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Moon, Park, Kim, Kim, and Lee: Phospholipase A2 in Herniated Lumbar Discs : Its Relevance to Pain
Original Article

Journal of Korean Spine Surg 2002;9(1):8-13.

Published online: 21 February 2002

DOI: https://doi.org/10.4184/jkss.2002.9.1.8

Phospholipase A2 in Herniated Lumbar Discs : Its Relevance to Pain

Seong-Hwan Moon, M.D., Moon-Soo Park, M.D., Hyang Kim, B.A., Hak-Sun Kim, M.D., Hwan-Mo Lee, M.D.

Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea

Address reprint requests to Hwan-Mo Lee, M.D. Department of Orthopaedic Surgery, College of Medicine, Yonsei University, Young-dong Severance Hospital, Young-dong PO Box 1217, Seoul, Korea Tel : 82-2-361-5648, Fax : 82-2-363-1139, E-mail : hwanlee@yumc.yonsei.ac.kr

Copyright © 2002 Korean Society of Spine Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A prospective study.

Objective

To determine whether phospholipase A 2(PLA 2) activity in herniated lumbar disc is correlated with clinical, radiographic and anatomic signs of the patients with herniated nucleus pulposus.

Summary of Literature Review

Several studies have suggested inflammation around nerve root as a mechanism of sciatica and PLA 2 emerges as a key enzyme of the inflammation. However, consensus about association between PLA 2 and sciatica has been lacking. In addition, there has been no report that investigated the relationship between cytosolic and membrane PLA 2 in herniated disc and patient's symptoms.

Materials and Methods

Human intervertebral disc materials were obtained from 33 patients who underwent discectomy for HNP. The information was noted about smoking history, medication of NSAID, symptom duration, pain score on a visual analog scale(VAS), positive angle of straight leg raising test (SLR), neurologic deficits, Thompson grade of herniated disc, volume of herniation shown by the MRI and type of herniation based on the operative record. These data were matched to the PLA 2 activity in herniated disc measured using Western blotting analysis. PLA 2 activity was expressed as the relative percentage compared to that of a 33- year- old female disc obtained during an operation for spinal fracture. The analysis was carried out using Mann-Whitney test, Pearson correlation analysis, simple linear regression analysis. A value of p<0.05 was considered significant.

Results

Cytosolic and membrane PLA 2 activity showed no statistical relationship to clinical, radiographic and anatomic characteristics of herniated disc. However, membrane PLA 2(active form) activity was correlated with the pain score on VA S(p=0.013, r=0.481), while cytosolic PLA 2(latent form) showed no statistically significant correlation with the pain score.

Conclusion

This study demonstrates that membrane PLA2 activity is correlated with the pain score. It also suggests that selective PLA2 inhibitors could be used for the alternative treatment modality of HNP.

Keywords: Herniated lumbar disc, Phospholipase A 2, Clinical relevance

REFERENCES

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Figures and Tables%

Fig. 1.
Comparison of disc PLA2 activity as Thompson grade. p value > 0.05
jkss-9-8f1.tif
Fig. 2.
Comparison of disc PLA2 activity as volume of disc herniation. p value > 0.05
jkss-9-8f2.tif
Fig. 3.
Comparison of disc PLA2 activity as type of disc herniation. p value > 0.05
jkss-9-8f3.tif
Fig. 4.
Correlation between cytosolic disc PLA2 activity and the patient's pain score on a visual analog scale. Cytosolic PLA 2 activity showed no statistical relationship to the patient's pain score. Fig. 5. p value > 0.05
jkss-9-8f4.tif
Fig. 5.
Correlation between membrane disc PLA2 activity and the patient's pain score on a visual analog scale. Membrane PLA2 activity was correlated with the patient's pain score on a visual analog scale. Fig. 5. r=0.481, p=0.013
jkss-9-8f5.tif
Table 1.
Relative activity of cytosolic PLA2 in patients with different patient's history and clinical manifestation.
Positive(%) Negative(%) p-value
Smoker 102.6± 12.2 88.7± 26.8 NS
NSAID user 90.2± 25.1 103.8± 13.9 NS
Motor dysfunction 96.2± 25.8 90.8± 21.9 NS
Motor dysfunction 93.1± 24.2 93.3± 23.4 NS

NS : not significant

Table 2.
Relative activity of membrane PLA2 in patients with different patient's history and clinical manifestation.
Positive(%) Negative(%) p-value
Smoker 104.0± 9.9 96.5± 21.3 NS
NSAID user 94.2± 21.4 107.4± 8.4 NS
Motor dysfunction 102.6± 13.0 97.6± 20.1 NS
Sensory dysfunction 99.8± 15.7 99.8± 19.3 NS

NS : not significant

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