Exploring the impact of macrophage polarization and Modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniation
Introduction: Lumbar intervertebral disc herniation (LDH) often manifests as sciatica, resulting from mechanical compression and/or an inflammation affecting the nerve root. Research question: This study aims to investigate the impact of inflammation and macrophage polarization on clinical symptoms...
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Elsevier
2025-01-01
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| author | Wensen Li Niek Djuric Christiaan Mink Carmen L.A. Vleggeert-Lankamp |
| author_facet | Wensen Li Niek Djuric Christiaan Mink Carmen L.A. Vleggeert-Lankamp |
| author_sort | Wensen Li |
| collection | DOAJ |
| description | Introduction: Lumbar intervertebral disc herniation (LDH) often manifests as sciatica, resulting from mechanical compression and/or an inflammation affecting the nerve root. Research question: This study aims to investigate the impact of inflammation and macrophage polarization on clinical symptoms in surgical LDH patients. Material and methods: Nucleus pulposus (NP) tissue samples were obtained from LDH patients. Clinical symptoms were assessed using the Numerical Rating Scale (NRS) for back pain and leg pain, and the Oswestry Disability Index (ODI). HE and CD68 staining were employed to detect inflammation in the samples while CD163 and CD192 were utilized as markers for M1 and M2 macrophage phenotypes respectively. MRI was screened for Modic changes (MC). Results: A total of 187 patients were included. Inflammation was found in 140 patients, with 93 having severe inflammation. MC type I was present in only 8 % of patients (16 patients), type II in 37 %. Inflammation severity correlated with back pain (p = 0.021). M1 macrophage dominance associated with the presence of more intense back pain, especially in patients with MC type II (p = 0.001). Inflammation severity positively correlated with leg pain, but only in patients without Modic changes (p = 0.003). Discussion and conclusion: The link between back and leg pain and intervertebral disc inflammation appears to be influenced by the presence or absence of MC. These findings reveal distinct roles for M1 and M2 macrophages in clinical symptoms, warranting further investigation. Large-scale cohort studies are needed to validate and expand upon these observations. |
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| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Brain and Spine |
| spelling | doaj-art-e6d463877fb64e83910b7f4c994c048d2025-08-20T03:36:06ZengElsevierBrain and Spine2772-52942025-01-01510438810.1016/j.bas.2025.104388Exploring the impact of macrophage polarization and Modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniationWensen Li0Niek Djuric1Christiaan Mink2Carmen L.A. Vleggeert-Lankamp3Neurosurgical Center Holland, Leiden University Medical Center & Haaglanden Medical Center & Haga Teaching Hospital, the Netherlands; Corresponding author. J11-R-83, Department of Neurosurgery, Leiden University Medical Centre, Albinusdreef 2, Leiden, 2300 RC, the Netherlands.Neurosurgical Center Holland, Leiden University Medical Center & Haaglanden Medical Center & Haga Teaching Hospital, the Netherlands; Erasmus MC, Rotterdam, the NetherlandsNeurosurgical Center Holland, Leiden University Medical Center & Haaglanden Medical Center & Haga Teaching Hospital, the NetherlandsNeurosurgical Center Holland, Leiden University Medical Center & Haaglanden Medical Center & Haga Teaching Hospital, the Netherlands; Spaarne Gasthuis, Hoofddorp, Haarlem, the NetherlandsIntroduction: Lumbar intervertebral disc herniation (LDH) often manifests as sciatica, resulting from mechanical compression and/or an inflammation affecting the nerve root. Research question: This study aims to investigate the impact of inflammation and macrophage polarization on clinical symptoms in surgical LDH patients. Material and methods: Nucleus pulposus (NP) tissue samples were obtained from LDH patients. Clinical symptoms were assessed using the Numerical Rating Scale (NRS) for back pain and leg pain, and the Oswestry Disability Index (ODI). HE and CD68 staining were employed to detect inflammation in the samples while CD163 and CD192 were utilized as markers for M1 and M2 macrophage phenotypes respectively. MRI was screened for Modic changes (MC). Results: A total of 187 patients were included. Inflammation was found in 140 patients, with 93 having severe inflammation. MC type I was present in only 8 % of patients (16 patients), type II in 37 %. Inflammation severity correlated with back pain (p = 0.021). M1 macrophage dominance associated with the presence of more intense back pain, especially in patients with MC type II (p = 0.001). Inflammation severity positively correlated with leg pain, but only in patients without Modic changes (p = 0.003). Discussion and conclusion: The link between back and leg pain and intervertebral disc inflammation appears to be influenced by the presence or absence of MC. These findings reveal distinct roles for M1 and M2 macrophages in clinical symptoms, warranting further investigation. Large-scale cohort studies are needed to validate and expand upon these observations.http://www.sciencedirect.com/science/article/pii/S2772529425002073SciaticaLumbarInflammationMacrophageM1 and M2Modic changes |
| spellingShingle | Wensen Li Niek Djuric Christiaan Mink Carmen L.A. Vleggeert-Lankamp Exploring the impact of macrophage polarization and Modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniation Brain and Spine Sciatica Lumbar Inflammation Macrophage M1 and M2 Modic changes |
| title | Exploring the impact of macrophage polarization and Modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniation |
| title_full | Exploring the impact of macrophage polarization and Modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniation |
| title_fullStr | Exploring the impact of macrophage polarization and Modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniation |
| title_full_unstemmed | Exploring the impact of macrophage polarization and Modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniation |
| title_short | Exploring the impact of macrophage polarization and Modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniation |
| title_sort | exploring the impact of macrophage polarization and modic changes on baseline clinical condition in radiculopathy due to lumbar disc herniation |
| topic | Sciatica Lumbar Inflammation Macrophage M1 and M2 Modic changes |
| url | http://www.sciencedirect.com/science/article/pii/S2772529425002073 |
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