Bhomia Manish, Giordano Nicholas A, Highland Krista B, Lee Keren, Van Shufflin Matthew, Feng Yanru, Kane Alexandra, Kroma Raymond B, Knollmann-Ritschel Barbara
Department of Pathology, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20817, USA.
Int J Mol Sci. 2025 Jun 21;26(13):5959. doi: 10.3390/ijms26135959.
The bidirectional relationship between chronic pain and poor sleep are well reported. Disrupted sleep and chronic pain, either alone or in conjunction, are often associated with poor post-surgical outcomes. However, the relationship between peripheral blood biomarkers and chronic pain and sleep disturbances after orthopedic surgery has not been extensively studied. The goal of this observational prospective study was to conduct an analysis on the relationship of blood cytokines and chemokines with chronic pain and sleep outcomes among US service members undergoing orthopedic surgery. Active-duty service members (N = 114) who underwent orthopedic extremity or spinal surgery were recruited, of whom 69 completed pre-surgery and 64 completed 6-week post-surgery surveys and blood draws. Blood cytokine and chemokine analyses were performed using multiplex immunoassays. Non-parametric correlations with blood cytokine and chemokine showed significant associations with both pre- and post-surgical pain scores whereas no significant correlations were observed with sleep disturbance scores. Increased pain intensity 6 weeks after surgery was positively associated with increased hepatocyte growth factor (ρ = 0.11; < 0.05) and negatively correlated with interleukin-2r (ρ= -0.42; < 0.001). This study found that inflammatory biomarkers are associated with pre- and post-surgical pain but not sleep disturbances.
慢性疼痛与睡眠不佳之间的双向关系已有充分报道。睡眠中断和慢性疼痛，无论是单独出现还是同时出现，都常常与术后不良结果相关。然而，外周血生物标志物与骨科手术后慢性疼痛和睡眠障碍之间的关系尚未得到广泛研究。这项观察性前瞻性研究的目的是分析美国接受骨科手术的军人血液中的细胞因子和趋化因子与慢性疼痛和睡眠结果之间的关系。招募了接受骨科四肢或脊柱手术的现役军人（N = 114），其中69人完成了术前调查，64人完成了术后6周的调查和血液抽取。使用多重免疫测定法进行血液细胞因子和趋化因子分析。与血液细胞因子和趋化因子的非参数相关性显示，其与术前和术后疼痛评分均存在显著关联，而与睡眠障碍评分未观察到显著相关性。术后6周疼痛强度增加与肝细胞生长因子增加呈正相关（ρ = 0.11；<0.05），与白细胞介素-2r呈负相关（ρ = -0.42；<0.001）。本研究发现，炎症生物标志物与术前和术后疼痛相关，但与睡眠障碍无关。
