Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, 9000 Rockville Pike, , Bethesda, MD, 20892, USA.
College of Science, George Mason University, 4400 University Drive, Fairfax, VA, 22032, USA.
BMC Musculoskelet Disord. 2023 Aug 1;24(1):624. doi: 10.1186/s12891-023-06744-9.
Myofascial Pain Syndrome (MPS) is a common pain disorder. Diagnostic criteria include physical findings which are often unreliable or not universally accepted. A precise biosignature may improve diagnosis and treatment effectiveness. The purpose of this study was to assess whether microanalytic assays significantly correlate with characteristic clinical findings in people with MPS.
This descriptive, prospective study included 38 participants (25 women) with greater than 3 months of myofascial pain in the upper trapezius. Assessments were performed at a university laboratory. The main outcome measures were the Beighton Index, shoulder range of motion, strength asymmetries and microanalytes: DHEA, Kynurenine, VEGF, interleukins (IL-1b, IL-2, IL-4, IL-5, IL-7, IL-8, IL-13), growth factors (IGF-1, IGF2, G-CSF, GM-CSF), MCP-1, MIP-1b, BDNF, Dopamine, Noradrenaline, NPY, and Acetylcholine. Mann-Whitney test and Spearman's multivariate correlation were applied for all variables. The Spearman's analysis results were used to generate a standard correlation matrix and heat map matrix.
Mean age of participants was 32 years (20-61). Eight (21%) had widespread pain (Widespread Pain Index ≥ 7). Thirteen (34%) had MPS for 1-3 years, 14 (37%) 3-10 years, and 11 (29%) for > 10 years. The following showed strong correlations: IL1b,2,4,5,7,8; GM-CSF and IL 2,4,5,7; between DHEA and BDNF and between BDNF and Kynurenine, NPY and acetylcholine. The heat map analysis demonstrated strong correlations between the Beighton Index and IL 5,7, GM-CSF, DHEA. Asymmetries of shoulder and cervical spine motion and strength associated with select microanalytes.
Cytokine levels significantly correlate with selected clinical assessments. This indirectly suggests possible biological relevance for understanding MPS. Correlations among some cytokine clusters; and DHEA, BDNF kynurenine, NPY, and acetylcholine may act together in MPS. These findings should be further investigated for confirmation that link these microanalytes with select clinical findings in people with MPS.
肌筋膜疼痛综合征（MPS）是一种常见的疼痛障碍。诊断标准包括物理发现，这些发现通常不可靠或不被普遍接受。精确的生物标志物可能会提高诊断和治疗效果。本研究的目的是评估微分析检测是否与 MPS 患者的特征性临床发现有显著相关性。
这是一项描述性、前瞻性研究，纳入了 38 名（25 名女性）患有上斜方肌大于 3 个月的肌筋膜疼痛的参与者。评估在大学实验室进行。主要的结局指标是 Beighton 指数、肩部活动范围、力量不对称和微分析物：脱氢表雄酮、犬尿氨酸、血管内皮生长因子、白细胞介素（IL-1b、IL-2、IL-4、IL-5、IL-7、IL-8、IL-13）、生长因子（IGF-1、IGF2、G-CSF、GM-CSF）、MCP-1、MIP-1b、BDNF、多巴胺、去甲肾上腺素、NPY 和乙酰胆碱。对所有变量均采用曼-惠特尼检验和斯皮尔曼多元相关性分析。斯皮尔曼分析结果用于生成标准相关矩阵和热图矩阵。
参与者的平均年龄为 32 岁（20-61 岁）。8 人（21%）有广泛疼痛（广泛性疼痛指数≥7）。13 人（34%）MPS 病程为 1-3 年，14 人（37%）病程为 3-10 年，11 人（29%）病程超过 10 年。以下显示出较强的相关性：IL1b、2、4、5、7、8；GM-CSF 和 IL 2、4、5、7；DHEA 和 BDNF 之间以及 BDNF 和犬尿氨酸、NPY 和乙酰胆碱之间。热图分析显示 Beighton 指数与 IL 5、7、GM-CSF、DHEA 之间有较强的相关性。肩部和颈椎运动和力量的不对称与特定的微分析物有关。
细胞因子水平与特定的临床评估有显著相关性。这间接表明，对于理解 MPS，生物相关性是可能的。一些细胞因子簇之间的相关性；以及 DHEA、BDNF 犬尿氨酸、NPY 和乙酰胆碱可能在 MPS 中共同作用。这些发现应进一步研究，以证实这些微分析物与 MPS 患者的特定临床发现之间存在关联。
