Autoimmunity in intervertebral disc herniation: from bench to bedside

Alberto Di Martino, Luciano Merlini, Cesare Faldini

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Introduction: The cause of low back pain and the pathophysiology of lumbar pain and sciatica have recently been reconsidered basing on current knowledge on cellular and molecular mediators of inflammation. Several cytokines have been considered as potential therapeutic targets to contrast sciatica in patients with disc herniation, and supportive studies suggest a leading role of TNF-α in this contest: therefore, clinical trials have tested TNF-α inhibitors in the clinical setting of the patient with radicular pain secondary to an herniated disc. Areas covered: The current review deals with the autoimmune theory of disc herniation and its role in determining radiculopathy and neuropathic pain. It also reports the recent evidences that led to the introduction of anti-TNF-α drugs into the clinical setting as a biological therapy for radiculopathy and disc herniation. Expert opinion: Targeting the TNF-α pathway has demonstrated controversial effects in the tested study population and available results only report a short-term follow-up. More confirmatory studies in terms of long-term clinical results, complications, more effective route of administration and cost-effective analysis are required to establish the real role of this biological therapy in the treatment of patients with disc herniation and neuropathy.

Original languageEnglish
Pages (from-to)1461-1470
Number of pages10
JournalExpert Opinion on Therapeutic Targets
Volume17
Issue number12
DOIs
Publication statusPublished - Dec 2013

Fingerprint

Inflammation Mediators
Intervertebral Disc
Autoimmunity
Sciatica
Biological Therapy
Radiculopathy
Cytokines
Pharmaceutical Preparations
Costs
Pain
Intervertebral Disc Displacement
Expert Testimony
Neuralgia
Low Back Pain
Clinical Trials
Costs and Cost Analysis
Therapeutics
Population

Keywords

  • Anti-TNF-α
  • Autoimmunity
  • Biological therapy
  • Intervertebral disc herniation
  • Neuropathic pain
  • Sciatica

ASJC Scopus subject areas

  • Drug Discovery
  • Pharmacology
  • Clinical Biochemistry
  • Molecular Medicine

Cite this

Autoimmunity in intervertebral disc herniation : from bench to bedside. / Di Martino, Alberto; Merlini, Luciano; Faldini, Cesare.

In: Expert Opinion on Therapeutic Targets, Vol. 17, No. 12, 12.2013, p. 1461-1470.

Research output: Contribution to journalArticle

Di Martino, Alberto ; Merlini, Luciano ; Faldini, Cesare. / Autoimmunity in intervertebral disc herniation : from bench to bedside. In: Expert Opinion on Therapeutic Targets. 2013 ; Vol. 17, No. 12. pp. 1461-1470.
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