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.

项目摘要/摘要 每年多达25％的人会出现急性下腰痛（LBP）。多达63％的人会 开发慢性LBP，几个月来大部分或每天都持续存在。某些人过渡的原因 从急性到慢性LBP的定义很差。我们以前的资金期以及其他人的工作已经确定 患有慢性LBP的个体的炎症细胞因子。炎症持续存在的原因是未知的。我们的 长期目标是发现免疫系统调节的炎症如何预测从急性到 慢性LBP。识别调节急性LBP炎症反应的机制和慢性的发展 LBP可以识别新的治疗靶标，并广泛影响疼痛研究领域。为了实现这一目标，我们将 进行一项观察队列研究，招募n = 480名参与者，患有来自两个不同社区的急性LBP 北卡罗来纳州达勒姆和卡巴鲁斯。在基线，3个月（主要终点）和6个月的时间里，参与者将提供 血液标本，压力蛋白阈值测试，身体表现测量，动作法的体育锻炼和 患者报告的问卷。在12个月时，将收集基于调查的措施。提出的理由 研究来自我们强大的试点工作，其中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，种族可能有所不同（黑色与白色）和3）急性LBP过渡到慢性LBP可以 由生物，社会，心理领域或这些来源和明确定义的表型的组合产生的 这些领域可以改善慢性LBP预测。据我们所知，我们将是第一个全面定义的 从急性到慢性LBP的过渡中，生化反应以及炎症和免疫调节的轨迹 多元化的社区。了解对急性LBP的免疫反应将导致LBP的新多因素表型 基于表型组成的过渡和特定干预靶标。

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