Roles of thromboxane A2 and leukotriene B4 in radicular pain induced by herniated nucleus pulposus

Abstract Biologically active substances, such as prostaglandins, thromboxanes, and leukotrienes, which are metabolites involved in the arachidonic acid cascade, are detected in herniated disc samples obtained from patients with lumbar disc herniation. However, little is known concerning the relationships between these substances and clinical symptoms such as radicular pain. Thromboxane A 2 (TXA 2 ) induces not only potent platelet aggregation, but also blood vessel contraction. Leukotriene B 4 (LTB 4 ), a potent chemotactic agent, plays a role in inflammatory reactions by recruiting neutrophils and lymphocytes. The purpose of this study was to examine the roles of TXA 2 and LTB 4 in the hyperalgesia induced by application of nucleus pulposus to the lumbar nerve root in the rat. TXA 2 synthetase inhibitor and LTB 4 receptor antagonist, which were injected into the epidural space, decreased mechanical hyperalgesia at both three and seven days after epidural injection. There were no significant differences in sensitivity to noxious thermal stimuli following application of the nucleus pulposus or an epidural injection. Epidural injection of LTB 4 receptor antagonist and/or TXA 2 synthetase inhibitor may attenuate the painful radiculopathy due to lumbar disc herniation. In conclusion, our findings suggest that TXA 2 and LTB 4 may play significant roles in mechanical hyperalgesia induced by autologous nucleus pulposus. © 2001 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.