Percutaneously-quantified advanced glycation end-products (AGEs) accumulation associates with low back pain and lower extremity symptoms in middle-aged low back pain patients

Biomarkers for intervertebral disc and associated back pain: From diagnosis to disease prognosis and personalized treatment

Biomarkers are commonly recognized as objective indicators of a medical state or clinical outcome and have been widely used as clinical and diagnostic tools and surrogate endpoints in many pathological conditions. In the context of intervertebral disc (IVD) and associated back pain, also known as degenerative disc disease (DDD), the use of biomarkers has been poorly explored. DDD is currently diagnosed using imaging techniques and subjective pain scales, limiting an objective association between DDD and pain levels, as well as an evaluation of disease progression. There is a need for objective and reliable measurements for DDD, pain and pathology progression. DDD predictors could also help clinicians in deciding on the optimal treatment for distinct patient groups. This review addresses the current candidate biomarkers in DDD, including imaging, genetic, metabolite and protein-based parameters, both at the tissue and systemic levels, that may become a major advance in the diagnosis and prognosis of the disease, as well as in the management of therapeutic approaches to DDD.

Are serum thyroid hormone, parathormone, calcium, and vitamin D levels associated with lumbar spine degeneration? A cross-sectional observational clinical study

PURPOSE

Low back pain (LBP) impairs the quality of life and rises healthcare costs. The association of spine degeneration and LBP with metabolic disorders have been reported, previously. However, metabolic processes related with spine degeneration remained unclear. We aimed to analyze whether serum thyroid hormones, parathormone, calcium, and vitamin D levels were associated with lumbar intervertebral disc degeneration (IVDD), Modic changes, and fatty infiltration in the paraspinal muscles.

METHODS

We cross-sectionally analyzed a retrospective database. Patients who visited internal medicine outpatient clinics with suspect of endocrine disorders and chronic LBP were searched. Patients with biochemistry results within 1 week before lumbar spine magnetic resonance imaging (MRI) were included. Age- and gender-matched cohorts were made-up and analyzed.

RESULTS

Patients with higher serum free thyroxine levels were more likely to have severe IVDD. They were also more likely to have fattier multifidus and erector spinae at upper lumbar levels, less fatty psoas and less Modic changes at lower lumbar levels. Higher PTH levels were observed in patients with severe IVDD at L4-L5 level. Patients with lower serum vitamin D and calcium levels had more Modic changes and fattier paraspinal muscles at upper lumbar levels.

CONCLUSION

Serum hormone, vitamin D, and calcium levels were associated with not only IVDD and Modic changes but also with fatty infiltration in the paraspinal muscles, mainly at upper lumbar levels in patients with symptomatic backache presenting to a tertiary care center. Complex inflammatory, metabolic, and mechanical factors present in the backstage of spine degeneration.

Analysis of the Effect of Percutaneous Cone Shaping in Patients with Osteoporotic Vertebral Fractures

Objective. To study and analyze the clinical effect of percutaneous cone shaping in patients with osteoporotic vertebral fractures. Methods. A total of 100 patients with vertebral osteoporotic fracture treated in our hospital from June 2019 to September 2020 were selected, and there were 50 patients with vertebral osteoporotic fracture in each group. Patients could be divided into two groups according to different treatment plans: one group was vertebroplasty patients for group A, and the other group was nonsurgical treatment patients for group B. The incidence of complications during treatment and follow-up was recorded in both groups. Results. According to a study, both groups of patients completed the treatment and follow-up, no patients lost to follow-up or death, the VAS scores and ADL scores of patients before treatment were higher, and there was no significant difference at baseline ( $P>0.05$ ). After different treatment methods, the VAS score and ADL score of group A showed good improvement after treatment compared with that before treatment, and there were certain differences within the group, with statistical significance ( $P<0.05$ ). Intragroup comparison. The VAS scores of group B at 1 week, 1 month, 3 months, and 12 months after treatment were all superior to those before treatment, and the ADL scores at 1 month, 3 months, and 12 months after treatment were all superior to those before treatment, with statistically significant differences ( $P<0.05$ ). VAS scores and ADL scores showed good improvement 1 day, 1 week, and 1 month after treatment compared with those before treatment. However, there were no significant differences in the VAS score and ADL score between the two groups at 3 and 12 months after treatment. The incidence of complications in group A is lower than that in group B. The incidence of complications in group A is as follows: there was 1 case of recurrent vertebral fracture and 1 case of urinary tract infection, and the overall incidence of complications was 4.00%. In group B, there were 1 case of recurrent fracture, 3 cases of bedsore, 2 cases of urinary tract infection, and 2 cases of pulmonary infection, and the incidence of total complications was 16.00%. After comparison between groups, there was a significant difference in the incidence of complications between the two groups, and the difference was statistically significant ( $P<0.05$ ). Conclusions. Percutaneous cone plasty can provide rapid relief of pain symptoms in patients with osteoporotic vertebral fractures and significantly improve their daily activities. However, there was no significant difference in long-term recovery from group B. In terms of the incidence of complications, the incidence of complications in group A was lower than that in group B after certain treatment.

Circular RNAs in Intervertebral Disc Degeneration: An Updated Review

Low back pain, a common medical condition, could result in severe disability and inflict huge economical and public health burden. Its pathogenesis is attributed to multiple etiological factors, including intervertebral disc degeneration (IDD). Emerging evidence suggests that circular RNAs (circRNAs), a major type of regulatory non-coding RNA, play critical roles in cellular processes that are pertinent to IDD development, including nucleus pulposus cell proliferation and apoptosis as well as extracellular matrix deposition. Increasing number of translational studies also indicated that circRNAs could serve as novel biomarkers for the diagnosis of IDD and/or predicting its clinical outcomes. Our review aims to discuss the recent progress in the functions and mechanisms of newly discovered IDD-related circRNAs.

Association Between the Accumulation of Pentosidine at the Sciatic Nerve and Cutaneous Hindpaw Hypersensitivity in a Rat Ovariectomy Model

Introduction

Advanced glycation end-products (AGEs) have the potential to serve as biomarkers of aging and metabolic diseases; however, how their expression relates to clinical symptoms is not well defined. In this study, we sought to determine whether the accumulation of pentosidine, one type of AGE, at the peripheral nerve is associated with cutaneous pain or hypersensitivity caused by ovariectomy (OVX).

Methods

We assigned 12-week-old female Sprague Dawley rats into either the OVX group (n = 6) or the sham group (n = 6). Cutaneous hindpaw sensitivity to mechanical stimuli was measured with von Frey filaments, using Chaplan’s adapted method, and the 50% withdrawal threshold was calculated. Then, the accumulation of pentosidine, which represents AGEs, was measured in sciatic nerve fibers after staining with an anti-pentosidine antibody.

Results

OVX rats showed significantly increased plantar hypersensitivity to mechanical stimuli compared to sham rats 8 weeks after OVX (P = 0.017). Pentosidine-positive sciatic nerves were detected at a higher rate in OVX rats than in sham rats (P = 0.035). The pentosidine positivity rate in sciatic nerve fibers showed a negative correlation with withdrawal threshold (P < 0.001).

Conclusions

This study showed that higher levels of pentosidine in sciatic nerve fibers are associated with higher plantar hypersensitivity. Accumulation of pentosidine at the sciatic nerve, caused by OVX, may result in cutaneous hindpaw hypersensitivity.