neuropeptide-y and Intervertebral-Disc-Displacement

Intervertebral disc diseases (IVDDs) form a group of a vertebral column disorders affecting a large number of people worldwide. It is estimated that approximately 30% of individuals at the age of 35 and approximately 90% of individuals at the age of 60 and above will have some form of disc-affecting pathological changes leading to disc herniation, prolapse and degeneration as well as discogenic pain. Here, we aimed to establish the origins and neurochemical characteristics of porcine intervertebral disc sympathetic innervation involved in pain signalling in IVDD patients. Pigs were given an injection of the Ominipaque contrast agent and Fast Blue (FB) retrograde tracer into the L

Topics: Animals; Dopamine beta-Hydroxylase; Enkephalin, Leucine; Female; Galanin; Ganglia, Sympathetic; Intervertebral Disc; Intervertebral Disc Degeneration; Intervertebral Disc Displacement; Neurons; Neuropeptide Y; Somatostatin; Swine

A prospective analysis of patients with lumbar disc herniation (LDH).. To determine the role of neuropeptides as a biochemical signature of pain states in patients with LDH.. Increases in the plasma level of neuropeptides have been reported in patients suffering from a variety of painful conditions. However, there is no such report on patients with LDH.. From a total of 27 patients with a single-level LDH, blood samples were collected before and 3 weeks after lumbar discectomy. Plasma levels of alpha calcitonin gene-related peptide (CGRP), galanin, neuropeptide Y, and substance P were determined by using enzyme-linked immunosorbent assay. The association or correlation between preoperative concentration of plasma neuropeptides and gender, patients' age, and VAS were analyzed statistically. Also, the concentration of plasma neuropeptides was compared before and after lumbar discectomy.. Preoperative plasma levels of CGRP were correlated significantly with the extent of sciatica as determined by VAS. In addition, plasma levels of CGRP and galanin significantly decreased after lumbar discectomy in line with the disappearance of pain symptoms.. These findings indicate the role of plasma CGRP and possibly galanin as a systemic neurochemical signature of pain states in patients with LDH.

Topics: Adolescent; Adult; Aged; Calcitonin Gene-Related Peptide; Diskectomy; Enzyme-Linked Immunosorbent Assay; Female; Galanin; Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Male; Middle Aged; Neuropeptide Y; Neuropeptides; Pain Measurement; Postoperative Period; Preoperative Care; Prospective Studies; Sciatica; Substance P

We obtained intervertebral discs with cartilage endplates and underlying cancellous bone at operation from patients with degenerative disc disease and then used immunohistochemical techniques to localise the nerves and nerve endings in the specimens. We used antibodies for the ubiquitous neuronal protein gene product 9.5 (PGP 9.5). Immunoreactivity to neuropeptide Y was used to identify autonomic nerves and calcitonin gene-related peptide (CGRP) and substance P to identify sensory nerves. Blood vessels were identified by immunoreactivity with platelet-endothelial cell-adhesion molecule (CD31; PECAM). In a control group with no known history of chronic back pain, nerve fibres immunoreactive to PGP 9.5 and neuropeptide Y were most closely related to blood vessels, with occasional substance P and CGRP immunoreactivity. In patients with severe back pain and markedly reduced disc height, proliferation of blood vessels and accompanying nerve fibres was observed in the endplate region and underlying vertebral bodies. Many of these nerves were immunoreactive to substance P or CGRP, and in addition, substance P- and CGRP-immunoreactive nociceptors were seen unrelated to blood vessels. Quantification by image analysis showed a marked increase in CGRP-containing sensory nerve fibres compared with normal control subjects. We speculate that a chemotactic response to products of disc breakdown is responsible for the proliferation of vascularity and CGRP-containing sensory nerves found in the endplate region and vertebral body adjacent to degenerate discs. The neuropeptides substance P and CGRP have potent vasodilatory as well as pain-transmitting effects. The increase in sensory nerve endings suggests increase in blood flow, perhaps as an attempt to augment the nutrition of the degenerate disc. The increase in the density of sensory nerves, and the presence of endplate cartilage defects, strongly suggest that the endplates and vertebral bodies are sources of pain; this may explain the severe pain on movement experienced by some patients with degenerative disc disease.

