Department of Anesthesiology, University of Southern California, Los Angeles, California.
Department of Anesthesiology.
Pain Med. 2018 May 1;19(5):1033-1043. doi: 10.1093/pm/pnx126.
Multiple processes have been identified as potential contributors to chronic pain, with increasing evidence illustrating an association with aberrant levels of neuroimmune mediators. The primary objectives of the present study were to examine central nervous system cytokines, chemokines, and growth factors present in a chronic pain population and to explore patterns of the same mediator molecules over time. Secondary objectives explored the relationship of central and peripheral neuroimmune mediators while examining the levels of anxiety, depression, sleep quality, and perception of pain associated with the chronic pain patient experience.
Cerebrospinal fluid (CSF) from a population of majority postlaminectomy syndrome patients (N = 8) was compared with control CSF samples (N = 30) to assess for significant differences in 10 cytokines, chemokines, and growth factors. The patient population was then followed over time, analyzing CSF, plasma, and psychobehavioral measures.
The present observational study is the first to demonstrate increased mean CSF levels of interleukin-8 (IL-8; P < 0.001) in a small population of majority postlaminectomy syndrome patients, as compared with a control population. Over time in pain patients, CSF levels of IL-8 increased significantly (P < 0.001).
These data indicate that IL-8 should be further investigated and psychobehavioral components considered in the overall chronic pain paradigm. Future studies examining the interactions between these factors and IL-8 may identify novel targets for treatment of persistent pain states.
多种过程被认为是导致慢性疼痛的潜在因素,越来越多的证据表明其与神经免疫介质异常水平有关。本研究的主要目的是检测慢性疼痛人群中中枢神经系统细胞因子、趋化因子和生长因子的水平,并探讨同一介质分子随时间的变化模式。次要目的是在研究与慢性疼痛患者体验相关的中枢和外周神经免疫介质水平以及焦虑、抑郁、睡眠质量和疼痛感知的同时,探讨这些介质之间的关系。
将大部分椎板切除术后综合征患者(N=8)的脑脊液与对照组脑脊液样本(N=30)进行比较,以评估 10 种细胞因子、趋化因子和生长因子是否存在显著差异。然后对患者人群进行随访,分析脑脊液、血浆和心理行为测量结果。
本观察性研究首次证明,与对照组相比,大部分椎板切除术后综合征患者的脑脊液中白细胞介素-8(IL-8;P<0.001)的平均水平升高。在疼痛患者中,脑脊液中 IL-8 的水平随时间显著增加(P<0.001)。
这些数据表明,应进一步研究 IL-8,并在整体慢性疼痛模式中考虑心理行为成分。未来研究检查这些因素与 IL-8 之间的相互作用,可能会确定治疗持续性疼痛状态的新靶点。