Injeyan H Stephen, Teodorczyk-Injeyan Julita A, Hogg-Johnson Sheilah, Rashed Shadi, Lee Joyce, Harris Glen
Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
Biomark Insights. 2025 Jul 27;20:11772719251355038. doi: 10.1177/11772719251355038. eCollection 2025.
Chronic non-specific low back pain (CNSLBP) is a debilitating condition with unclear underlying mechanisms. The presence of systemic biomarkers associated with inflammation in nonspecific low back pain (NSLBP) has been inconsistently reported primarily through invasive blood sampling.
This study evaluates the use of saliva as an alternative medium for assessing inflammatory biomarker levels in patients with CNSLBP.
Prospective cross-sectional pilot study.
Twenty-five patients with CNSLBP and 25 age and sex matched asymptomatic participants were selected according to specific inclusion and exclusion criteria. The primary outcome was determination of the levels of inflammatory biomarkers in unstimulated saliva samples of CNSLBP patients relative to controls using Luminex™ 200 technology. Secondary outcomes were pain, disability and anxiety/stress levels of participants.
In CNSLBP patients, 9 biomarkers interferon γ (IFNγ), interleukin-2 (IL-2), IL-4, IL-5, IL-10, IL-13, IL-12p40, IL-12p70, and tumor necrosis factor α (TNFα) were comparable to controls ( = .25-.94). However, 4 pro-inflammatory mediators were significantly elevated, exhibiting medium to large effect sizes: IL-1β ( = .028, Cohen's = 1.62), IL-6 ( = .001, = 1.0), IL-8 ( = .002, = 0.86), and MCP-1 ( = .001, = 0.77). Additionally, IL-1Ra levels were significantly higher, though with a small effect size ( = .03, = 0.43). A significant correlation ( = .02) was observed between VAS pain scores and MCP-1 levels.
Saliva represents a viable medium for assessing key inflammatory biomarkers in patients with chronic non-specific low back pain (CNSLBP). Elevated levels of proinflammatory cytokines, IL-1, IL-6, IL-8, and the nociceptive chemokine MCP-1 were observed in comparison to asymptomatic controls, with MCP-1 showing a positive correlation with self-reported pain intensity. Future studies utilizing unstimulated saliva samples may further investigate changes in inflammatory biomarker levels to monitor treatment outcomes.
慢性非特异性下腰痛（CNSLBP）是一种使人衰弱的疾病，其潜在机制尚不清楚。关于非特异性下腰痛（NSLBP）中与炎症相关的全身生物标志物的存在情况，主要通过侵入性血液采样的报告并不一致。
本研究评估使用唾液作为评估CNSLBP患者炎症生物标志物水平的替代介质。
前瞻性横断面试点研究。
根据特定的纳入和排除标准，选择25例CNSLBP患者以及25例年龄和性别匹配的无症状参与者。主要结局是使用Luminex™ 200技术测定CNSLBP患者未刺激唾液样本中相对于对照组的炎症生物标志物水平。次要结局是参与者的疼痛、残疾和焦虑/压力水平。
在CNSLBP患者中，9种生物标志物，即干扰素γ（IFNγ）、白细胞介素-2（IL-2）、IL-4、IL-5、IL-10、IL-13、IL-12p40、IL-12p70和肿瘤坏死因子α（TNFα）与对照组相当（P = 0.25 - 0.94）。然而，4种促炎介质显著升高，表现出中等至大的效应量：IL-1β（P = 0.028，Cohen's d = 1.62）、IL-6（P = 0.001，d = 1.0）、IL-8（P = 0.002，d = 0.86）和单核细胞趋化蛋白-1（MCP-1）（P = 0.001，d = 0.77）。此外，IL-1Ra水平也显著升高，尽管效应量较小（P = 0.03，d = 0.43）。视觉模拟评分（VAS）疼痛评分与MCP-1水平之间存在显著相关性（P = 0.02）。
唾液是评估慢性非特异性下腰痛（CNSLBP）患者关键炎症生物标志物的可行介质。与无症状对照组相比，观察到促炎细胞因子IL-1、IL-6、IL-8和伤害感受趋化因子MCP-1水平升高，且MCP-1与自我报告的疼痛强度呈正相关。未来利用未刺激唾液样本的研究可能会进一步调查炎症生物标志物水平的变化以监测治疗效果。