Topics: Adolescent; Adult; Aged; Calcitonin Gene-Related Peptide; Cartilage; Female; Humans; Immunohistochemistry; Intervertebral Disc; Intervertebral Disc Displacement; Male; Middle Aged; Nerve Endings; Nerve Tissue Proteins; Neurons, Afferent; Neuropeptide Y; Nociceptors; Platelet Endothelial Cell Adhesion Molecule-1; Substance P; Sympathetic Nervous System; Thiolester Hydrolases; Ubiquitin Thiolesterase

Thirty-five lumbar disc herniations removed at surgery were studied by indirect immunocytochemistry.. To localize immunohistochemically both sensory and autonomic nerve terminals in disc herniations.. Using various more or less specific histologic and histochemical methods, investigators have reported the presence of free nerve terminals in disc tissue. However, very few studies have, to date, convincingly demonstrated nerve terminals in disc tissue that morphologically resemble the tiny nerve terminals of sensory and autonomic nerve fibers.. Amplification of the peroxidase reaction product in avidin-biotin-peroxidase complex immunostaining by the glucose oxidase-diaminobenzidine-nickel sulfate method was used to visualize small punctate nerve terminals at high magnification. Thin frozen sections from disc herniation tissue prefixed in Zamboni fixative were incubated with antibodies to synaptophysin to visualize nerve terminals in general, and with antibodies to substance P and C-flanking peptide of neuropeptide Y to further characterize nerve terminals as either sensory or sympathetic.. Nerve terminals could be demonstrated in 29 (83%) of the 35 disc herniations. They were observed with the synaptophysin antibody in 17 of 35 (49%) disc herniations, with substance P in 16 of 35 (46%) disc herniations, and with C-flanking peptide of neuropeptide Y in 13 of 35 (37%) disc herniations. Morphologically, the nerve terminals were seen as tiny immunoreactive dots. Some of the nerve terminals were observed close to disc cells, possibly suggesting direct interaction.. Small nerve terminals in disc herniations, both sensory substance P endings and sympathetic C-flanking peptide of neuropeptide Y endings, could be involved in mechanisms of discogenic pain, disc tissue neurogenic inflammation, tissue repair processes after injury, and control of local blood circulation in the newly formed blood vessels. Disc cells may be directly affected by the neuropeptides released from nearby nerve terminals.

Topics: Adult; Autonomic Nervous System; Female; Humans; Immunohistochemistry; Intervertebral Disc Displacement; Lumbar Vertebrae; Male; Middle Aged; Nerve Endings; Neuropeptide Y; Peptide Fragments; Sensation; Staining and Labeling; Substance P; Synaptophysin

Neuropeptide Y (NPY) was measured in central and peripheral cerebrospinal fluid (CSF) in patients suffering from various intracranial disorders. The central NPY-like immunoreactivity (LI) level showed a concentration of 129 +/- 19 pmol.l-1 and was significantly increased (p less than 0.05) compared to peripheral CSF (73 +/- 9 pmol.l-1). From five patients with subarachnoid haemorrhage the CSF NPY-LI levels reached 154 +/- 47 pmol.l-1. In five patients peripheral and central CSF was collected at the same occasion and the CSF NPY-LI concentration was 76 +/- 17 pmol.l-1 in peripheral and 142 +/- 23 pmol.l-1 in central CSF (p less than 0.01), respectively. In a reference group of 9 patients, who were examined by lumbar myelography because of suspected intervertebral herniated discs, the peripheral CSF NPY-LI concentration was 59 +/- 5 pmol.l-1 a value which was also significantly lower compared to NPY-LI levels in central CSF. Thus it is obvious that NPY is present in human CSF with a relatively higher concentration in central than in peripheral CSF at least in patients with disorders of the central nervous system, suggesting a central origin of the NPY.

Topics: Brain Diseases; Brain Neoplasms; Humans; Intervertebral Disc Displacement; Neuropeptide Y