NF-kB decoy oligodeoxynucleotide preserves disc height in a rabbit anular-puncture model and reduces pain induction in a rat xenograft-radiculopathy model
1 Department of Orthopedic Surgery, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
2 Department of Orthopedic Surgery, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA
3 Department of Orthopedic Surgery, Mie University, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
4 Department of Orthopedic Surgery, Rush University Medical Center, 1611 West Harrison St. Suite 300, Chicago, IL 60612, USA
5 Department of Orthopedic Surgery, Kobe University, 7-5-1 Kusunokimachi, Chuo-ku, Kobe, Hyogo 650-0017, Japan
6 Spine Center, Gifu Municipal Hospital, 7-1 Kashima-cho, Gifu, Gifu 500-8513, Japan
7 Department of Orthopedic Surgery, Murase hospital, 3-12-10 Kanbe, Suzuka, Mie 513-0801, Japan
8 AnGes, Inc. 4-13-3, Shiba, Minato-ku, Tokyo 108-0014, Japan
§ These authors equally contributed to this paper
Abstract
While it is known that the degenerated intervertebral disc (IVD) is one of the primary reasons for low-back pain and subsequent need for medical care, there are currently no established effective methods for direct treatment. Nuclear factor-κB (NF-κB) is a transcription factor that regulates various genes’ expression, among which are inflammatory cytokines, in many tissues including the IVD. NF-κB decoy is an oligodeoxynucleotide containing the NF-κB binding site that entraps NF-κB subunits, resulting in suppression of NF-κB activity. In the present preclinical study, NF-κB decoy was injected into degenerated IVDs using the rabbit anular-puncture model. In terms of distribution, NF-κB decoy persisted in the IVDs up to at least 4 weeks after injection. The remaining amount of NF-κB decoy indicated that it fit a double-exponential-decay equation. Investigation of puncture-caused degeneration of IVDs showed that NF-κB decoy injection recovered, dose-dependently, the reduced disc height that was associated with reparative cell cloning and morphological changes, as assessed through histology. Gene expression, by quantitative real-time polymerase chain reaction (qRT-PCR), showed that NF-κB decoy attenuated inflammatory gene expression, such as that of interleukin-1 and tumor necrosis factor-α, in rabbit degenerated IVDs. NF-κB decoy also reduced the pain response as seen using the “pain sensor” nude rat xenograft-radiculopathy model. This is the first report demonstrating that NF-κB decoy suppresses the inflammatory response in degenerated IVDs and restores IVD disc height loss. Therefore, the intradiscal injection of NF-κB decoy may have the potential as an effective therapeutic strategy for discogenic pain associated with degenerated IVDs.
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