Access to the text (HTML) Access to the text (HTML)
PDF Access to the PDF text

Access to the full text of this article requires a subscription.
  • If you are a subscriber, please sign in 'My Account' at the top right of the screen.

  • If you want to subscribe to this journal, see our rates

  • You can purchase this item in Pay Per ViewPay per View - FAQ : 30,00 € Taxes included to order
    Pages Iconography Videos Other
    8 0 0 0

Joint Bone Spine
Volume 73, n° 3
pages 270-277 (mai 2006)
Doi : 10.1016/j.jbspin.2005.03.004
Received : 31 January 2005 ;  accepted : 9 Mars 2005
Pathophysiology of disk-related low back pain and sciatica. II. Evidence supporting treatment with TNF- antagonists

Denis Mulleman a, b, Saloua Mammou b, Isabelle Griffoul b, Hervé Watier a, Philippe Goupille a, b,
a François Rabelais de Tours University, EA 3853 Immuno-Pharmaco-genetics of Therapeutic Antibodies (IPGA), Tours, France 
b Rheumatology Department, CHU, Trousseau Teaching Hospital, 37044 Tours cedex 9, France 

*Corresponding author. Tel.: +33 2 47 47 59 17; fax: +33 2 47 47 46 39.

Strong evidence suggests that TNF- may be among the chemical factors involved in disk-related sciatica. TNF- is involved in the genesis of nerve pain in animal models and may promote pain-signal production from nerve roots previously subjected to mechanical deformation. In animal experiments, TNF- has been identified in nucleus pulposus and Schwann cells. Local production of endogenous TNF- may occur early in the pathogenic process. Exposure to exogenous TNF- induces electrophysiological, histological, and behavioral changes similar to those seen after exposure to nucleus pulposus, and these changes are more severe when mechanical compression is applied concomitantly. TNF- antagonists diminish or abolish abnormalities in animal models. Other cytokines may be involved also, as suggested by the potent inhibitory effects of compounds such as doxycycline. Two open-label studies in humans suggest dramatic efficacy of TNF- antagonists in alleviating disk-related sciatica. In contrast, the results of the only controlled study available to date do not support a therapeutic effect of TNF- antagonists. Thus, whether TNF- antagonist therapy is warranted in patients with disk-related sciatica remains an open question, and further randomized controlled studies are needed.

The full text of this article is available in PDF format.

Keywords : Disk-related sciatica, Tumor necrosis factor alpha, TNF- antagonists

© 2005  Elsevier SAS. All Rights Reserved.
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Article Outline