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Triamcinolone decreases bupivacaine toxicity to intervertebral disc cell in vitro

Authors
 Ju-Hyung Moon  ;  Sung-Uk Kuh,  ;  Hyo-Suk Park  ;  Kyung-Hyun Kim  ;  Jeong-Yoon Park  ;  Dong-Kyu Chin  ;  Keun-Su Kim  ;  Yong-Eun Cho 
Citation
 Spine Journal, Vol.12(8) : 665-673, 2012 
Journal Title
 Spine Journal 
ISSN
 1529-9430 
Issue Date
2012
MeSH
Anesthetics, Local/toxicity* ; Bupivacaine/toxicity* ; Cell Survival/drug effects* ; Cells, Cultured ; Drug Interactions ; Glucocorticoids/pharmacology* ; Humans ; Intervertebral Disc/cytology ; Intervertebral Disc/drug effects* ; Triamcinolone/pharmacology*
Keywords
Bupivacaine ; Triamcinolone ; Intervertebral disc ; Nucleus pulposus cell ; Cytotoxicity
Abstract
BACKGROUND CONTEXT: Local anesthetics combined with corticosteroids are commonly used for management of back pain in interventional spinal procedures. Several recent studies suggest cytotoxicity of bupivacaine, whereas others report protective and cytotoxic effects of corticosteroids on chondrocytes and intervertebral disc cells. Considering the frequent use of these agents in spinal interventions, it is meaningful to know how they affect intervertebral disc cells. PURPOSE: This study was conducted to assess the effects of bupivacaine and triamcinolone, both alone and in combination, on viability of intervertebral disc cells in vitro. STUDY DESIGN: Controlled laboratory study. METHODS: Nucleus pulposus cells were isolated from human disc specimens from patients undergoing surgery because of disc herniation or degenerative disc disease. They were grown in three-dimensional alginate beads for 1 week to maintain their differentiated phenotypes and to allow for matrix formation before analysis. After 1 week of culture, the cells were exposed to bupivacaine (0.1%, 0.25%, 0.5%, and 1%) or bupivacaine (0.1%, 0.25%, 0.5%, and 1%) with 1 mg of triamcinolone for 1, 3, or 6 hours. Cell viability was measured using trypan blue exclusion assay and flow cytometry. Live cell/dead cell fluorescent imaging was assessed using confocal microscopy. RESULTS: Trypan blue exclusion assays demonstrated dose- and time-dependent cytotoxic effects of bupivacaine on human nucleus pulposus cells. Similar but reduced cytotoxicity was observed after exposure to the combination of bupivacaine and 1 mg of triamcinolone. Flow cytometry showed a dose-dependent cytotoxic effect of bupivacaine on nucleus pulposus cells after 3 hours of exposure. The reduced cytotoxicity of bupivacaine combined with 1 mg of triamcinolone was also confirmed in flow cytometry. Confocal images showed that the increase in dead cells correlated with the concentration of bupivacaine. Nevertheless, fewer cells died after exposure to several different concentrations of bupivacaine combined with 1 mg of triamcinolone than did after exposure to bupivacaine alone. CONCLUSIONS: The combination of bupivacaine and triamcinolone induced dose- and time-dependent cytotoxicity on human intervertebral disc cells in vitro, but the cytotoxicity was much weaker than that of bupivacaine alone. This study shows a potential protective influence of triamcinolone on intervertebral disc cells.
Full Text
http://www.sciencedirect.com/science/article/pii/S1529943012004330
DOI
22819189
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Kyung Hyun(김경현)
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Park, Jeong Yoon(박정윤) ORCID logo https://orcid.org/0000-0002-3728-7784
Park, Hyeong Cheon(박형천) ORCID logo https://orcid.org/0000-0002-1550-0812
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91864
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