Immunomorphogenesis in Degenerative Disc Disease: The Role of Proinflammatory Cytokines and Angiogenesis Factors.

Back pain (BP) due to degenerative disc disease (DDD) is a severe, often disabling condition. The aim of this study was to determine the association between the expression level of proinflammatory cytokines (IL-1ß, IL-6, and IL-17), angiogenesis markers (VEGF-A and CD31) in intervertebral disc (IVD) tissue and IVD degeneration in young people with discogenic BP. In patients who underwent discectomy for a disc herniation, a clinical examination, magnetic resonance imaging of the lumbar spine, histological and immunohistochemical analyses of these factors in IVD were performed in comparison with the parameters of healthy group samples (controls). Histology image analysis of IVD fragments of the DDD group detected zones of inflammatory infiltration, combined with vascularization, the presence of granulation tissue and clusters of chondrocytes in the tissue of nucleus pulposus (NP). Statistically significant increased expression of IL-1ß, IL-6, IL-17, VEGF-A and CD31 was evident in the samples of the DDD group compared with the controls, that showed a strong correlation with the histological disc degeneration stage. Our results denote an immunoinflammatory potential of chondrocytes and demonstrates their altered morphogenetic properties, also NP cells may trigger the angiogenesis.

Comparison of rilmenidine and lisinopril on ambulatory blood pressure and plasma lipid and glucose levels in hypertensive women with metabolic syndrome.

OBJECTIVE: In previous studies, the I1 imidazoline specific agonist rilmenidine effectively lowered office blood pressure (BP) in patients with metabolic syndrome, improved glucose metabolism and did not demonstrate unfavourable effects on plasma lipids. The aim of the present study was to investigate the effects of 12weeks therapy with rilmenidine compared with the ACE inhibitor lisinopril on ambulatory BP, plasma lipid and fasting glucose levels in women with metabolic syndrome. RESEARCH DESIGN: Prospective randomised open-label, blinded end-points study. METHODS: Female patients (n = 51) with hypertension and other components of metabolic syndrome were treated with 1 mg rilmenidine (n = 24) or 10 mg lisinopril (n = 27), once- or twice-daily. Anthropometric measurements, office BP and heart rate (HR) measurements, ambulatory BP monitoring, lipid and fasting glucose assessment were performed before and after 12weeks of treatment MAIN OUTCOME MEASURES: Changes in ambulatory BP and HR, including 24-h, daytime and night-time values, and in lipids and glucose levels. All changes were adjusted for baseline values using the analysis of covariance method. RESULTS: Ambulatory 24-h systolic BP and diastolic BP were decreased significantly in the rilmenidine group (-11.9 +/- 1.9 and -7.7 +/- 0.8 mm Hg, p < 0.001) respectively and the lisinopril group (-11.0 +/- 1.8 and -6.7 +/- 0.7 mm Hg respectively, p < 0.001). There were no significant differences between the two groups. Rilmenidine reduced 24-h ambulatory HR (-3.6 +/- 0.8 bpm versus 0.3 +/- 0.8 bpm with lisinopril; p = 0.002). The reductions of day-time and night-time BP were also significant for both treatment groups, but the rilmenidine group demonstrated a greater decrease in night-time diastolic BP (p = 0.046). Rilmenidine significantly increased HDL cholesterol and decreased fasting glucose levels (p = 0.009 and p = 0.012, respectively). HDL cholesterol tended to increase and fasting glucose tended to decrease in the lisinopril group. However, differences between groups were not significant. CONCLUSION: Rilmenidine has similar effects on ambulatory BP patterns in hypertensive women with metabolic syndrome as lisinopril. Rilmenidine compared with lisinopril significantly reduces ambulatory HR. In this study, rilmenidine and lisinopril demonstrate similar effects on plasma lipid and fasting glucose levels.

Relationships between erythrocyte membrane properties and components of metabolic syndrome in women.

BACKGROUND: Membrane structure in metabolic syndrome has not been fully investigated. The aim of our study was to determine the relationship between structural parameters of the erythrocyte membrane and blood pressure, indices of obesity, plasma lipids, and glucose levels in female patients with metabolic syndrome. MATERIAL/METHODS: In 23 women with metabolic syndrome and 12 control normotensive women, anthropometric indices, blood pressure, and serum lipids were evaluated and an oral glucose tolerance test was performed. Erythrocyte membranes obtained from these patients were investigated by electron spin resonance spectroscopy and the spin-labeling method. The order parameter S (membrane microviscosity), parameter h (index of membrane hydrophobicity), and the a/b ratio (index of the membrane surface configuration) were calculated. Data were analyzed using univariate correlation and stepwise multiple regression analysis. RESULTS: All membrane parameters differed significantly in women with metabolic syndrome from controls (P<0.001). The order parameter S was negatively related to waist circumference (R=-0.59, P<0.01) and positively to systolic blood pressure (R=0.44, P<0.05). Negative correlations of parameter h and the a/b ratio with postload plasma glucose level (R=-0.60 and -0.63, respectively, P<0.01) were observed. In stepwise multiple regression analysis the variation in the order parameter S was mainly explained by waist circumference and systolic BP (52%), and in parameter h and a/b ratio by postload glucose level (35% and 34%, respectively). CONCLUSIONS: Erythrocyte membrane structural changes in women are associated with features of metabolic syndrome, especially with abdominal obesity, high systolic blood pressure, and postload glucose level.