1. Unraveling the neuroimmune interface in chronic pain-the association between cytokines in the cerebrospinal fluid and pain in patients with lumbar disk herniation or degenerative disk disease.
- Author
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Rosenström AHC, Ahmed AS, Kultima K, Freyhult E, Berg S, Bersellini Farinotti A, Palada V, Svensson CI, and Kosek E
- Subjects
- Humans, Male, Female, Middle Aged, Adult, Aged, Lumbar Vertebrae, Pain Measurement methods, Neuroimmunomodulation physiology, Cytokines cerebrospinal fluid, Cytokines blood, Intervertebral Disc Displacement cerebrospinal fluid, Intervertebral Disc Displacement complications, Intervertebral Disc Displacement immunology, Intervertebral Disc Degeneration cerebrospinal fluid, Intervertebral Disc Degeneration immunology, Chronic Pain cerebrospinal fluid, Chronic Pain immunology, Chronic Pain blood
- Abstract
Abstract: Recent evidence highlights the importance of the neuroimmune interface, including periphery-to-central nervous system (CNS) neuroimmune crosstalk, in chronic pain. Although neuroinflammatory processes have been implicated in central sensitization for a long time, their potential neuroprotective and analgesic effects remain relatively elusive. We have explored the relationships between cytokine expression and symptom severity, and candidates for periphery-to-CNS crosstalk. Patients with degenerative disk disease (DDD) (nociceptive pain) or patients with lumbar disk herniation (LDH) with radiculopathy (predominantly neuropathic pain) completed questionnaires regarding pain and functional disability, underwent quantitative sensory testing, and provided blood and cerebrospinal fluid (CSF) samples. Proximity extension assay (PEA) was used to measure the levels of 92 inflammatory proteins in the CSF and serum from a total of 160 patients and controls, and CSF/serum albumin quotients was calculated for patients with DDD and patients with LDH. We found signs of neuroimmune activation, in the absence of systemic inflammation. Regarding periphery-to-CNS neuroimmune crosstalk, there were significant associations between several cytokines and albumin quotient, despite the latter being primarily at subclinical levels. The cytokines CCL11, CD5, IL8, and MMP-10 were elevated in the CSF, had positive correlations between CSF and serum levels, and associated in a nonlinear manner with back, but not leg, pain intensity in the LDH, but not the DDD, group. In conclusion, we found evidence for neuroimmune activation in the CNS of both patient groups in the absence of systemic inflammation and signs of a communication between CSF and serum. Complex and disease-specific associations were found between cytokines in CSF and back pain intensity., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.)
- Published
- 2024
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