The aim of this study was to observe the inflammatory response of the sympathetic trunk to an autologous degenerative nucleus pulposus (NP) injection under fluoroscopy. Methods: A total of 72 rats were used. In 24 rats, the autologous NP suspension was injected into the right sympathetic trunk. Next, food intake and body weight of each rat were monitored for 14 days. Fourteen days after the injection, the right lumbar sympathetic trunk was harvested for histological assessment, and protein levels of IL-1 β, IL-6, and TNF-α were quantified via ELISA. Results: In the NP-treated group, endoneural hyperemia and intensive infiltration of inflammatory cells could be identified in sections of the sympathetic trunk by the hematoxylin and eosin (H&E) stain. Meanwhile, elevated concentrations of IL-1 β, IL-6, and TNF-α were determined in the sympathetic trunk of the NP group as compared to that of the naïve and control groups, which indicated the development of an inflammatory response. Furthermore, food intake and body weight of rats in the NP group decreased significantly. Conclusions: The results indicated that an inflammatory response in the sympathetic trunk can be caused by anterior herniation of the lumbar disc, which can generate a sympathetic inflammatory pain response.
基金资助: Supported by the Beijing Municipal Administration of Hospitals Youth program, code: 20160807 and Capital Medical University basicclinical research cooperation fund project, code: 16JL43
引用本文:
Yuanzhang Tang, Jingjing Bian, Yuna Guo, Chenli Sun, Yawei, Xiuhua Li, Jiaxiang Ni. Effects of degenerative autologous nucleus pulposus on the lumbar sympathetic trunk: Sympathetic inflammation in rats[J]. 临床转化神经科学, 2017, 3(4): 213-219.
Yuanzhang Tang, Jingjing Bian, Yuna Guo, Chenli Sun, Yawei, Xiuhua Li, Jiaxiang Ni. Effects of degenerative autologous nucleus pulposus on the lumbar sympathetic trunk: Sympathetic inflammation in rats. Translational Neuroscience and Clinics, 2017, 3(4): 213-219.
20180119184338 Figure 1 Established rat model of intervertebral disc degeneration and right sympathetic trunk injection. (a) (lateral fluoroscopic guidance): 35-gauge needle was inserted at the midline of the tail, parallel to the endplates, and into the center of Co4/5 to Co8/9 discs respectively; (b) (anteroposterior fluoroscopic guidance) and (c) (lateral fluoroscopic guidance): 35-gauge needle was guided to the right lumbar sympathetic trunk and the contrast medium spread along the anterolateral border of lumbar spine.
20180119184359 Figure 2 Food intake (a) and body weight (b) were record for each rat after the sympathetic injection. Data are reported as mean ± SD of the material obtained from each rat. (* indicates a statistical difference VS naïve group; # indicates a statistical difference VS control group, p < 0.05)
20180119184414 Figure 3 Histological observation shows sympathetic trunk sections in naïve (a), control (b), and NP groups (c). In the NP group, the signs of sympathetic trunk inflammation, such as infiltration of inflammatory cells (straight arrow) and endoneural hyperemia (dovetail arrow) could be seen. Hematoxylin and eosin stain; Magnification 400×.
