机构：[1]Spine Labs, St George and Sutherland Clinical School, University of New South Wales, Randwick, New South Wales, Australia[2]Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China首都医科大学宣武医院[3]Spine Service, Department of Orthopaedic Surgery, St George and Sutherland Clinical School, University of New South Wales, Kogarah, New South Wales, Australia
IntroductionLow back disorder (LBD) is a major cause of disability worldwide. Inflammation results in proliferation of cytokines or consequent degradation products (collectively known as inflammatory biomarkers) that activate pain pathways which can result in non-specific LBD. This systematic review and meta-analysis aim to evaluate the relationship between inflammatory biomarkers and clinical outcomes in patients with LBD.MethodsThe PRISMA guideline was followed for the systematic reivew. Three online databases were searched. Four RCTs and sixteen observational studies with 1142 LBD patients were analysed. The primary outcomes were back and leg pain scores, back-specific disability scores and expression of inflammatory biomarkers. Standardized mean difference (SMD) and their 95% confidence intervals (CI) were evaluated. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to summarize the strength of evidence.ResultsFour RCTs and sixteen observational studies were included in the analysis of 1142 patients with LBD. There was a statistically significant reduction in back pain score and IL-1 beta and increase in the expression of CTX-1 and IL-10 levels post treatment. There was a significant relationship between increase in the expression of MCP- and reduction in the expression of hsCRP with increase in back pain. Significant relationship was also observed between increase in the expression of MCP-1 and reduction in the expression of IL-6 with increase in leg pain. Increase in the expression of IL-8 and reduction in the expression of hsCRP was also associated with increased disability score.ConclusionInflammatory biomarkers play a significant role in the pathogenesis of LBD. CTX-1, IL-10 and IL-1 beta may be responsible for the decrease in back pain scores post treatment. There is a relationship between MCP-1, IL-6, IL-8 and hsCRP with clinical and functional assessments for LBD. Further studies will improve understanding of the pathogenesis of LBD and aid in targeted management strategies.
基金：
This work was supported by a University Postgraduate Award from the
University of New South Wales to Stone Sima. Spine Labs is supported
via unrestricted research grants to its institution by Baxter Inc and
Nuvasive Inc.
第一作者机构：[1]Spine Labs, St George and Sutherland Clinical School, University of New South Wales, Randwick, New South Wales, Australia[*1]Spine Labs, St George and Sutherland Clinical School, University of New South Wales, Randwick, New South Wales, Australia
通讯作者：
通讯机构：[1]Spine Labs, St George and Sutherland Clinical School, University of New South Wales, Randwick, New South Wales, Australia[2]Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China[*1]Spine Labs, St George and Sutherland Clinical School, University of New South Wales, Randwick, New South Wales, Australia[*2]Department of Orthopaedics, Xuanwu Hospital Capital Medical University, Changchun Street 45, Xicheng District, Beijing, China
推荐引用方式(GB/T 7714)：
Sima Stone,Chen Xiaolong,Diwan Ashish D..The association between inflammatory biomarkers and low back disorder: a systematic review and meta-analysis[J].BIOMARKERS.2024,29(4):171-184.doi:10.1080/1354750X.2024.2339285.
APA：
Sima, Stone,Chen, Xiaolong&Diwan, Ashish D..(2024).The association between inflammatory biomarkers and low back disorder: a systematic review and meta-analysis.BIOMARKERS,29,(4)
MLA：
Sima, Stone,et al."The association between inflammatory biomarkers and low back disorder: a systematic review and meta-analysis".BIOMARKERS 29..4(2024):171-184
