. 2021 Dec 28;5(2):e1189.
doi: 10.1002/jsp2.1189.
eCollection 2022 Jun.
Affiliations
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JOR Spine.
.
Abstract
Cell-free circulating DNA (cfDNA), extracted by liquid biopsy, has been studied as a noninvasive biomarker for various diseases. The potential of cfDNA fragment size and level as a marker in lumbar canal stenosis (LCS) patients has never been studied. We investigated whether cfDNA is a biomarker of low back pain, leg pain, leg numbness severity in patients with an LCS. Blood samples were obtained from patients with LCS (n = 22) before and immediately after spinal surgery. Plasma DNA was isolated and examined for cfDNA fragment size and concentration. A cohort of healthy volunteers (n = 5) constituted the control group. The cfDNA fragment size tended to be shorter in patients than in healthy controls, but this difference was not significant (P = .186). cfDNA level was significantly higher in LCS patients (mean 0.614 ± 0.198 ng/μL, range 0.302-1.150 ng/μL) than in healthy controls (mean 0.429 ± 0.064 ng/μL, range 0.366-0.506 ng/μL) (P = .008). cfDNA level correlated positively with average pain (r = .435, P = .026) and leg numbness (r = .451, P = .018). cfDNA fragment size did not differ from before to after surgery, but cfDNA level increased postoperatively in patients with LCS. This was the first study investigating whether cfDNA fragment size and level are associated with pain in patients with LCS. Our findings suggest that cfDNA level may be an objective indicator of pain and surgical invasiveness in patients with LCS.
Keywords:
cell‐free circulating DNA; lateral lumbar interbody fusion; low back pain; lumbar canal stenosis; numeric rating scale.
© 2021 The Authors. JOR Spine published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.
Conflict of interest statement
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Figures
FIGURE 1
Distribution of cfDNA fragment size and cfDNA level in plasma. cfDNA from LCS patients (A) showed larger fragment size (x‐axis) and cfDNA levels compared to healthy controls (B). 35 bp and 10 380 bp are markers. LCS, lumbar canal stenosis; FU, fluorescence intensity
FIGURE 2
Distribution of cfDNA fragment size and cfDNA level in LCS patient and control samples. Each point shows differences in (A) cfDNA fragment size and (B) cfDNA level between samples from healthy controls (HC; n = 5) and patients with a lumbar canal stenosis (LCS; n = 22). HC; healthy controls, LCS, lumbar canal stenosis. n.s., not significant; *P < 0.05
FIGURE 3
Changes in cfDNA fragment size and cfDNA levels from before to after surgery. Each point indicates (A) cfDNA fragment size and (B) cfDNA level before and after surgery for patients with an LCS (n = 22). The data are expressed as mean values. LCS, lumbar canal stenosis. n.s., not significant; ***P < 0.001
FIGURE 4
Scatter plot and Spearman’s correlation between each pain and cfDNA level. Each point on the scatter plot represents one patient. NRS, Numeric Rating Scale; NRSLBP, NRS of low back pain; NRSLP, NRS of leg pain; NRSLN, NRS of leg numbness
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