Role of lipid-phospholipid state in the development of neurodegeneration due to compression of spinal roots

I.Yu. Bagmut, V.V. Pogorelov, V.I. Zhukov


Background. The study deals with the pathophysiological changes in nervous tissue at spinal roots ischemia and the search for neurodegradation markers at the early stages of the pathological process for more effective treatment. The purpose of the study: to determine structural changes in lipid metabolism in spinal roots compression and their relationship to the vascular growth factor (VEGF-A) under the influence of pathogenetically oriented therapy. Materials and methods. Seventy-six patients with chronic spinal roots compression are divided into 2 groups. Patients in the first group (31 patients) received a complex therapy with pentoxifylline, whereas 45 patients in group 2 received melatonin C3 in addition to this therapy. Serotonin, VEGF-A indexes were studied, lipid oxidation status was evaluated by malonic dialdehyde content. Also, the rates of total cholesterol, high-density lipoprotein cholesterol, sphingomyelin, and glutathione peroxidase were assessed. Results. Before treatment, the patients were detected with an increase in malonic dialdehyde, IL-1β, IL-6 and TNF-α, which indicates the development of immune inflammation as a result of the release of free radicals and accumulation of neurotoxic substances and increased oxidative stress. There were also an increase of total cholesterol and VEGF-A, reduced high-density lipoprotein cholesterol, sphingomyelin, glutathione peroxidase and serotonin. The complex therapy added with pentoxifylline in combination with melatonin leads to the decrease in malonic dialdehyde, VEGF-A, proinflammatory interleukins and increase in total cholesterol, high-density lipoprotein cholesterol, sphingomyelin, glutathione peroxidase and serotonin. Thus, ele-vated levels of high-density lipoprotein cholesterol and sphingomyelin after treatment contributed to the ordering of the lipid bilayer of the neuron-vascular membranes and led to a more rapid recovery and reparation of the conductive function of spinal roots and prevented the development of radiculomyelopathy. Conclusions. Compression of spinal roots showed changes in the activity of VEGF-A, neurohormones, and exacerbation of immune inflammation, which caused damage to the vascular neuronal cells of the membranes of spinal roots and led to the accumulation of neurotoxic products that cause intraneural damage with development of radiculomyelopathy. The use of pentoxifylline in combination with melatonin led to normalization of the above indicators and resulted in faster restoration of the structure and function of the nervous tissue and prevented the formation of radiculomyelopathy.


compression ischemic radiculomyelopathy; VEGF-A; lipid-phospholipid metabolism; neurohormones; interleukins; pentoxifylline + melatonin


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