A systematic review of the role of inflammatory biomarkers in acute, subacute and chronic non-specific low back pain

Morris, P.; Ali, Kareem; Merritt, Mackenzie; Pelletier, Joey; Macedo, Luciana

doi:10.1186/s12891-020-3154-3

Cited by 78 publications

(72 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our post hoc analysis showed significantly increased circulating TNF-α in fibromyalgia patients, only after the exclusion of two outlier studies, which was robust on sensitivity analysis. In support of our findings, a recent systematic review of biomarkers associated with chronic non-specific back pain also identified two studies that reported increased levels of circulating TNF-α [ 52 ].…”

Section: Discussionsupporting

confidence: 88%

Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Objectives The aetiology of primary chronic pain syndromes (CPS) is highly disputed. We performed a systematic review and meta-analysis aiming to assess differences in circulating cytokines levels in patients with diffuse CPS (fibromyalgia) versus healthy controls (HC). Methods Human studies published in English from the PubMed and MEDLINE/Scopus and Cochrane databases were systematically searched from inception up to January 2020. We included full text cross-sectional or longitudinal studies with baseline cytokine measurements, reporting differences in circulating cytokine levels between fibromyalgia patients and HC. Random-effects meta-analysis models were used to report pooled effects and 95% CIs. This study is registered with PROSPERO(CRD42020193774). Results Our initial search yielded 324 papers and identified 29 studies (2458 participants) eligible for systematic review and 22 studies (1772 participants) suitable for meta-analysis. The systematic analysis revealed reproducible findings supporting different trends of cytokine levels when fibromyalgia patients were compared to HC, while the chemokine eotaxin, was consistently raised in fibromyalgia . Meta-analysis showed significantly increased tumour necrosis factor alpha (TNF-α) (SMD=0.36, p = 0.0034, 95%CI=0.12-0.60; I2=71%, Q2 p = 0.0002), interleukin (IL)-6 (SMD=0.15, p = 0.045, %95CI=0.003-0.29; I2=39%, Q2 p = 0.059), IL- 8 (SMD=0.26, p = 0.01, 95%CI =0.05-0.47; I2=61%, Q2 p = 0.005) and IL-10 (SMD=0.61; %95 = 0.34-0.89, p < 0.001; I2 = 10%, Q2 p = 0.34) in fibromyalgia patients compared to HC. Conclusion We found evidence of significant differences in the peripheral blood cytokine profiles of fibromyalgia patients compared to HC. However, the distinctive profile associated with fibromyalgia includes both pro-inflammatory (TNF-α, IL-6, IL-8), and anti-inflammatory cytokines (IL-10) in pooled analysis, as well as chemokine (eotaxin) signatures. Further research is required to elucidate the role of cytokines in fibromyalgia.

show abstract

Section: Discussionsupporting

confidence: 88%

Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Biomarkers are key to the pursuit of stratifying disease progression and prognosis in chronic back pain. To date, primary areas of foci often require minimally-invasive procedures (e.g., blood-based markers) to examine genetic or pro-inflammatory cytokine associations with pain severity, with mixed diagnostic success 39 , 40 .…”

Section: Discussionmentioning

confidence: 99%

Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance

Stamenkovic

Clark

Pidcoe

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Chronic low back pain (cLBP) rates among younger individuals are rising. Although pain and disability are often less severe, underlying changes in trunk behavior may be responsible for recurrence. We examine the biomarker capacity of a simple Trunk Compliance Index (TCI) to distinguish individuals with and without cLBP. A random subset (n = 49) of the RELIEF RCT were matched to healthy controls for sex, age, height and weight. We measured TCI (as displacement/ weight-normalized perturbation force) using anthropometrically-matched, suddenly-applied pulling perturbations to the trunk segment, randomized across three planes of motion (antero-posterior, medio-lateral, and rotational). Mean differences between cLBP, sex and perturbation direction were assessed with repeated-measures analysis of variance. Discriminatory accuracy of TCI was assessed using Receiver Operator Characteristic (ROC) analysis. Baseline characteristics between groups were equivalent (x̅ [range]): sex (57% female / group), age (23.0 [18–45], 22.8 [18–45]), height, cm (173.0 [156.5–205], 171.3 [121.2–197], weight, kg (71.8 [44.5–116.6], 71.7 [46.8–117.5]) with cLBP associated with significantly lower TCI for 5 of 6 directions (range mean difference, − 5.35: − 1.49, range 95% CI [− 6.46: − 2.18 to − 4.35: − 0.30]. Classification via ROC showed that composite TCI had high discriminatory potential (area under curve [95% CI], 0.90 [0.84–0.96]), driven by TCI from antero-posterior perturbations (area under curve [95% CI], 0.99 [0.97–1.00]). Consistent reductions in TCI suggests global changes in trunk mechanics that may go undetected in classic clinical examination. Evaluation of TCI in younger adults with mild pain and disability may serve as a biomarker for chronicity, leading to improved preventative measures in cLBP.Trial Registration and Funding RELIEF is registered with clinicaltrials.gov (NCT01854892) and funded by the NIH National Center for Complementary & Integrative Health (R01AT006978).

show abstract

“…In the past, several putative non-imaging biomarkers have been investigated in LBP (5)(6)(7). However, these biomarkers are often invasive and do not assess the impact of LBP on the brain.…”

Section: Introductionmentioning

confidence: 99%

Functional Disruptions of the Brain in Low Back Pain: A Potential Imaging Biomarker of Functional Disability

et al. 2021

View full text Add to dashboard Cite

Chronic low back pain (LBP) is one of the leading causes of disability worldwide. While LBP research has largely focused on the spine, many studies have demonstrated a restructuring of human brain architecture accompanying LBP and other chronic pain states. Brain imaging presents a promising source for discovering noninvasive biomarkers that can improve diagnostic and prognostication outcomes for chronic LBP. This study evaluated graph theory measures derived from brain resting-state functional connectivity (rsFC) as prospective noninvasive biomarkers of LBP. We also proposed and tested a hybrid feature selection method (Enet-subset) that combines Elastic Net and an optimal subset selection method. We collected resting-state functional MRI scans from 24 LBP patients and 27 age-matched healthy controls (HC). We then derived graph-theoretical features and trained a support vector machine (SVM) to classify patient group. The degree centrality (DC), clustering coefficient (CC), and betweenness centrality (BC) were found to be significant predictors of patient group. We achieved an average classification accuracy of 83.1% (p < 0.004) and AUC of 0.937 (p < 0.002), respectively. Similarly, we achieved a sensitivity and specificity of 87.0 and 79.7%. The classification results from this study suggest that graph matrices derived from rsFC can be used as biomarkers of LBP. In addition, our findings suggest that the proposed feature selection method, Enet-subset, might act as a better technique to remove redundant variables and improve the performance of the machine learning classifier.

show abstract

A systematic review of the role of inflammatory biomarkers in acute, subacute and chronic non-specific low back pain

Cited by 78 publications

References 34 publications

Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis

Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis

Distinguishing chronic low back pain in young adults with mild to moderate pain and disability using trunk compliance

Functional Disruptions of the Brain in Low Back Pain: A Potential Imaging Biomarker of Functional Disability

Contact Info

Product

Resources

About