Effi­cacy of Epidural Per­ineural Injec­tions With Autol­o­gous Con­di­tioned Serum for Lum­bar Radic­u­lar Com­pres­sion (pdf)

Cordelia Becker, Ste­fan Hei­der­s­dorf, Sascha Drewlo, Sonja Zirke de Rodriguez, Juer­gen Kramer and Roland Ernst Willburger

Evi­dence from ani­mal stud­ies indi­cates that cytokines such as interleukin-​1 play a deci­sive role in the patho­phys­i­ol­ogy of lum­bar radicu­lopa­thy. ACS is enriched in the interleukin-​1 recep­tor antag­o­nist and other anti-​inflammatory cytokines. Thirty-​two patients were treated by epidural per­ineural injec­tions with ACS; 27 patients were treated with 5 mg tri­am­ci­nolone and 25 patients with 10 mg tri­am­ci­nolone. Treat­ment was applied once per week for 3 con­sec­u­tive weeks and fol­lowed for 6 months.

Effi­cacy of Epidural Injec­tions with Orthokine™-derived Autol­o­gous Con­di­tioned Serum (ACS) for Lum­bar Radicu­lopa­thy (pdf)

C. Moser, C. Becker, D.W. Groen­e­meyer, P. Wehling

Based on what is known so far about the mech­a­nisms involved in processes lead­ing to inflam­ma­tion and back pain, the inhi­bi­tion of cata­bolic cytokines, the local admin­is­tra­tion of autol­o­gous ana­bolic growth fac­tors — or both together — appear to be log­i­cal and promis­ing approaches to ther­apy. A new method based on expo­sure of blood leuko­cytes to glass beads elic­its an accu­mu­la­tion of anti-​inflammatory cytokines, includ­ing IL-​1Ra, and sev­eral growth fac­tors, includ­ing IGF-​1, PDGF, TGF-​ß1 and prob­a­bly many others.

Poten­tial Bio­logic Ther­a­pies for the Inter­ver­te­bral Disc (pdf)

Christo­pher Evans

Biol­ogy offers sev­eral strate­gies for restor­ing the degen­er­at­ing disc, includ­ing the use of recom­bi­nant or nat­ural pro­teins that increase matrix accu­mu­la­tion and assem­bly, enhance the num­ber of disc cells, or in other ways lead to restora­tion of the native healthy disc. Recom­bi­nant bone mor­pho­genetic protein-​7 (osteogenic protein-​1) shows promise in this regard. Other growth fac­tors, as well as cytokine antag­o­nists such as the interleukin-​1 recep­tor antag­o­nist, are also good can­di­dates. Because disc degen­er­a­tion is a chronic, pro­gres­sive dis­or­der occur­ring over many years, it is likely that growth fac­tors and other ther­a­peu­tic pro­teins will need to be present in the disc for extended peri­ods of time. The intradis­cal injec­tion of recom­bi­nant or nat­ural pro­teins is unlikely to ful­fill this require­ment. In this sce­nario, the deliv­ery of genes that encode the pro­tein in ques­tion may pro­vide a bet­ter deliv­ery sys­tem. Kang and asso­ciates have pio­neered this strat­egy, demon­strat­ing the respon­sive­ness of disc cells to in situ genetic modification.

Intradis­cal Injec­tions of Orthokine™-derived Autol­o­gous Con­di­tioned Serum (ACS) for Lum­bar Disc Pain (pdf)

C. Moser, D.W. Groen­e­meyer, T. Paduch, J. Becker, J. Hart­mann, P. Wehling

Biol­ogy offers sev­eral strate­gies for restor­ing the degen­er­at­ing disc, includ­ing the use of nat­ural pro­teins that increase matrix accu­mu­la­tion and assem­bly, enhance the num­ber of disc cells, or in other ways lead to restora­tion of the native healthy disc. Based on what is known so far about the mech­a­nisms involved in processes lead­ing to inflam­ma­tion the inhi­bi­tion of cata­bolic cytokines, the local admin­is­tra­tion of autol­o­gous ana­bolic growth fac­tors, or both together appear to be log­i­cal and promis­ing approaches to therapy.

Wirk­samkeit von Autolo­gem Orthokin® Con­di­tion­ierten Serum im Ver­gle­ich zu Tri­am­ci­nolon bei der epidural-​perineuralen Injek­tions­be­hand­lung von lum­balen Ner­ven­wurzelkom­pres­sion­ssyn­dromen (pdf)

C. Becker, S. Heidersdorf,S. Drewlo, S. Zirke de Rodriguez, J. Krämer, R. Willburger

State of the art” in der Behand­lung von lum­balen Ner­ven­wurzelkom­pres­sion­ssyn­dromen sind epidural verabre­ichte Steroide, jedoch ist die Effek­tiv­ität, auch in Zusam­men­hang mit möglichen Neben­wirkun­gen, in der aktuellen Lit­er­atur kon­tro­vers. Eine Alter­na­tive zu Kor­tikoiden kön­nte IL-​1Ra darstellen, das eine wesentliche Rolle in der Patho­phys­i­olo­gie der Radiku­lopathie spielt. Es existiert eine neue und ein­fache Meth­ode um autologes IL1-​Ra (Orthokin®) herzustellen. IL1-​Ra kon­di­tion­iertes Serum ist anti­noz­izep­tiv und antiinflammatorisch.