Tong Yanping, Liu Jie, Yang Tao, Wang Jingwen, Zhao Tianyou, Kang Yuezhi, Fan Yongping
Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China.
Beijing Integrative Medicine on Encephalopathy Research Institution, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, People's Republic of China.
Neuropsychiatr Dis Treat. 2022 May 17;18:1039-1046. doi: 10.2147/NDT.S359620. eCollection 2022.
To investigate the association of pain with plasma C5a levels and other related inflammatory cytokines in neuromyelitis optica spectrum disorders (NMOSD) patients during remission.
NMOSD patients (n = 87) and healthy controls (HC; n = 44) were consecutively recruited between January 2017 and April 2018. Plasma complement 5 (C5), C5a, interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-1β levels were detected. Visual Analogue Scale (VAS), ID pain scale, 24-item Hamilton Depression Scale (HAMD), Multiple Sclerosis Impact Scale (MSIS-29), and Kurtzke Expanded Disability Status Scale (EDSS) were used to evaluate the degree and types of pain, the existence of depression and anxiety, and the life quality and disability status of patients. Binary logistic regression equation was used to assess the association of pain with plasma C5a levels.
Among the 87 NMOSD patients, 40 complained of pain that in 67.5% (27/40) of cases had a neuropathic component (ID pain ≥2). Plasma C5a, IL-6, TNF-α, and IL-1β levels were significantly elevated in NMOSD patients than in HC. Plasma C5 levels were negatively correlated with the time from sampling to the last relapse or disease onset. NMOSD patients with pain had higher plasma C5a levels, and they suffered from a higher disability, more anxiety, and worse life quality compared to those patients without pain. In NMOSD patients with pain, there were not significant differences between plasma levels of C5, C5a, IL-6, TNF-α, or IL-1β, regardless of neuropathic pain or not. Binary logistic regression showed that the OR of plasma C5a level was 1.002, with gender and EDSS score were identified as independent factors associated with pain in NMOSD.
NMOSD patients during remission had elevated C5a and related inflammatory cytokines levels in peripheral blood. Elevated C5a may have a unique role in the pathogenesis of pain in NMOSD patients.
探讨视神经脊髓炎谱系障碍（NMOSD）缓解期患者疼痛与血浆C5a水平及其他相关炎性细胞因子的关系。
2017年1月至2018年4月连续纳入NMOSD患者（n = 87）和健康对照者（HC；n = 44）。检测血浆补体5（C5）、C5a、白细胞介素（IL）-6、肿瘤坏死因子（TNF）-α和IL-1β水平。采用视觉模拟评分法（VAS）、ID疼痛量表、24项汉密尔顿抑郁量表（HAMD）、多发性硬化症影响量表（MSIS-29）和库尔特克扩展残疾状态量表（EDSS）评估疼痛的程度和类型、抑郁和焦虑的存在情况以及患者的生活质量和残疾状态。采用二元逻辑回归方程评估疼痛与血浆C5a水平的关系。
87例NMOSD患者中，40例主诉疼痛，其中67.5%（27/40）的病例有神经病理性成分（ID疼痛≥2）。NMOSD患者血浆C5a、IL-6、TNF-α和IL-1β水平显著高于HC。血浆C5水平与从采样到最后一次复发或疾病发作的时间呈负相关。与无疼痛的患者相比，有疼痛的NMOSD患者血浆C5a水平更高，残疾程度更高，焦虑更严重，生活质量更差。在有疼痛的NMOSD患者中，无论是否为神经病理性疼痛，血浆C5、C5a、IL-6、TNF-α或IL-1β水平均无显著差异。二元逻辑回归显示，血浆C5a水平的比值比为1.002，性别和EDSS评分被确定为与NMOSD患者疼痛相关的独立因素。
NMOSD缓解期患者外周血中C5a及相关炎性细胞因子水平升高。C5a升高可能在NMOSD患者疼痛的发病机制中起独特作用。
