Regulation of Nerve Growth Factor by Anti-Inflammatory Drugs, a Steroid, and a Selective Cyclooxygenase 2 Inhibitor in Human Intervertebral Disc Cells Stimulated With Interleukin-1

Study Design. Regulation of nerve growth factor (NGF) by 2 different anti-inflammatory drugs was investigated in vitro using isolated human intervertebral disc (IVD) cells stimulated with the proinflammatory cytokine interleukin-1 (IL-1). Objective. To investigate the regulation of NGF by a synthetic steroid and a selective cyclooxygenase-2 (COX-2) inhibitor and to clarify the biological role of prostaglandin E-2 (PGE(2)) in this process. Summary of Background Data. NGF is known to play an important role in pain, including low back pain, and to be induced by proinflammatory cytokines in IVD cells. However, the effect of clinically used drugs for managing low back pain on the regulation of NGF is unclear. Methods. Isolated human IVD cells were stimulated with interleukin-1 (IL-1) in the presence or absence of dexamethasone or a selective COX-2 inhibitor (NS-398). NGF expression and release were determined by real-time polymerase chain reaction and enzyme-linked immuno sorbent assay, respectively. Inhibition of PGE(2) release was determined by enzyme-linked immuno sorbent assay. The effects of exogenous PGE(2) and its receptor (E-series prostanoid receptors [EPs] 1-4) agonists were also tested for NGF regulation. Results. IL-1 transiently induced, in a dose-dependent manner, the induction of NGF in human IVD cells. Pretreatment with dexamethasone strongly inhibited the NGF expression, whereas NS-398 significantly enhanced it at the concentration at which PGE(2) release was substantially inhibited. Exogenous PGE(2) inhibited IL-1 induction of NGF and this effect was mimicked when EP2 and EP4, but not EP1 and EP3, agonists were supplemented to the culture. Conclusion. Although selective COX-2 inhibitors have been shown to be effective for acute low back pain by inhibiting PGE(2) release, our findings suggest that it may have a limited efficacy because it exaggerated NGF expression, whereas dexamethasone inhibited it. On the other hand, PGE(2) had an inhibitory function for NGF induction by mediating EP2/4 in human IVD cells. Further studies are needed to clarify whether these observations could take place in vivo.