Higher levels of antibodies against the psoriasis-associated antigen Pso p27 in cerebrospinal fluid from patients with low back pain and sciatica

Design. A prospective study comparing the presence of antibodies against th e psoriasis-associated antigen pso p27 in pain-free Control subjects and pa tients with low back pain and/or sciatica. Objectives. To analyze the amount of local inflammation present Inhuman lum bar disc disorders, using anti.. pso p27 antibodies tn me cerebrospinal flu id as a marker and to analyze whether pain intensity correlates with this m arker of inflammation. Summary of Background Data, Pso p27 is a major antigen in psoriasis that is also present, mostly locally, in other inflammatory disorders, such as sar coidosis, inflammatory bowel disease, and ankylosing spondylitis. Inflammat ion is also thought to play a major role in the generation of lumbar and ra dicular pain in degenerative disc disorders. Methods. Anti-pso p27 antibodies in cerebrospinal fluid were quantified usi ng an indirect enzyme-linked immunosorbent assay with pso p27 obtained from patients with psoriasis for use as an antigen. Fifteen patients with spina l, stenosis, 11 patients without myelographic disc herniation, 17 patients with disc herniation, and 24 pain-free patient control subjects were studie d. Results. Significantly higher levers of anti-pso p27 antibodies were found in patients with myelographic signs of disc herniation than in with patient s with no signs of herniation, patients with spinal stenosis, and control s ubjects Patients with no known signs of disc herniation and patients with m yelographic signs of spinal stenosis (<10 mm: in diameter) caused by degene rative changes, had higher levels of anti-pso p27 antibodies than did contr ol subjects. However, these differences reached only borderline statistical significance, Conclusions. The results support those in previous reports, that inflammati on probably plays an important role in degenerative disk disorders, particu larly in disk :herniations. that there.-was no correlation between pain int ensity and anti-pso p27 activity indicates that the antigen is probably not essential in pain generation per se. The results may indicate that pso p27 is expressed secondary to, not as an initiator of, inflammation.