Pain Management

Chronic Pain Management

The Red Wine Polyphenol Resveratrol Shows Promising Potential for the Treatment of Nucleus Pulposus–Mediated Pain In Vitro and In Vivo

Wuertz K, Quero L, Sekiguchi M, et al (Univ of Zurich, Switzerland; Fukushima Med Univ, Japan; et al) Spine 36:E1372-E1384, 2011^§

Abstract

Study Design

Descriptive and mechanistic investigation of the anti-inflammatory and anticatabolic effect of resveratrol in intervertebral discs (IVDs) in vitro and of the analgetic effect in vivo.

Objective

To determine whether resveratrol may be useful in treating nucleus pulposus (NP)–mediated pain.

Summary of Background Data

Proinflammatory cytokines seem to be key mediators in the development of NP-mediated pain. Patients with discogenic or radiculopathic pain may substantially benefit from anti-inflammatory substances that could be used in a minimal-invasive treatment approach. Resveratrol, a polyphenolic phytoalexin found in red wine exhibits anti-inflammatory effects in various cell types and tissues, but no data exists so far with regards to the IVD in the context of low back and leg pain.

Methods

In part 1, the anti-inflammatory and anticatabolic effect of resveratrol was investigated in a cell culture model on interleukin 1β (IL-1β) prestimulated human IVD cells on the gene and protein expression level. In part 2, the molecular mechanisms underlying the effects observed upon resveratrol treatment were investigated (toll-like receptors, nuclear factor κB, sirtuin 1 (SIRT1), mitogen-activated protein (MAP) kinases p38/ERK/JNK). In part 3, the analgetic effects of resveratrol were investigated in vivo using a rodent model of radiculopathy and von Frey filament testing. All quantitative data were statistically evaluated either by Mann-Whitney U test or by one-way analysis of variance and Bonferroni post hoc testing (P < 0.05).

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