Artikel
Pro- and anti-inflammatory cytokines in chronic low back pain – a prospective longitudinal study
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Veröffentlicht: | 16. Oktober 2008 |
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Gliederung
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Objectives: The aim of this 6-month study in 140 patients with chronic low back pain and 84 healthy volunteers was to investigate the cytokine expression profile in sera in chronic low back pain.
Methods: Serum levels of pro-inflammatory cytokines IL-6, IL-8, TNF-α and anti-inflammatory cytokines IL-4 and IL-10 were measured by a Bio-Plex cytokine assay on admission and on days 10, 21 and 180 after multidisciplinary pain therapy. At each time point pain intensity was documented on a visual analogue scale (VAS).
Results: We found significantly higher serum TNF-α (p0.001) and significantly lower serum IL-10 (p0.001) in patients with chronic low back pain than in healthy controls on admission. Significant reductions in serum IL-8 (p0.001) and TNF-α (p0.001) and a significant elevation of IL-4 (p0.001) were found 10 days after multidisciplinary pain therapy. During the 6 months the significant elevation of TNF-α and lowering of IL-10 in serum persisted on days 10, 21 and 180 of follow-up. Patients´ pain intensity declined significantly (p0.001) as soon as 21 days after initiation of multidisciplinary pain therapy. No correlation was found between cytokines and pain intensity.
Conclusions: Pro-inflammatory cytokine TNF-α and anti-inflammatory cytokine IL-10 in serum seems to contribute to the pathogenesis of chronic low back pain. No correlation was observed between circulating cytokines and pain intensity in the current study. Thus, the serum level of TNF-α and IL-10 cannot be used as a predictor of clinical prognosis in patients with chronic low back pain.