STUDY DESIGN: Prospective observational cohort. OBJECTIVE: Correlate epidural inflammatory cytokines with the clinical response to epidural @entity134 injection in @entity1 with lumbar nerve root irritation. SUMMARY OF BACKGROUND DATA: Some back @entity158 syndromes are thought to be associated with activation of inflammatory pathways and others may be associated with primary mechanical derangements. @entity1 studies providing detailed evidence for the primary inflammatory causation, which may be best treated with anti-inflammatory strategies, are lacking. There are currently no accurate diagnostic tests to predict the response to epidural @entity134 injection or surgical intervention in back @entity158 . METHODS.: Forty-seven consecutive @entity1 with @entity1643 were prospectively enrolled. An epidural lavage was performed, followed by injection of @entity1341 / @entity8745 . Subjects scored their @entity158 before and 3 months after the procedure. The immunoreactivity of an array of cytokines was measured in lavage samples and compared with clinical response to the therapeutic injection. Ten subjects underwent repeat epidural lavage sampling 3 months after the @entity134 injection. RESULTS: @entity379 ( @entity379 ) was the most consistently detected cytokine. @entity379 -immunoreactivity also highly correlated with reported reduction of @entity158 3-months after the epidural @entity134 injection. In subjects reporting significant @entity158 relief (>50%) from the injection, mean [ @entity379 ] was significantly greater compared with @entity1 experiencing no significant relief. The @entity379 -immunoreactivity in repeat lavage samples decreased to trace residual concentrations in @entity1 who reported @entity158 relief from the @entity134 injection. CONCLUSION: The presence of epidural @entity379 -immunoreactivity corresponding to >10 pg/mL predicted significant @entity158 relief after epidural @entity134 injection with >95% accuracy. These results suggest that @entity379 may be part of a biochemical cascade triggering @entity158 in sciatica; @entity379 -immunoreactivity may aid as a biomarker for predicting the response to @entity134 therapy and/or surgical intervention, and may serve as a future therapeutic target.

Epidural XXXX -immunoreactivity: a biomarker for lumbar nerve root irritation.

@entity1 :: ('9606', 'Species') :: ['patients', 'Human'] @entity1643 :: ('MESH:D017116', 'Disease') :: ['lumbar degenerative changes and low back and/or leg pain'] @entity134 :: ('CHEBI:35341', 'Chemical') :: ['steroid'] @entity1341 :: ('MESH:D002045', 'Chemical') :: ['marcaine'] @entity379 :: ('3458', 'Gene') :: ['Interferon gamma', 'IFNgamma'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain', 'pain and sciatica syndromes'] @entity8745 :: ('MESH:C000873', 'Chemical') :: ['depo-medrol']
@entity379 :: (3458,Gene) :: ['interferon gamma']
