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Surprising find may yield new avenue of treatment for painful herniated discs
Date:6/28/2010

DURHAM, N.C. -- An immune cell known to cause chronic inflammation in autoimmune disorders has been identified as a possible culprit in low back pain associated with herniated discs, according to doctors at Duke University Medical Center.

The finding implicates the cytokine molecule interleukin-17, and supports the burgeoning theory that an immune response plays a significant role in disc disease, says William J. Richardson, MD, an orthopedic surgeon at Duke. It may also open the door for new, therapeutic approaches that target a specific immune response in hopes of halting disc destruction, and possibly reversing the disease process.

"By identifying the specific subpopulation of lymphocytes (immune cells that are excited into action by the cytokine), it may soon be possible to arrest the body's inflammatory response to disc cells," says Richardson, senior author of the research published online this week in the July issue of Arthritis and Rheumatism. Doing so could reduce the painful inflammation associated with degenerative disc disease, and halt the evolution of arthritis. It may also reduce the need for back surgery.

"Mechanical forces may initiate the degenerative process, but biochemical inflammatory changes certainly play a role in disc pathology," says the study's first author, Mohammed Shamji, MD, PhD, senior neurosurgery resident at The Ottawa Hospital, Ontario, Canada, who participated in the research while at Duke. Decreasing the inflammation may arrest or reverse the patient's disease process and perhaps reduce the need for surgery. "Now we are learning which pathways we have to block."

Low back pain is one of the most common reasons people seek medical care, and both degenerative and herniated discs -- also referred to as slipped discs or ruptured discs -- are common causes of that pain. The economic impact of medical care for herniated discs in the U.S. is estimated to be as high as $200 billion per
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Contact: Debbe Geiger
Debbe.Geiger@duke.edu
919-660-9461
Duke University Medical Center
Source:Eurekalert

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