A recent study from Johns Hopkins University School of Medicine showed promising results for relieving lower back pain using parathyroid hormone (PTH). The hormone stimulated the production of the Slit3 protein in osteoblasts in damaged intervertebral discs, which reduced the growth of the nerves that cause pain and alleviated the feeling of it, according to the journal Bone Research, affiliated with the Nature group.
Mechanism of action of the hormone
The study was conducted on laboratory mice to track the effect of the PTH hormone in relieving lower back pain, as the production of Slit3 protein increased after the mice were injected with the hormone. PTH begins to bind to osteoblast cells via surface receptors, activating the FoxA2 protein, which stimulates the Slit3 gene to increase its production.
Elevated Slit3 protein in damaged vertebrae blocks nerve growth, reducing the transmission of pain signals to the central nervous system, and its effect continues to gradually reduce pain with regular doses of PTH.
The Slit3 protein is the key
To confirm the results, the researchers knocked out the gene responsible for producing the Slit3 protein in the osteoblasts of a group of mice, then gave them the hormone PTH. The experiment showed that the hormone continued to promote bone building in damaged areas of the vertebrae, but did not relieve pain, which confirmed the neuro-vital role of the Slit3 protein in reducing pain caused by vertebrae degeneration.
It is noteworthy that spinal problems resulting from aging or injuries are often accompanied by severe pain that hinders daily life.
The reason is due to the increased activity of osteoclasts to quickly remove damaged tissue, which stimulates the production of Netrin-1 protein, which attracts the growth of nerve fibers and increases nerve nutrition to pre-existing nerves, raising pain signals sent to the brain. The Slit3 protein intervenes in this process, reducing nerve input at the site of pain and reducing the Netrin-1-mediated effect of PTH, leading to a reduction in low back pain.
Promising medicine
The importance of this study is highlighted in shedding light on the relationship between the PTH hormone (PTH) and the neurological role of the Slit3 protein, as it can help about 42% of people who suffer from lower back pain, especially resulting from osteoarthritis and vertebrae degeneration.
Thanks to the pivotal role of the Slit3 protein, the researchers recommended developing a drug that mimics its effect directly at the site of the defect, reducing the need for hormonal medications and limiting their side effects.
The Slit3 protein has a dual ability to restore damaged bones and relieve pain, as it stimulates bone building in the damaged areas, and enhances blood circulation through the formation of new blood vessels, in addition to its new neurological role in reducing nerve nutrition to the peripheral nerves of the vertebrae, which controls random nerve growth and reduces pain, while increasing bone density at the same time.
Previous studies
PTH, a hormone secreted by the parathyroid gland, has not suddenly emerged as a champion in relieving back pain. Previous studies have proven its significant role in enhancing bone density and treating osteoporosis.
A study published in 2009 in the journal Calcified Tissue International, which included 1,648 post-menopausal women, showed that the use of PTH via teripratide preparations increased bone density and reduced the rate of fractures. Participants also reported a decrease in back pain during a period of 18 months of treatment.
A scientific review led by Dr. Nicholas Harvey from the University of Southampton in Britain and his team confirmed the effectiveness of PTH-based drugs in promoting bone building and increasing their density, with a high level of safety.