Urinary TNF-α as a potential biomarker for chronic primary low back pain.

IF 2.6 3区医学 Q2 BEHAVIORAL SCIENCES Frontiers in Integrative Neuroscience Pub Date : 2023-01-01 DOI:10.3389/fnint.2023.1207666

Carlos Gevers-Montoro, Mariana Puente-Tobares, Aléxiane Monréal, Francisco Miguel Conesa-Buendía, Mathieu Piché, Arantxa Ortega-De Mues

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Abstract

Introduction: Over two thirds of individuals with low back pain (LBP) may experience recurrent or persistent symptoms in the long term. Yet, current data do not allow to predict who will develop chronic low back pain and who will recover from an acute episode. Elevated serum levels of the proinflammatory cytokine tumor necrosis factor-α (TNF-α) have been associated with poor recovery and persistent pain following an acute episode of LBP. Inflammatory cytokines may also mediate mechanisms involved in nociplastic pain, and thus, have significant implications in chronic primary low back pain (CPLBP).

Methods: This study aimed to investigate the potential of urinary TNF-α levels for predicting outcomes and characterizing clinical features of CPLBP patients. Twenty-four patients with CPLBP and 24 sex- and age-matched asymptomatic controls were recruited. Urinary TNF-α concentrations were measured at baseline and after 4 weeks, during which CPLBP patients underwent spinal manipulative therapy (SMT).

Results: Concentrations of TNF-α were found to be elevated in baseline urine samples of CPLBP patients compared to asymptomatic controls. Moreover, these values differed among patients depending on their pain trajectory. Patients with persistent pain showed higher levels of TNF-α, when compared to those with episodic CPLBP. Furthermore, baseline TNF-α concentrations and their changes after 4 weeks predicted alterations in pain intensity and disability following SMT in patients with CPLBP.

Discussion: These findings warrant further research on the potential use of urinary TNF-α concentrations as a prognostic biomarker for CPLBP.

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尿TNF-α作为慢性原发性腰痛的潜在生物标志物。

简介:超过三分之二的个体腰痛(LBP)可能会经历复发或长期持续的症状。然而，目前的数据还不能预测谁会患上慢性腰痛，谁会从急性发作中恢复过来。血清促炎细胞因子肿瘤坏死因子-α (TNF-α)水平升高与腰痛急性发作后恢复不良和持续疼痛有关。炎症细胞因子也可能介导伤害性疼痛的机制，因此，在慢性原发性腰痛(CPLBP)中具有重要意义。方法:本研究旨在探讨尿TNF-α水平在预测CPLBP患者预后和临床特征方面的潜力。24例CPLBP患者和24例性别和年龄匹配的无症状对照组被招募。在基线和4周后测量尿TNF-α浓度，在此期间，CPLBP患者接受脊柱推拿治疗(SMT)。结果:与无症状对照组相比，CPLBP患者基线尿液样本中TNF-α浓度升高。此外，根据患者的疼痛轨迹不同，这些值也不同。与发作性CPLBP患者相比，持续性疼痛患者TNF-α水平较高。此外，基线TNF-α浓度及其4周后的变化预测了CPLBP患者SMT后疼痛强度和残疾的变化。讨论:这些发现为进一步研究尿TNF-α浓度作为CPLBP预后生物标志物的潜在用途提供了依据。

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来源期刊

Frontiers in Integrative Neuroscience Neuroscience-Cellular and Molecular Neuroscience

CiteScore

4.60

自引率

2.90%

发文量

148

审稿时长

14 weeks

期刊介绍： Frontiers in Integrative Neuroscience publishes rigorously peer-reviewed research that synthesizes multiple facets of brain structure and function, to better understand how multiple diverse functions are integrated to produce complex behaviors. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Our goal is to publish research related to furthering the understanding of the integrative mechanisms underlying brain functioning across one or more interacting levels of neural organization. In most real life experiences, sensory inputs from several modalities converge and interact in a manner that influences perception and actions generating purposeful and social behaviors. The journal is therefore focused on the primary questions of how multiple sensory, cognitive and emotional processes merge to produce coordinated complex behavior. It is questions such as this that cannot be answered at a single level – an ion channel, a neuron or a synapse – that we wish to focus on. In Frontiers in Integrative Neuroscience we welcome in vitro or in vivo investigations across the molecular, cellular, and systems and behavioral level. Research in any species and at any stage of development and aging that are focused at understanding integration mechanisms underlying emergent properties of the brain and behavior are welcome.