Severity of intervertebral disc herniation regulates cytokine and chemokine levels in patients with chronic radicular back pain.
Severity of intervertebral disc herniation regulates cytokine and chemokine levels in patients with chronic radicular back pain.
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DOI：
10.1016/j.joca.2020.06.009
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发表时间：
2020-10
影响因子：
7
通讯作者：
Chahine NO
中科院分区：
文献类型：
--
作者：
Jacobsen HE;Khan AN;Levine ME;Filippi CG;Chahine NO
椎间盘疾病和受试者特异性协变量对腰痛全身性炎症的影响尚不清楚。我们研究了症状性椎间盘突出（DH）和MRI突出严重程度对临床受试者血清细胞因子水平的影响。考虑DH、年龄、BMI和性别的影响，将腰椎DH受试者（N=78）与对照组（N=57）的细胞因子水平进行比较。分析DH严重程度对急性或慢性疼痛患者亚群细胞因子水平的影响。血清细胞因子也在手术前和术后3个月的一部分患者中进行了分析。有症状DH患者血清中细胞因子水平升高，年龄、BMI和性别对某些细胞因子水平有显著影响。疝的严重程度是疼痛强度（VAS）、血清HMGB1、PDGFbb和IL-9水平的重要影响因素。DH严重程度与细胞因子水平之间的关系在慢性而非急性症状的受试者中得到证实。术后血清MIF水平降低，而CCL3、CCL11、CXCL1和CXCL10水平显著升高。这项研究首次表明，慢性疼痛患者DH严重程度与血清炎症细胞因子水平的变化密切相关。HMGB1、PDGFbb和IL-9是增加DH严重程度的新介质，表明细胞损伤、神经炎症和血管生成。术后MIF降低，炎症消退。然而，趋化因子水平升高表明在3个月的时间点上正在进行重塑和伤口愈合。
The contributions of intervertebral disc disease and subject-specific covariates to systemic inflammation in low back pain are unknown. We examined the effects of symptomatic disc herniation (DH) and MRI herniation severity on serum cytokine levels in clinical subjects. Cytokine levels from lumbar DH subjects (N=78) were compared to control subjects (N=57) accounting for effects of DH, age, BMI and gender. Effect of DH severity on cytokine levels was analyzed on subsets of subjects with acute or chronic pain. Serum cytokines were also analyzed in a subset of patients between pre- and 3 months post-surgery. Cytokine levels were elevated in the serum of patients with symptomatic DH, and the covariates age, BMI and gender significantly contributed to levels of some cytokines. Severity of herniation was a significant contributor to pain intensity (VAS), serum levels of HMGB1, PDGFbb, and IL-9. The relationship between DH severity and cytokine levels was confirmed in subjects with chronic, but not acute symptoms. Serum levels of MIF decreased, whereas levels of CCL3, CCL11, CXCL1, and CXCL10 were significantly elevated post surgery. This study is the first to show that DH severity is coordinately associated with changes in serum levels of inflammatory cytokines in chronic pain subjects. HMGB1, PDGFbb and IL-9 are novel mediators of increasing DH severity, indicative of cellular damage, neuro-inflammation and angiogenesis. Resolution of inflammation was observed with decrease in MIF post surgery. However, elevated chemokine levels indicate ongoing remodeling and wound healing at 3-month time point.
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影响因子：
15.1
作者：
Pedersen, Linda Margareth;Schistad, Elina;Gjerstad, Johannes
通讯作者：
Gjerstad, Johannes
影响因子：
3
作者：
DeVine, John;Norvell, Daniel C.;Andersson, Gunnar
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影响因子：
2
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Gordh, Torsten
影响因子：
2.4
作者：
Park, Moon-Soo;Lee, Hwan-Mo;Riew, K. Daniel
通讯作者：
Riew, K. Daniel
影响因子：
3.7
作者：
de Goeij M;van Eijk LT;Vanelderen P;Wilder-Smith OH;Vissers KC;van der Hoeven JG;Kox M;Scheffer GJ;Pickkers P
通讯作者：
Pickkers P