Xu Jun, E Xiaoqiang, Liu Huiyong, Li Feng, Cao Yanhui, Tian Jun, Yan Jinglong
Department of Orthopedics, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Orthopedics, First Affiliated Hospital of Harbin Medical University, Harbin, China.
Neurosci Lett. 2015 May 19;595:30-4. doi: 10.1016/j.neulet.2015.04.004. Epub 2015 Apr 3.
Neuropathic pain (NP) is one of the most common complications after spinal cord injury (SCI), but no protein biomarkers has ever been introduced into clinical diagnosis. Previous studies implicated that toll-like receptor (TLR) 4 played a critical role in the development of NP in animal SCI models. Here, a total of 140 participants were recruited, 70 of them were SCI-NP subject and the rest 70 controls did not show neuropathic symptoms. TLR4 was upregulated significantly in SCI-NP patients compared with SCI-noNP subjects. Furthermore, we measured the concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), two TLR4 downstream pro-inflammatory cytokines, to assess their diagnostic values. Receiver operating characteristics (ROC) analysis revealed that TNF-α had great potential advantages to predict the progression of neuropathy, the risks of NP were strongly increased in SCI subjects with higher levels of TNF-α (odds ratio: 4.92; 95% confidence interval: 1.89-12.32). These results suggested neuro-immune activation contributed to the development of neuropathic disorder after SCI, and TNF-α could be a potential sensitive diagnostic biomarker for chronic neuropathic pain in SCI patients.
神经性疼痛（NP）是脊髓损伤（SCI）后最常见的并发症之一，但尚无蛋白质生物标志物被引入临床诊断。先前的研究表明，在动物SCI模型中，Toll样受体（TLR）4在NP的发生发展中起关键作用。本研究共招募了140名参与者，其中70名为SCI-NP患者，其余70名对照者未表现出神经病变症状。与无NP的SCI患者相比，SCI-NP患者的TLR4显著上调。此外，我们检测了TLR4下游的两种促炎细胞因子肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）的浓度，以评估它们的诊断价值。受试者工作特征（ROC）分析显示，TNF-α在预测神经病变进展方面具有很大的潜在优势，TNF-α水平较高的SCI患者发生NP的风险显著增加（优势比：4.92；95%置信区间：1.89-12.32）。这些结果表明，神经免疫激活促进了SCI后神经病变的发展，TNF-α可能是SCI患者慢性神经性疼痛的潜在敏感诊断生物标志物。
