Lee Joshua Y, Walton David M
Faculty of Health Sciences, Western University, London, Ontario, Canada.
Can J Pain. 2021 Feb 16;5(1):30-42. doi: 10.1080/24740527.2020.1870102.
: The prevalence of inadequate treatments for chronic pain has necessitated the search for biological factors that influence the transition to chronicity. : Antecubital blood was drawn from those who experienced acute, noncatastrophic musculoskeletal trauma. Follow-up occurred at 1, 3, 6, and 12 months with the primary outcome being Brief Pain Inventory (BPI) Functional Interference scores. Eight markers were chosen for latent profile analysis: brain-derived neurotrophic factor (BDNF); transforming growth factor-beta 1 (TGF-β1); C-reactive protein (CRP); tumor necrosis factor-alpha (TNF-α); interleukins (ILs) 1-beta, 6, and 10; and the stress hormone cortisol. : Mean age of the 106 participants was 44.6 years and 58.5% were female. The final model indicated a three-class solution that could be adequately described by three of the eight markers: class 1 = low concentration of all markers (33.9% of the sample), class 2 = average concentration of all markers (47.7%), and class 3 = high concentration of BDNF and TGF-β1 (18.3%). BPI Pain Interference scores captured at both inception and 6-month follow-up were compared across the three groups. Mean scores were significantly higher in class 3 for the BPI Interference subscale at inception (27.0 [SD 16.4] vs. 35.8 [SD 17.3], = 0.05) and at 6-month follow-up (2.2 [SD 4.8] vs. 7.3 [SD 10.7], = 0.03) compared to those of the other two classes. : Although recovered populations are not significantly different in BDNF and TGF-β1 levels, those who experience persisting disability are more likely to have moderate to high levels in serum.
慢性疼痛治疗不足的普遍情况使得人们有必要寻找影响慢性化转变的生物学因素。从经历急性、非灾难性肌肉骨骼创伤的患者中采集肘前静脉血。在1、3、6和12个月进行随访,主要结局指标为简明疼痛量表(BPI)功能干扰评分。选择了八个标志物进行潜在类别分析:脑源性神经营养因子(BDNF);转化生长因子-β1(TGF-β1);C反应蛋白(CRP);肿瘤坏死因子-α(TNF-α);白细胞介素(ILs)1-β、6和10;以及应激激素皮质醇。106名参与者的平均年龄为44.6岁,58.5%为女性。最终模型显示为三类解决方案,可由八个标志物中的三个充分描述:第1类=所有标志物浓度低(占样本的33.9%),第2类=所有标志物浓度平均(47.7%),第3类=BDNF和TGF-β1浓度高(18.3%)。比较了三组在基线和6个月随访时的BPI疼痛干扰评分。在基线时,第3类的BPI干扰子量表平均得分显著高于其他两类(27.0[标准差16.4]对35.8[标准差17.3],P=0.05),在6个月随访时也是如此(2.2[标准差4.8]对7.3[标准差10.7],P=0.03)。虽然康复人群的BDNF和TGF-β1水平无显著差异,但经历持续残疾的人群血清中更可能有中度至高水平。