Clin J Pain. 2019 Jul 5. doi: 10.1097/AJP.0000000000000745. [Epub ahead of print]
Teodorczyk-Injeyan JA1, Triano JJ1, Injeyan HS2.
Abstract
BACKGROUND:
The pathogenesis of low back pain (LBP) remains unclear. However, recent studies suggest that the inflammatory response may be inherent in spinal pain.
PURPOSE:
To discern inflammatory profiles in patients with non-specific acute and chronic low back pain (LBP) in relation to those in asymptomatic subjects.
METHODS:
Peripheral blood samples were obtained from asymptomatic subjects and patients with non-specific acute and chronic LBP reporting a minimum pain score of 3 on a 10-point visual analogue scale (VAS). The levels of in vitro production of pro-inflammatory (TNFα, IL-1β, IL-6, IL-2, IFN[Latin Small Letter Gamma]) and anti-inflammatory (IL-1 RA, sTNFR2 and IL-10) mediators were determined by specific immunoassays.
RESULTS:
The mean VAS scores were comparable between the acute and chronic LBP patient groups. Compared to asymptomatic subjects, the production of TNFα, IL-1β, IL-6 and their ratios to IL-10 levels were significantly elevated in both patient groups (P=0.0001-0.003). In acute LBP group, the ratio of IL-2: IL-10 was also significantly increased (P=0.02). In contrast, the production of IFN[Latin Small Letter Gamma] was significantly reduced compared with the other study groups (P=0.005-0.01), nevertheless, it was positively correlated (P=0.006) with pain scores. In chronic LBP patients, the production of TNFα, IL-1RA and sTNFR2 was significantly increased (P=0.001-0.03) in comparison with the control and acute LBP groups, and TNFα and IL-1β levels were positively correlated (P<0.001) with VAS scores.
CONCLUSION:
The inflammatory profiles of patients with acute and chronic LBP are distinct. Nonetheless, in both patient groups, an imbalance between pro- and anti-inflammatory mediator levels favors the production of pro-inflammatory components.
PMID: 31283548 DOI: 10.1097/AJP.0000000000000745