Semmelweis University School of Ph.D studies, Ulloi street 26, Budapest, 1086, Hungary.
National Center for Spinal Disorders, Kiralyhago street 1, Budapest, 1126, Hungary.
BMC Musculoskelet Disord. 2022 Aug 13;23(1):774. doi: 10.1186/s12891-022-05711-0.
Successfully surgically treating degenerative disc diseases can be challenging to the spine surgeons, the long-term outcome relies on both the physical and mental status of the patient before and after treatment. Numerous studies underlined the role of inflammatory cytokines - like interleukin 1B and 6 - in the development of chronic diseases such as failed back surgery syndrome (FBSS) and major depressive disorder (MDD) which alter the outcome after spinal surgery. Our aim was to evaluate the associations of IL6 and IL1B gene polymorphisms with the long-term outcome of degenerative lumbar spine surgeries.
An international genetical database (GENODISC) was combined with our institute's clinical database to create a large pool with long term follow up data. Altogether 431 patient's data were analysed. Patient reported outcome measures and surgical outcome was investigated in association with IL1B and IL6 SNPs with the help of 'SNPassoc' R genome wide association package.
Interleukin 1B variants analysis confirmed association with improvement of pain after surgery on individual SNP level and on haplotype level, moreover relationship with patient reported outcome and preoperative level of depression was found on individual SNP level. IL6 variants were associated with preoperative depression, somatization and with subsequent surgery.
Understanding the complexity of spinal surgery patients' long-term well-being is crucial in effectively treating chronic debilitating somatic diseases and the associated mental illnesses. Further studies should investigate more comprehensively the linkage of chronic physical and mental illnesses focusing on their simultaneous treatment.
成功治疗退行性椎间盘疾病对脊柱外科医生来说是一个挑战,长期疗效取决于患者治疗前后的身体和精神状态。许多研究强调了炎症细胞因子(如白细胞介素 1B 和 6)在慢性疾病(如失败的腰椎手术后综合征和重度抑郁症)发展中的作用,这些疾病会改变脊柱手术后的结果。我们的目的是评估白细胞介素 6 和白细胞介素 1B 基因多态性与退行性腰椎手术长期疗效的关系。
国际基因数据库(GENODISC)与我们研究所的临床数据库相结合,创建了一个具有长期随访数据的大型数据库。共分析了 431 例患者的数据。利用“SNPassoc”R 全基因组关联包,研究了白细胞介素 1B 和白细胞介素 6 SNP 与患者报告的结果和手术结果之间的关系。
白细胞介素 1B 变异分析证实了个体 SNP 水平和单体型水平上与手术后疼痛改善的相关性,此外,个体 SNP 水平上还发现与患者报告的结果和术前抑郁水平有关。IL6 变异与术前抑郁、躯体化以及随后的手术有关。
了解脊柱手术患者长期健康的复杂性对于有效治疗慢性衰弱性躯体疾病和相关精神疾病至关重要。进一步的研究应该更全面地研究慢性躯体和精神疾病的联系,重点是同时治疗。