Orthopaedic and Traumatology Surgery, Spine Division, Entre Douro e Vouga Hospital Center, Rua do Rustelhal, nº523, 4520-819, Santa Maria da Feira, Portugal.
Centro Hospitalar São João, Porto, Portugal.
Eur Spine J. 2023 Sep;32(9):3230-3244. doi: 10.1007/s00586-023-07717-1. Epub 2023 May 17.
OBJECTIVE: The purpose of this study was to systematically review the evidence on inflammatory biomarkers as analytic predictors of non-specific low back pain (NsLBP). Low back pain (LBP) is the number one cause of disability globally, posing a major health problem that causes an enormous social and economic burden, and there is an increasing interest on the importance of biomarkers in quantifying and even emerge as potential therapeutic tools to LBP. METHODS: A systematic search was conducted on July 2022 in Cochrane Library, MEDLINE and Web of Science for all the available literature. Cross-sectional, longitudinal cohort or case-control studies that evaluated the relationship between inflammatory biomarkers collected from blood samples and low back pain in humans were considered eligible for inclusion, as well as prospective and retrospective studies. RESULTS: The systematic database search resulted in a total of 4016 records, of which 15 articles were included for synthesis. Sample size comprised a total of 14,555 patients with LBP (acute LBP (n = 2073); chronic LBP (n = 12482)) and 494 controls. Most studies found a positive correlation between classic pro-inflammatory biomarkers and NsLBP, namely C-reactive protein (CRP), interleukin 1 (IL-1) and IL-1β, interleukin 6 (IL-6) and tumour necrosis factor α (TNF-α). On the other hand, anti-inflammatory biomarker interleukin 10 (IL-10) demonstrated a negative association with NsLBP. Four studies have made direct comparisons between ALBP and CLBP groups regarding their inflammatory biomarkers profile. CONCLUSIONS: This systematic review found evidence of increased levels of pro-inflammatory biomarkers CRP, IL-6 and TNF-α and decreased levels of anti-inflammatory biomarker IL-10 in patients with LBP. Hs-CRP was not correlated with LBP. There is insufficient evidence to associate these findings with the degree of pain severity or the activity status of the lumbar pain over time.
目的:本研究旨在系统回顾炎症生物标志物作为非特异性下腰痛(NsLBP)分析预测因子的证据。腰痛(LBP)是全球头号致残原因,是一个主要的健康问题,造成了巨大的社会和经济负担,人们对生物标志物在量化甚至作为腰痛潜在治疗工具的重要性越来越感兴趣。
方法:2022 年 7 月,我们在 Cochrane 图书馆、MEDLINE 和 Web of Science 上对所有可用文献进行了系统检索。纳入评估从血液样本中收集的炎症生物标志物与人类下腰痛之间关系的横断面、纵向队列或病例对照研究,以及前瞻性和回顾性研究。
结果:系统数据库搜索共产生了 4016 条记录,其中有 15 篇文章被纳入综合分析。样本量共包括 14555 名 LBP 患者(急性 LBP(n=2073);慢性 LBP(n=12482))和 494 名对照者。大多数研究发现经典促炎生物标志物与 NsLBP 之间存在正相关,即 C 反应蛋白(CRP)、白细胞介素 1(IL-1)和 IL-1β、白细胞介素 6(IL-6)和肿瘤坏死因子α(TNF-α)。另一方面,抗炎生物标志物白细胞介素 10(IL-10)与 NsLBP 呈负相关。四项研究对急性和慢性 LBP 组的炎症生物标志物谱进行了直接比较。
结论:本系统评价发现 LBP 患者的促炎生物标志物 CRP、IL-6 和 TNF-α水平升高,抗炎生物标志物 IL-10 水平降低。hs-CRP 与 LBP 不相关。目前尚无足够证据将这些发现与疼痛严重程度或腰痛随时间活动状态相关联。
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