TAILIEUCHUNG - Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 14

Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 14. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | Age-Related Changes of the Spine Chapter 4 105 Table 3. Major cytokines of the intervertebral disc Enzyme Function References TNF-a Proinflammatory cytokine proapoptic 7 9 20 93 IL-1 as Proinflammatory cytokine chemokine 18 58 123 IL-10 Proinflammatory cytokine chemokine 60 132 IL-6 Proinflammatory cytokine chemokine 7 132 IL-8 Proinflammatory cytokine chemokine 7 132 IL-10 Inhibition of pro-inflammatory cytokine chemokine 132 GM-CSF Proinflammatory cytokine 7 21 pge2 Tissue degradation inflammation angiogenesis 7 21 TGF-0 Growth factors for proteoglycan synthesis 7 74 PLA-2 Biosynthesis of prostaglandins COX2 Biosynthesis of prostaglandins 93 cytokines and growth factors are responsible for the alterations of the disc matrix described above 7 20 93 . However for most factors it is difficult to distinguish if they are part of the normal age-related degeneration process or mainly important during pathological changes of the disc. Therefore the mechanism of cytokine action is of major importance for the understanding of disc degeneration and also represents a potential target for therapeutic interventions. Despite this importance only little is known about the age-related changes in cytokine and growth factor expression patterns. Among the factors that have been identified to be either produced by disc cells or that can be recognized by disc cells two major groups can be distinguished proinflammatory cytokines with mostly catabolic activity represented by interleukins and TNF-a and growth factors with mostly anabolic effects such as TGF-0 7 . Recent studies provide evidence that factors of both classes are induced during age-related degeneration. Weiler et al. demonstrated that TNF-a was found in an increasing proportion of cells with increasing age in non-symp-tomatic intervertebral discs 153 . Among the adult disc specimens increasing levels of TNF-a were found with increasing degeneration. In addition members of the interleukin-1 IL-1 family were found to be .

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