The Relationship Between ADAMTS-4 and ADAMTS-5 Enzyme Levels in Patients With Degenerative Disc Disease: A Prospective Biochemical Study

Study design: Prospective biochemical study of comparison of A Disintegrin and Metalloproteinase with Thrombospondin motifs-4 (ADAMTS-4) and A Disintegrin and Metalloproteinase with Thrombospondin motifs 5 (ADAMTS5) levels in preoperative and postoperative venous blood, as well as in disc tissue obtained during surgery, in patients undergoing surgery for intervertebral disc disease, with enzyme levels in venous blood from a control group.

Objective: To compare the levels of ADAMTS-4 and ADAMTS-5 between patients with degenerative intervertebral discs and a healthy control group, aiming to identify biomarkers associated with intervertebral disc degeneration.

Literature: Although numerous studies have investigated the relationship between ADAMTS-4 and ADAMTS-5 enzymes and degeneration in experimental rat models and human tissues, no study has correlated their serum levels with intervertebral disc degeneration.

Method and materials: Venous blood samples were obtained preoperatively and postoperatively from 41 patients (age: 42 ± 9.7 years, range 20-63) diagnosed with intervertebral disc disease. The affected disc levels were L4-L5 in 22 patients and L5-S1 in 19 patients. These patients were selected based on surgical indications due to radicular pain that persisted after an adequate course of conservative management, without any non-neurological deficit. Disc tissue samples were also obtained during surgery. Additionally, venous blood samples were collected from a control group with no diagnosed diseases, and lumbar MRIs of the control group showed no significant signs of degeneration. ADAMTS-4 and ADAMTS-5 levels were measured using the ELISA method on samples obtained after centrifugation of the collected blood and tissue specimens.

Results: The level of ADAMTS-4 in patient serum was found to be lower compared to the control group, while the level of ADAMTS-5 was higher in the patient serum and lower in the control group.

Conclusion: Elevated levels of ADAMTS-5 in the blood may be associated with intervertebral disc degeneration.