Dhahri Rim, Ben Ayed Hiba, Dergaa Ismail, Ceylan Halil İbrahim, Tazaghdanti Aymen, Kochkar Radhia, Ghazouani Ezzedine, Fenniche Insaf, Ben Ammar Lobna, Jebri Refka, Dorgham Imen, Slouma Maroua, Muntean Raul-Ioan, Gharsallah Imen
Rheumatology Department, Military Hospital of Instruction of Tunis, Tunis 1006, Tunisia.
High Institute of Sport and Physical Education of Ksar Said, University of Manouba, Manouba 2010, Tunisia.
J Clin Med. 2025 May 27;14(11):3761. doi: 10.3390/jcm14113761.
Chronic low back pain (LBP) remains a leading cause of disability and healthcare utilization globally, with complex, multifactorial pathophysiology. Despite advances in imaging, diagnosis often remains challenging due to poor correlation between structural findings and clinical symptoms. Recent evidence suggests inflammatory mechanisms may underlie persistent pain. This study investigated whether systemic inflammatory cytokines are altered in military personnel with chronic LBP and examined their relationships with clinical manifestations, psychological factors, and radiological findings. In this cross-sectional study, we enrolled 50 patients with chronic non-specific LBP (duration ≥ 3 months) and 50 age-, sex-, and BMI-matched healthy controls. All patients underwent a comprehensive clinical assessment, which included evaluation of pain intensity (VAS), neuropathic pain screening (DN4), psychological assessment (HADS), fibromyalgia screening (FIRST), and assessment of functional disability (Oswestry Disability Index and Roland-Morris Disability Questionnaire, EIFEL). Serum levels of IL-6, IL-8, IL-1β, TNF-α, and IL-10 were measured using chemiluminescence and enzyme-linked immunosorbent assay (ELISA) techniques. Radiological findings were documented through MRI and CT imaging of the lumbar spine. Serum IL-8 levels were significantly elevated in patients with chronic LBP compared to healthy controls (8.52 ± 6.7 vs. 4.8 ± 0.56 pg/mL, < 0.001). Weak positive correlations were observed between IL-8 levels and anxiety scores (r = 0.3, = 0.02) and functional disability, as measured by the EIFEL questionnaire (r = 0.3, = 0.04); however, these associations did not remain significant after Bonferroni correction for multiple testing. Similarly, IL-6 showed a weak positive correlation with BMI (r = 0.21, = 0.03) and a weak negative correlation with lumbar mobility, as assessed by Schober's test (r = -0.38, = 0.03), which also did not survive correction for multiple comparisons. This study identified serum IL-8 as a potential biomarker for chronic LBP. While we observed associations between specific inflammatory markers and psychological distress and functional disability, these correlations were weak and did not remain significant after correction for multiple testing. These preliminary findings suggest possible connections between inflammation and the psychophysiological aspects of chronic LBP that warrant further investigation in larger cohorts.
慢性下腰痛（LBP）仍是全球残疾和医疗保健利用的主要原因，其病理生理复杂且多因素。尽管影像学取得了进展，但由于结构检查结果与临床症状之间的相关性较差，诊断往往仍具有挑战性。最近的证据表明，炎症机制可能是持续性疼痛的基础。本研究调查了慢性LBP军人的全身炎症细胞因子是否发生改变，并研究了它们与临床表现、心理因素和影像学检查结果之间的关系。在这项横断面研究中，我们纳入了50例慢性非特异性LBP患者（病程≥3个月）和50例年龄、性别和BMI匹配的健康对照。所有患者均接受了全面的临床评估，包括疼痛强度评估（视觉模拟评分法，VAS）、神经性疼痛筛查（DN4）、心理评估（医院焦虑抑郁量表，HADS）、纤维肌痛筛查（FIRST）以及功能障碍评估（Oswestry功能障碍指数和Roland-Morris功能障碍问卷，EIFEL）。采用化学发光和酶联免疫吸附测定（ELISA）技术检测血清白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）和白细胞介素-10（IL-10）水平。通过腰椎的磁共振成像（MRI）和计算机断层扫描（CT）记录影像学检查结果。与健康对照相比，慢性LBP患者血清IL-8水平显著升高（8.52±6.7 vs. 4.8±0.56 pg/mL，P<0.001）。观察到IL-8水平与焦虑评分（r = 0.3，P = 0.02）以及EIFEL问卷测量的功能障碍之间存在弱正相关（r = 0.3，P = 0.04）；然而，在进行多重检验的Bonferroni校正后，这些关联不再显著。同样，IL-6与BMI呈弱正相关（r = 0.21，P = 0.03），与Schober试验评估的腰椎活动度呈弱负相关（r = -0.38，P = 0.03），在进行多重比较校正后也不再显著。本研究确定血清IL-8为慢性LBP的潜在生物标志物。虽然我们观察到特定炎症标志物与心理困扰和功能障碍之间存在关联，但这些相关性较弱，在进行多重检验校正后不再显著。这些初步发现提示炎症与慢性LBP的心理生理方面可能存在联系，值得在更大的队列中进一步研究。
