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Systemic blood biomarker levels higher in patients with moderate-to-severe lumbar degeneration
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SAN FRANCISCO — It may eventually prove more cost-effective to determine whether a patient has lumbar degenerative disc disease by identifying the presence of the proinflammatory chemokines CCL5 and CXCL6A, which are biomarkers in the blood, than it is to perform an MRI, according to a presenter here.
“We believe these may be potential biomarkers to use when you review the diagnostic and therapeutic options,” Dino Samartzis, DSc, PhD(C), MSc, MRIPH, Dip EBHC, said at the International Society for the Study for the Lumbar Spine Annual Meeting.
In a multicenter study, Samartzis and colleagues studied the more than 3,500 Southern Chinese volunteers with lumbar disc degeneration (DD) who have been recruited to date, most of whom had 5 years to 10 years follow-up data available.
Dino Samartzis
“We have actually had MRIs and X-rays done to assess and profile [the patients],” he said, noting other information, including lifestyle and risk factors specifically related to spinal degeneration and pain, were also available for the patients.
From the larger group, the researchers obtained peripheral blood plasma samples from 40 volunteers whose MRIs showed no lumbar DD based on their Schneiderman score. They were matched by age, BMI, sex and workload to 40 patients with Schneiderman scores that showed moderate-to-severe lumbar DD. ELISA was then used to determine the concentration of CCL5 / RANTES and CXCL6 in both groups.
“Between the two groups, the demographics did not differ whatsoever. [With regard to] the levels of CCL5 in the blood, we noticed something very striking: that individuals who had … moderate-to-severe forms of disc degeneration had significantly higher levels of CCL5 in the blood. We also saw this with the chemokine CXCL6,” Samartzis said.
The elevated levels demonstrated, upon subsequent research, the ability to be a good predictor of DD in the lumbar, but not the cervical spine, he said.
“With regard to cervical disc changes, we really did not see any difference between these elevated levels, suggesting that what we may be seeing may be coming from the lumbar spine, more or less,” Samartzis said. “In conclusion, this is the first study to our knowledge that is actually assessing, and identifying, that elevated systemic blood plasma levels of CCL5 and CXCL6 were associated with moderate-to-severe lumbar DD on MRI in humans,” Samartzis said.
A study by Sowa and colleagues supports his group’s findings concerning CCL5, he said. – by Susan M. Rapp
References:
Grad S, et al. Paper #29. Presented at: International Society for the Study of the Lumbar Spine Annual Meeting; June 8-12, 2015; San Francisco.
Sowa GA, et al. J Am Geriatr Soc. 2014;doi:10.1111/jgs.13102.
Disclosure: Samartzis reports the project was funded by AOSpine International.