Kullmann Miriam, Rühle Paul F, Harrer Alexandra, Donaubauer Anna, Becker Ina, Sieber Renate, Klein Gerhart, Fournier Claudia, Fietkau Rainer, Gaipl Udo S, Frey Benjamin
Department of Radiation Oncology, Radiation Immunobiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 27, 91054, Erlangen, Germany.
Practice for Cardiology, Bad Steben, Germany.
Radiat Environ Biophys. 2019 Mar;58(1):129-135. doi: 10.1007/s00411-018-0768-z. Epub 2018 Nov 19.
Sustained pain relief following radon spa therapy in patients suffering from chronic painful diseases has been well described. But still, the underlying mechanisms are not fully understood. We conducted the prospective and explorative RAD-ON01 study which included 103 patients who suffered from chronic painful musculoskeletal disorders of the spine and/or joints and present here the data of the examination of pro- and anti-inflammatory cytokines in the serum of the patients before and at weeks 6, 12 and 30 after therapy. While TNFα, IL-1β, IFNγ, IL-1Ra and IL-10 were not altered, TGFβ was temporarily significantly (p = 0.013) elevated 6 weeks after therapy. Importantly, this elevation positively correlated with lowered pain sensitivity (r = 0.41). Further, the amount of IL-18 in the serum positively correlated with lowered pain sensitivity. Therefore, IL-18 can be considered as predictive marker for pain sensitivity of radon spa patients. We conclude that alterations in TGFβ and general IL-18 levels in serum have prognostic and predictive value in situations of lowered pain by exposure of patients to very low-doses of radiation as it is the case in radon spa.
氡泉疗法对患有慢性疼痛疾病的患者具有持续的止痛效果，这一点已有充分描述。但即便如此，其潜在机制仍未完全明确。我们开展了前瞻性探索性RAD-ON01研究，纳入了103例患有脊柱和/或关节慢性疼痛性肌肉骨骼疾病的患者，并在此展示患者治疗前以及治疗后第6周、12周和30周血清中促炎和抗炎细胞因子的检测数据。虽然肿瘤坏死因子α（TNFα）、白细胞介素-1β（IL-1β）、干扰素γ（IFNγ）、白细胞介素-1受体拮抗剂（IL-1Ra）和白细胞介素-10（IL-10）未发生改变，但转化生长因子β（TGFβ）在治疗后6周出现暂时显著升高（p = 0.013）。重要的是，这种升高与疼痛敏感性降低呈正相关（r = 0.41）。此外，血清中白细胞介素-18（IL-18）的含量与疼痛敏感性降低呈正相关。因此，IL-18可被视为氡泉治疗患者疼痛敏感性的预测标志物。我们得出结论，血清中TGFβ和一般IL-18水平的变化在患者接受极低剂量辐射（如氡泉治疗）导致疼痛减轻的情况下具有预后和预测价值。
