PRELIMINARY-STUDY OF AN INCREASE OF A PLASMA APOLIPOPROTEIN-E VARIANTASSOCIATED WITH PERIPHERAL-NERVE DAMAGE - A FINDING IN PATIENTS WITH CHRONIC SPINAL PAIN

Study Design. This two-dimensional gel electrophoretic study analyzed the plasma of six groups of patients to determine the association of a n elevated apolipoprotein E variant with peripheral nerve damage (PND) . Objectives. To find a statistically significant plasma protein alter ation in patients with PND including chronic spinal pain. Summary of B ackground Data. A twofold to fivefold increase in human plasma apolipo protein E may be a physiologic response to PND as a 250-fold local inc rease in apolipoprotein E was reported in experimental PND studies in mammals. Methods, A total of 36 patients with chronic lumbar pain, 28 normal control subjects, and 33 patients with other conditions were st udied. Venipuncture was performed and plasma was studied using the tec hnique of two-dimensional gel electrophoresis. Chi-square analysis was used to evaluate results. Results. A statistically significant (P < 0 .005) elevation of the plasma apolipoprotein E variant was found in pa tients with chronic lumbar pain. It also was elevated in patients with chronic cervical pain, extraspinal pain with PND, and chronic inflamm atory diseases; but not in extraspinal pain without PND, or asymptomat ic biomechanically deficient lumbar spines. Conclusions. This quantita tive protein alteration, although not specific for PND, may prove usef ul in the treatment of conditions with this disorder, including chroni c spinal pain.