20180119184426 Figure 4 Determination of inflammatory cytokines in the right sympathetic trunk of rats. Data are reported as mean ± SD of the material obtained from 18 animal which served as 6 samples. (* indicates a statistical difference VS naïve group; # indicates a statistical difference VS control group, p < 0.05)
[1] Goupille P, Jayson MI, Valat JP, Freemont AJ. The role of inflammation in disk herniation-associated radiculopathy. Semin Arthritis Rheum 1998, 28: 60-71. [2] Norimoto M, Sakuma Y, Suzuki M, Orita S, Yamauchi K, Inoue G et al. Up-Regulation of Pain Behavior and Glial Activity in the Spinal Cord after Compression and Application of Nucleus Pulposus onto the Sciatic Nerve in Rats. Asian Spine J 2014, 8: 549-556. [3] Andrade P, Hoogland G, Garcia MA, Steinbusch HW, Daemen MA, Visser-Vandewalle V. Elevated IL-1beta and IL-6 levels in lumbar herniated discs in patients with sciatic pain. EUR SPINE J 2013, 22: 714-720. [4] de Souza GA, Ferrari LF, Defino HL. Cytokine inhibition and time-related influence of inflammatory stimuli on the hyperalgesia induced by the nucleus pulposus. EUR SPINE J 2012, 21: 537-545. [5] Liu J, Zhou H, Lu L, Li X, Jia J, Shi Z et al. The Effectiveness of Transforaminal Versus Caudal Routes for Epidural Steroid Injections in Managing Lumbosacral Radicular Pain: A Systematic Review and Meta-Analysis. Medicine (Baltimore) 2016, 95: e3373. [6] Johansen JG. Demonstration of anterior intervertebral disc herniation by CT. 1987. [7] Garg K, Nagi ON, Suri S, Garg SK. CT of anterior intervertebral disc herniation. Australas Radiol 1988, 32: 458-459. [8] Cavanaugh JM, Ozaktay AC, Yamashita T, Avramov A, Getchell TV, King AI. Mechanisms of low back pain: a neurophysiologic and neuroanatomic study. Clin Orthop Relat Res 1997, 166-180. [9] Ness TJ, Gebhart GF. Visceral pain: a review of experimental studies. PAIN 1990, 41: 167-234. [10] Geiss A, Larsson K, Junevik K, Rydevik B, Olmarker K. Autologous nucleus pulposus primes T cells to develop into interleukin-4-producing effector cells: an experimental study on the autoimmune properties of nucleus pulposus. J ORTHOP RES 2009, 27: 97-103. [11] Murai K, Sakai D, Nakamura Y, Nakai T, Igarashi T, Seo N et al. Primary immune system responders to nucleus pulposus cells: evidence for immune response in disc herniation. Eur Cell Mater 2010, 19: 13-21. [12] Tang YZ, Shannon ML, Lai GH, Li XY, Li N, Ni JX. Anterior herniation of lumbar disc induces persistent visceral pain: discogenic visceral pain: discogenic visceral pain. Chin Med J (Engl) 2013, 126: 4691-4695. [13] Zhang KB, Zheng ZM, Liu H, Liu XG. The effects of punctured nucleus pulposus on lumbar radicular pain in rats: a behavioral and immunohistochemical study. J Neurosurg Spine 2009, 11: 492-500. [14] Sasaki N, Sekiguchi M, Shishido H, Kikuchi S, Yabuki S, Konno S. A comparison of pain-related behavior following local application of nucleus pulposus and/or mechanical compression on the dorsal root ganglion. Fukushima J Med Sci 2011, 57: 46-53. [15] Tufan K, Sen O, Cekinmez M, Bolat FA, Alkan O, Sarica FB 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: 443-446. [16] Wong-Chung JK, Naseeb SA, Kaneker SG, Aradi AJ. Anterior disc protrusion as a cause for abdominal symptoms in childhood discitis. A case report. Spine (Phila Pa 1976) 1999, 24: 918-920. [17] Baron R, Janig W, Kollmann W. Sympathetic and afferent somata projecting in hindlimb nerves and the anatomical organization of the lumbar sympathetic nervous system of the rat. J COMP NEUROL 1988, 275: 460-468. [18] Rand N, Reichert F, Floman Y, Rotshenker S. 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: 2598-2601, 2602. [19] Uceyler N, Rogausch JP, Toyka KV, Sommer C. Differential expression of cytokines in painful and painless neuropathies. NEUROLOGY 2007, 69: 42-49. [20] Koch A, Zacharowski K, Boehm O, Stevens M, Lipfert P, von Giesen HJ et al. Nitric oxide and pro-inflammatory cytokines correlate with pain intensity in chronic pain patients. INFLAMM RES 2007, 56: 32-37. [21] Genevay S, Finckh A, Payer M, Mezin F, Tessitore E, Gabay C et al. Elevated levels of tumor necrosis factor-alpha in periradicular fat tissue in patients with radiculopathy from herniated disc. Spine (Phila Pa 1976) 2008, 33: 2041-2046.
2017, Vol. 3 
