Dr. Nadine O. Chahine Published in Osteoarthritis and Cartilage

August 6, 2020
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Nadine O. Chahine, PhD, recently published an article in Osteoarthritis and Cartilage titled “Severity of Intervertebral Disc Herniation Regulates Cytokine and Chemokine Levels in Patients with Chronic Radicular Back Pain.”

The study examined the effects of symptomatic disc herniation (DH) and MRI herniation severity on serum cytokine levels in clinical subjects in order to figure out how intervertebral disc disease and subject-specific covariates contributes to lower back pain.

“We’ve known from our prior studies that patients with painful disc degeneration have systemic inflammation. In this new study, we show for the first time, that the degree of inflammation is in fact correlated with severity of disc herniation as measured on MRI- a gold standard for herniation diagnosis,” said Dr. Chahine. “Interestingly, we also found that this relationship holds only in patients with chronic symptoms, suggesting that the inflammation is developing over the longer course of herniation. When we looked at inflammation after surgical treatment, it mostly recovered to normal levels in most, but not all, factors we tested.”

The study was the first to show that DH severity is coordinately associated with changes in serum levels of inflammatory cytokines in chronic pain subjects. The study also found that HMGB1, PDGFbb and IL-9 mediate the increase of DH severity, indicative of cellular damage, neuro-inflammation and angiogenesis. Inflammation diminished, as a result of a decrease in the migration inhibitory factor, post-surgery. However, elevated chemokine levels indicate ongoing remodeling and wound healing at 3-month time point.

“This study helped us understand the specific inflammatory proteins that are contributing to pain and disability in patients with painful disc degeneration and provides an opportunity to develop new therapies for patients with painful disc herniation who have recurring symptoms or aren’t good candidates for surgery,” said Dr. Chahine.

Read the full article here.