The inflammatory response in the regression of lumbar disc herniation

被引:298
作者
Cunha, Carla [1 ,2 ]
Silva, Ana J. [1 ,2 ]
Pereira, Paulo [3 ,4 ,5 ]
Vaz, Rui [1 ,3 ,4 ,5 ]
Goncalves, Raquel M. [1 ,2 ,6 ]
Barbosa, Mario A. [1 ,2 ,6 ]
机构
[1] Univ Porto, Inst Invest & Inovacao Saude, Rua Alfredo Allen 208, P-4200135 Porto, Portugal
[2] Univ Porto, INEB Inst Engn Biomed, Rua Campo Alegre 823, P-4150180 Porto, Portugal
[3] Ctr Hosp Sao Joao, Dept Neurosurg, Porto, Portugal
[4] Univ Porto, Dept Clin Neurosci & Mental Hlth, Fac Med, Porto, Portugal
[5] CUF Porto Hosp, Neurosci Ctr, Porto, Portugal
[6] Univ Porto, ICBAS, Rua Jorge Viterbo Ferreira 228, P-4050313 Porto, Portugal
关键词
Low back pain; Spine; Intervertebral disc; Immunomodulation; Macrophages; MONOCYTE CHEMOATTRACTANT PROTEIN-1; NUCLEUS PULPOSUS RESORPTION; ENDOTHELIAL GROWTH-FACTOR; NECROSIS-FACTOR-ALPHA; INTERVERTEBRAL DISC; FAS LIGAND; MATRIX METALLOPROTEINASES; AUTOIMMUNE PROPERTIES; SEQUENTIAL DYNAMICS; IMMUNE PRIVILEGE;
D O I
10.1186/s13075-018-1743-4
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Lumbar disc herniation (LDH) is highly associated with inflammation in the context of low back pain. Currently, inflammation is associated with adverse symptoms related to the stimulation of nerve fibers that may lead to pain. However, inflammation has also been indicated as the main factor responsible for LDH regression. This apparent controversy places inflammation as a good prognostic indicator of spontaneous regression of LDH. This review addresses the molecular and cellular mechanisms involved in LDH regression, including matrix remodeling and neovascularization, in the scope of the clinical decision on conservative versus surgical intervention. Based on the evidence, a special focus on the inflammatory response in the LDH context is given, particularly in the monocyte/macrophage role. The phenomenon of spontaneous regression of LDH, extensively reported in the literature, is therefore analyzed here under the perspective of the modulatory role of inflammation.
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页数:9
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