Backonja Miroslav Misha, Coe Christopher L, Muller Daniel A, Schell Kathleen
Department of Neurology, Clinical Science Center, University of Wisconsin, Madison 53792, United States.
J Neuroimmunol. 2008 Mar;195(1-2):157-63. doi: 10.1016/j.jneuroim.2008.01.005. Epub 2008 Mar 6.
This study replicates and extends prior reports of abnormal cytokine levels in chronic pain patients and has correlated the alterations with pain severity. In addition, there appeared to be a need to directly assess cerebrospinal fluid (CSF) because previous findings on cytokine concentrations in peripheral circulation have been inconsistent. CSF and blood specimens were obtained from 14 patients with distal painful non-diabetic polyneuropathy (DPPN) or post-traumatic neuralgia (PTN). Elevated receptor levels for Tumor Necrosis Factor (sTNFr) were the most distinctive abnormality along with low interleukin-10 (IL-10). sTNFr in CSF and blood, and IL-1ss in CSF, were positively associated with pain intensity, whereas IL-10 in both compartments was inversely correlated with pain symptoms. An imbalance of pro- and anti-inflammatory cytokines appears to be a clinically relevant feature, which may contribute to the maintenance of chronic pain.
本研究重复并扩展了先前关于慢性疼痛患者细胞因子水平异常的报告，并将这些改变与疼痛严重程度相关联。此外，由于先前关于外周循环中细胞因子浓度的研究结果并不一致，因此似乎有必要直接评估脑脊液（CSF）。从14例患有远端疼痛性非糖尿病性多发性神经病（DPPN）或创伤后神经痛（PTN）的患者中获取了脑脊液和血液样本。肿瘤坏死因子受体（sTNFr）水平升高是最显著的异常，同时白细胞介素-10（IL-10）水平较低。脑脊液和血液中的sTNFr以及脑脊液中的IL-1ss与疼痛强度呈正相关，而两个部位的IL-10均与疼痛症状呈负相关。促炎细胞因子和抗炎细胞因子的失衡似乎是一个与临床相关的特征，这可能有助于慢性疼痛的维持。
