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Unexpectedly decreased plasma cytokines in patients with chronic back pain

Authors Capossela S, Pavlicek D, Bertolo A, Landmann G, Stoyanov JV

Received 12 October 2017

Accepted for publication 9 April 2018

Published 21 June 2018 Volume 2018:11 Pages 1191—1198

DOI https://doi.org/10.2147/JPR.S153872

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Minal Joshi

Peer reviewer comments 4

Editor who approved publication: Dr Erica Wegrzyn


Simona Capossela,1 David Pavlicek,1 Alessandro Bertolo,1 Gunther Landmann,2 Jivko V Stoyanov1

1Swiss Paraplegic Research, Nottwil, Switzerland; 2Centre for Pain Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland

Introduction: Chronic back pain is one of the most important socioeconomic problems that affects the global population. Elevated levels of inflammatory mediators, such as cytokines, have been correlated with pain, but their role in chronic back pain remains unclear. The effectiveness of anti-inflammatory drugs seems to be limited for chronic back pain. The authors wanted to investigate the levels of inflammatory mediators in long-term medically treated patients with persistent chronic back pain.
Methods: Cytokine plasma levels of patients with chronic back pain (n=23), compared to pain-free healthy controls (n=30), were investigated by immunoassay. Patients with chronic back pain were exposed to long-term conservative medical therapy with physiotherapy and anti-inflammatories, also combined with antidepressants and/or muscle-relaxants.
Results: The patients with chronic back pain expressed lower levels of the chemokines MCP1, CCL5, and CXCL6 compared to pain-free healthy controls. Significantly lower concentrations of the anti-inflammatory cytokines, interleukin (IL)-4 and granulocyte-colony stimulating factor were also found. Interestingly, levels of proinflammatory cytokines (IL-2, IL-6, IL-1β, tumor necrosis factor alpha), IL-10, granulocyte-macrophage colony-stimulating factor, and stromal cell-derived factor 1 alpha showed no significant differences between both groups.
Conclusion: This decrease of inflammatory mediators in medically treated patients with chronic back pain is of unclear origin and might be either a long-term side effect of medical therapy or related to chronic pain. Further longitudinal research is necessary to elucidate the underlying cause of these findings.

Keywords: chronic pain, back pain, inflammation, cytokine, chemokine

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