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Comparison of E-selectin and the Other Inflammatory Markers in Lumbar Disc Herniation: A New Promising Therapeutical Window for Radicular Pain

Tufan, Kadir MD*; Sen, Orhan MD*; Cekinmez, Melih MD*; Bolat, Filiz Aka MD; Alkan, Ozlem MD; Sarica, Feyzi Birol MD*; Caner, Hakan MD*

Journal of Spinal Disorders & Techniques: December 2012 - Volume 25 - Issue 8 - p 443–446
doi: 10.1097/BSD.0b013e318238e2db
ORIGINAL ARTICLES
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Study Design: Histopathologic and immunohistochemical analysis of the herniated disc specimens obtained from 50 patients who had unilateral persistent radicular pain or unilateral radicular motor paresis.

Objective: The aim of this study was to investigate the prevalence of inflammatory cells in lumbar disc herniations (LDH) and compare the prevalence of leukocyte adhesion protein “E-selectin” with other inflammatory cells such as T cells, B cells, and macrophages.

Summary of Background: Studies on inflammatory cells and biochemical mediators of inflammation have suggested that these factors may play an important role in pathophysiology of radicular pain, and the medical therapy was formed against to block these cells and inflammatory cytokines.

Methods: The herniated disc specimens obtained from 50 patients who had unilateral persistent radicular pain or unilateral radicular motor paresis were microscopically examined after staining with monoclonal antibodies of CD20, CD45, CD68, and E-selectin. Relative risk assessment of the straight-leg raising (SLR) test positivity or negativity with CD20, CD45, CD68, and E-selectin staining was investigated.

Results: Our data emphasize that, the cases with positive SLR test had higher rates of immunostaining with E-selectin and CD45. There were no statistically significant relationship between SLR positivity and CD20 and CD68.

Conclusions: We suggest that E-selectin is as valuable as the other well-known inflammatory markers in the pathogenesis of LDH. In our opinion, beside the well-known nonsteroidal anti-inflammatory drugs, antagonists targeting E-selectin can be potentially effective therapeutics for controlling inflammation in LDH.

Departments of *Neurosurgery

Pathology

Radiology, Baskent University, Ankara, Turkey

The authors declare no conflict of interest.

Reprints: Kadir Tufan, MD, Department of Neurosurgery, Baskent University, 01250 Yuregir, Ankara, Turkey (e-mail: kadirtufan@hotmail.com).

Received May 11, 2011

Accepted September 14, 2011

© 2012 Lippincott Williams & Wilkins, Inc.