THE ROLE OF CYTOKINE INHIBITORS AND CORTI COSTEROIDS IN PATHOPHYSIOLOGY AND TREATMENT OF NERVE ROOT INFLAMMATION

Immunological changes have been stated as one factor in the developmen t of painful radiculopathies. The aim of this study was to determine t he effect of cytokineinhibitors on the electrophysiological changes se en in experimentally autoimmune damaged lumbar nerve roots. 18 inbred female Lewis rats were sensitized with homogenates of the peripheral n ervous system. Experimental allergic radiculitis (EAR) was triggered b y inoculation with 3 mg myelin in 150 mu l normal saline with an equal volume of complete Freund's adjuvant containing 20 mg/ml Mycobacteriu m tuberculosis. Rats were treated either with Interleukin-1 Receptor A natagonist Protein, either with high dose prednisolone, or saline inje ctions. For neurophysiological evaluation evoked potential technique w as performed. One week after injection controll-animals developed clea r clinical and neurophysiological symptoms. The antiinflammatory effec t of prednisolone was higher compared to IL- 1 ra, but antiinflammator y effect of IL-l ra was still significantly higher compared to control ls (Fig. 1,2). Our results indicate that IL- 1 plays a role in lumbar radiculitis. Our results also show that cytokineinhibitors have a bene fical effect on the clinical and neurophysiological parameters of expe rimental radiculitis. This is of major importance since there are seve ral natural substances known, which inhibit cytokine effects in vitro. Furthermore regarding efficiency and side effects a genetherapeutical approach is of interest.