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- Title
Evidence for altered systemic cytokine levels in chronic musculoskeletal spinal pain and associations with pain severity: A systematic review.
- Authors
A., Billens; K., Canli; J., Van Oosterwijck; K., De Meulemeester; M., Meeus
- Abstract
Introduction: Chronic spinal pain (CSP) is the most common form of chronic musculoskeletal pain in which the cytokine mechanism appears to play a role1-3. This study reviewed the evidence on circulating cytokine level in people with CSP compared to healthy people and potential associations with pain severity. Methods: A systematic review was conducted. Three databases were searched to identify relevant literature. Risk-of-bias (ROB) was assessed using the Newcastle-Ottawa Scale (NOS). Level of evidence (LOE) and strength of conclusion were assigned using the EBRO-classification. Results: Nine articles were included (NOS mean score 83%) with a total of 437 patients suffering from chronic whiplash associated disorders (CWAD) or chronic low back pain (CLBP). Moderate evidence indicated elevated TNF-a and IL-6 levels in CLBP and CRP levels in CWAD. Results regarding IL-1ß in CLBP and TNF-a and IL-10 levels in CWAD were inconclusive. Moderate evidence indicated normal IFNγ and IL-2 levels in LBP and no association between TNF-a-, IL-6, IFNγ, IL-2 and pain severity in CLBP. Results for the relation between IL-1ß levels and pain severity in LBP and between TNF-a, CRP, and IL-10 levels and pain severity in CWAD were inconclusive. Discussion: Enhanced levels of increased cytokines, e.g. TNF-a, IL-6 and CRP, in CSP indicates the presence of systemic inflammation. Changes in TNF-a or IL-6 levels are not associated with pain severity in CLBP. Evidence for the association between other cytokine levels and pain severity is inconclusive and limited. Process evaluation: Only case-control studies were included and therefore received a moderate LOE.
- Subjects
NETHERLANDS; CHRONIC pain; MUSCULOSKELETAL system diseases; CYTOKINES; BACKACHE; CONFERENCES &; conventions; SEVERITY of illness index; SPINE
- Publication
Pain Practice, 2022, Vol 22, p25
- ISSN
1530-7085
- Publication type
Article
- DOI
10.1111/papr.13128