Biomarkers to Advance Clinical Phenotypes of Low Back Pain (BACk)

促进腰痛 (BACk) 临床表型的生物标志物

• 批准号: 10735846
• 负责人: Adam Goode
• 金额: $ 69.03万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-07 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10735846
• 关键词: Acute; Anxiety; B-Lymphocytes; Behavior Therapy; Biochemical; Biochemical Reaction; Biologic Characteristic; Biological; Biological Factors; Biological Markers; Black Populations; Black race; Blood Cells; Blood specimen; Cell Death; Cell physiology; Cells; Characteristics; Chronic low back pain; Cluster Analysis; Cognitive Therapy; Cohort Studies; Communities; Complex; Counseling; County; Data; Dependence; Development; Enrollment; Event; Exercise; Funding; Gender; Goals; High Prevalence; Immune; Immune response; Immune system; Immunotherapy; Individual; Inflammation; Inflammatory; Inflammatory Response; Interleukin-1 beta; Interleukin-6; Intervention; Life Style; Ligands; Low Back Pain; Machine Learning; Measurement; Measures; Medical; Mental Depression; Modeling; North Carolina; Pain; Pain Free; Pain Research; Pain Threshold; Participant; Patient Self-Report; Patients; Peripheral; Phase; Phenotype; Physical Function; Physical Performance; Physical activity; Plasma; Predictive Factor; Productivity; Proteoglycan; Psychosocial Factor; Questionnaires; Race; Reaction; Regulation; Reporting; Research; Resolution; Sampling; Social Work; Source; Surveys; T-Lymphocyte; TNF gene; Testing; United States; Validation; Work; actigraphy; biopsychosocial factor; clinical phenotype; cost; cytokine; desensitization; experience; immune activation; immunoreaction; improved; intervertebral disk degeneration; monocyte; necrotic tissue; new therapeutic target; novel; observational cohort study; pain chronification; pain score; pressure; prevent; primary endpoint; programs; psychologic; psychological distress; psychosocial; racial difference; random forest; response; risk stratification; social; sociodemographic factors; sociodemographics; systemic inflammatory response; unsupervised learning; years lived with disability

Project Summary/Abstract Up to 25% of individuals will develop acute low back pain (LBP) each year. As many as 63% of those individuals will develop chronic LBP that persists for most or every day for several months. The reasons why some individuals transition from acute to chronic LBP are poorly defined. Our prior funding period, and work from others, have identified elevated inflammatory cytokines among individuals with chronic LBP. The reasons why inflammation persists are unknown. Our long-term goal is to discover how inflammation, regulated by the immune system, predicts the transition from acute to chronic LBP. Identifying mechanisms that regulate the inflammatory response to acute LBP and the development of chronic LBP could identify novel therapeutic targets and broadly impact the pain research field. To accomplish this goal, we will conduct an observational cohort study enrolling n=480 participants with acute LBP from two diverse communities in Durham and Cabarrus, North Carolina. At baseline, 3 months (primary endpoint), and 6 months, participants will provide a blood specimen, pressure-pain threshold testing, physical performance measurement, physical activity via actigraphy, and patient-reported questionnaires. At 12 months, survey-based measures will be collected. The rationale for this proposed research comes from our strong pilot work in that 1) identifying a change in immune cell profiles and baseline inflammatory cytokines may be important biological factors predicting persistent inflammation and chronic LBP, and 2) these responses from the immune system may be different by race (Black versus White) and 3) acute LBP transition to chronic LBP can result from biological, social, psychological domains or a combination of these sources and well-defined phenotypes from these domains could improve chronic LBP prediction. To our knowledge, we will be the first to comprehensively define the biochemical reaction and inflammatory and immune-regulated trajectories in the transition from acute to chronic LBP in a diverse community. Understanding the immune response to acute LBP would lead to new multifactorial phenotypes of LBP transitions and specific intervention targets based on phenotype composition.

项目总结/摘要 每年高达25%的人会患上急性腰痛（LBP）。其中多达63%的人将 发展慢性LBP，持续大部分时间或每天持续数月。有些人转型的原因 从急性到慢性LBP的定义很差。我们之前的资助期和其他人的工作已经确定了 慢性LBP患者的炎症细胞因子。炎症持续存在的原因尚不清楚。我们 长期目标是发现由免疫系统调节的炎症如何预测从急性到慢性的转变。 慢性LBP确定调节急性LBP炎症反应和慢性LBP发展的机制 LBP可以识别新的治疗靶点，并广泛影响疼痛研究领域。为了实现这一目标，我们将 进行了一项观察性队列研究，招募了来自两个不同社区的n=480名急性LBP参与者， 达勒姆和卡巴鲁斯，北卡罗来纳州。在基线、3个月（主要终点）和6个月时，参与者将提供 血液样本、压力-疼痛阈值测试、身体性能测量、通过体动记录仪进行的身体活动，以及 患者自报问卷。在12个月时，将收集基于调查的指标。建议的理由是， 这项研究来自我们强大的试点工作，1）确定免疫细胞谱和基线炎症的变化， 细胞因子可能是预测持续性炎症和慢性LBP的重要生物学因素，2）这些反应 从免疫系统中释放的LBP可能因种族而异（黑人与白色人），以及3）急性LBP向慢性LBP的转变可以 结果来自生物，社会，心理领域或这些来源的组合和明确定义的表型， 这些结构域可以改善慢性LBP的预测。据我们所知，我们将是第一个全面界定 生化反应和炎症和免疫调节的轨迹从急性过渡到慢性LBP在一个 多样的社区。了解急性LBP的免疫反应将导致新的LBP多因子表型 基于表型组成的过渡和特定干预目标。

项目成果

Association between general joint hypermobility and knee, hip, and lumbar spine osteoarthritis by race: a cross-sectional study.

按种族划分的一般关节活动过度与膝、髋和腰椎骨关节炎之间的关联：一项横断面研究。

• DOI: 10.1186/s13075-018-1570-7
• 发表时间: 2018
• 期刊: Arthritis research & therapy
• 影响因子: 4.9
• 作者: Flowers,PortiaPE;Cleveland,RebeccaJ;Schwartz,ToddA;Nelson,AmandaE;Kraus,VirginiaB;Hillstrom,HowardJ;Goode,AdamP;Hannan,MarianT;Renner,JordanB;Jordan,JoanneM;Golightly,YvonneM
• 通讯作者: Golightly,YvonneM

Is the Association between Knee Injury and Knee Osteoarthritis Modified by the Presence of General Joint Hypermobility.

膝关节损伤和膝骨关节炎之间的关联是否因一般关节活动过度的存在而改变。

• DOI: 10.1016/j.ocarto.2020.100045
• 发表时间: 2020
• 期刊: Osteoarthritis and cartilage open
• 作者: Shiue,KristinY;Cleveland,RebeccaJ;Schwartz,ToddA;Nelson,AmandaE;Kraus,VirginiaB;Hannan,MarianT;Hillstrom,HowardJ;Goode,AdamP;Flowers,PortiaPE;Renner,JordanB;Jordan,JoanneM;Golightly,YvonneM
• 通讯作者: Golightly,YvonneM