Analysis of BiP Expression in the Cervical and Lumbar Spinal Cord Following Painful Whole-Body Vibration

2 Table of Contents Literature Review 1. Facet joint and pain 4 a) Facet joints 4 b) Cervical facet and pain 5 c) Lumbar facet and pain 7 2. Whole-body vibration and pain 8 3. Integrated stress response 8 4. Reactive oxygen species 12 5. References 13 Manuscript Introduction 20 Material and Methods 21 Results 24 Discussion 30 Conclusion 36 References 36 3 ACKNOWLEDGEMENT I would like to express my deepest appreciation to my principal investigator, co-advisor, Dr. Winkelstein for giving me the opportunity to join her research team and conduct this study. Without her patience, guidance and encouragement, my masters program would have not been like this. I sincerely thank her for all the support and guidance. I would like to thank Dr. Jordan-Sciutto for her constant help and input through this whole process. I would also like to thank Dr. Barton for being my committee member, and putting insight to enrich this thesis. Lastly, but not least, I would like to thank Dr. Kim, for connecting all wonderful researchers and helping me meet them to pursue my research. In addition to the Endodontic residency program, this masters program enriched my study not only in Endodontic perspective but in science as well. And I thank all members of SPRL and people that I met from Dr. Sciutto's lab, faculty and residents in Endodontic department. 4 LITERATURE REVIEW 1. Facet joint and pain a) Facet joints The facet joints, also referred to as " zygapophyseal joints " , or " Z-joints " , are paired joints in the posterior aspect of the spine. Along with the intervertebral disc anteriorly, they make up the basic functional unit of the spine (Figure A). They are numbered based on the vertebrae involved in forming the joint and named as left or right. The facet joints consist of the inferior articular process of one vertebra and the superior articular process of the adjacent inferior vertebra. Figure A. The spinal column, cord and vertebrae. Each facet joint is a diarthrodial joint with a distinct joint capsule that encloses a joint space that can accommodate approximately 1-1.5cc of fluid (Glover 5 1977). Studies have demonstrated that facet joint capsules are innervated richly with encapsulated, unencapsulated, and free nerve endings (Cavanaugh et al. 1996, Inami et al. 2001, McLain 1994). Nerve endings containing both substance P and calcitonin gene related protein (CGRP) along with neuropeptide Y, have …