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The contradictory effect of macrophage-related cytokine expression in lumbar disc herniations: a systematic review

N Djuric1, G C M Lafeber2, C L A Vleggeert-Lankamp2

  • 1Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, the Netherlands. n.djuric@lumc.nl.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|November 27, 2019
PubMed
Abstract

Insights

Sciatic pain from herniated discs involves inflammation. Pro-inflammatory M1 macrophages worsen pain, while anti-inflammatory M2 macrophages alleviate it, though more research is needed.

Area of Science:

  • Neuroscience
  • Immunology
  • Orthopedics

Background:

  • Sciatica from lumbar disc herniation involves both nerve compression and inflammatory processes.
  • M1 macrophages are linked to pro-inflammatory responses, while M2 macrophages are associated with anti-inflammatory actions.

Purpose of the Study:

  • To systematically review studies on the association between M1/M2 macrophages, inflammation factors, and pain in lumbar disc herniation.

Main Methods:

  • A comprehensive literature search was conducted.
  • Studies were selected based on predefined criteria and assessed for risk of bias.
  • 14 studies were included in the review, with a moderate overall risk of bias.

Main Results:

  • High levels of M1-related cytokines (TNF-α, IL-6, IL-8, IFN-γ) correlated with increased pain (VAS scores).
  • High TNFR2 levels and M2-related cytokines (IL-4, IL-10) were associated with decreased pain.
  • Macrophage presence (CD68) showed a negative association with pain scores.

Conclusions:

  • M1 cytokines exacerbate sciatica pain, whereas M2 cytokines alleviate it.
  • The current evidence is limited, highlighting the need for further research into the pathophysiology of sciatica.
Keywords:
CytokineDiscInflammationMacrophageSciatica

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