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Zhang J, Li Y, Gong A, Wang J. From proteome to pathogenesis: investigating polycystic ovary syndrome with Mendelian randomization analysis. Front Endocrinol (Lausanne) 2024; 15:1442483. [PMID: 39314522 PMCID: PMC11417002 DOI: 10.3389/fendo.2024.1442483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 08/21/2024] [Indexed: 09/25/2024] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is defined by oligo/anovulation, hyperandrogenism, and polycystic ovaries with uncertain pathogenesis. The proteome represents a substantial source of therapeutic targets, and their coding genes may elucidate the mechanisms underlying PCOS. However, reports on the profiles of the human plasma protein-coding genes and PCOS are limited. Here, we aimed to investigate novel biomarkers or drug targets for PCOS by integrating genetics and the human plasma proteome. Methods Our study acquired the protein quantitative trait loci from DECODE Genetics, offering 4,907 proteins in 35,559 individuals while obtaining PCOS summary statistics by accessing the FinnGen biobank (1,639 cases and 218,970 controls) and the genome-wide association study catalog (797 cases and 140,558 controls). Herein, we sequentially used two-sample Mendelian randomization (MR) analyses and colocalization to verify the causal link between candidate proteins, their coding genes, and PCOS. Further PCOS data download was conducted by accessing the Gene Expression Omnibus and Zenodo platforms. Gene expression level analysis, pathway enrichment analysis, immune cell infiltration, and transcription factor prediction were performed, aiming at detecting specific cell types with enriched expression and exploring potential optimized treatments for PCOS. Results MR analysis revealed 243 protein-coding genes with a causal relationship to PCOS risk, of which 12 were prioritized with the most significant evidence. Through colocalization analysis, three key genes, CUB domain-containing protein 1 (CDCP1), glutaredoxin 2 (GLRX2), and kirre-like nephrin family adhesion molecule 2 (KIRREL2), were identified. Subsequently, the three genes were strongly related to immune function and metabolism in terms of biological significance. In single-cell analysis, the expression levels of genes in ovarian theca cells were explored. Conclusion Overall, three protein-coding genes (CDCP1, GLRX2, and KIRREL2) may be related to a higher PCOS risk, suggesting that they may be entry points for exploration of PCOS pathogenesis and treatment, warranting further clinical investigations.
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Affiliation(s)
- Jiaqi Zhang
- Department of Digestive Endoscopy, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yuqing Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Aixia Gong
- Department of Digestive Endoscopy, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Jingmin Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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Ventura L, do Espírito-Santo RF, Keaser M, Zhang Y, Ro JY, Da Silva JT. Green Light Exposure Reduces Primary Hyperalgesia and Proinflammatory Cytokines in a Rodent Model of Knee Osteoarthritis: Shedding Light on Sex Differences. Biomedicines 2024; 12:2005. [PMID: 39335519 PMCID: PMC11429231 DOI: 10.3390/biomedicines12092005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/20/2024] [Accepted: 08/26/2024] [Indexed: 09/30/2024] Open
Abstract
Knee osteoarthritis (OA) often causes chronic pain that disproportionately affects females. Proinflammatory cytokines TNF-α, IL-1β, and IL-6 are key effectors of OA pathological changes. Green light shows potential as an alternative intervention for various pain conditions. However, no studies have investigated green light's analgesic effects in both sexes in chronic knee OA. We induced unilateral knee OA with intra-articular injection of monoiodoacetate (MIA) in male and female Sprague-Dawley rats. Two days post-injection, the rats were exposed to green-light-emitting diodes (GLED) or ambient room light eight hours daily for 24 days. Knee mechanical sensitivity was assessed using a small animal algometer. Blood serum concentrations of TNF-α, IL-1β, IL-6, and IL-10 were quantified at baseline and 23 days post-injection. MIA injection decreased the knee mechanical thresholds of the male and female rats. GLED exposure attenuated mechanical hypersensitivity in both sexes compared to the controls; however, GLED-induced analgesia occurred sooner and with greater magnitude in males than in females. In both sexes, the analgesic effects of green light lasted 5 days after the final GLED session. Finally, GLED exposure reversed the elevation of serum proinflammatory cytokines. These findings suggest that GLED exposure reduces primary hyperalgesia in OA, potentially by lowering proinflammatory cytokines, and indicate sex differences in GLED-induced analgesia.
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Affiliation(s)
- Laura Ventura
- Center to Advance Chronic Pain Research, Department of Neural and Pain Sciences, University of Maryland Baltimore School of Dentistry, Baltimore, MD 21201, USA
- Program in Neuroscience, University of Maryland Baltimore School of Medicine, Baltimore, MD 21201, USA
| | - Renan F do Espírito-Santo
- Center to Advance Chronic Pain Research, Department of Neural and Pain Sciences, University of Maryland Baltimore School of Dentistry, Baltimore, MD 21201, USA
| | - Michael Keaser
- Center to Advance Chronic Pain Research, Department of Neural and Pain Sciences, University of Maryland Baltimore School of Dentistry, Baltimore, MD 21201, USA
| | - Youping Zhang
- Center to Advance Chronic Pain Research, Department of Neural and Pain Sciences, University of Maryland Baltimore School of Dentistry, Baltimore, MD 21201, USA
| | - Jin Y Ro
- Center to Advance Chronic Pain Research, Department of Neural and Pain Sciences, University of Maryland Baltimore School of Dentistry, Baltimore, MD 21201, USA
| | - Joyce T Da Silva
- Center to Advance Chronic Pain Research, Department of Neural and Pain Sciences, University of Maryland Baltimore School of Dentistry, Baltimore, MD 21201, USA
- Program in Neuroscience, University of Maryland Baltimore School of Medicine, Baltimore, MD 21201, USA
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Åström Reitan JLM, Karshikoff B, Holmström L, Lekander M, Kemani MK, Wicksell RK. Associations between sickness behavior, but not inflammatory cytokines, and psychiatric comorbidity in chronic pain. Psychoneuroendocrinology 2024; 167:107094. [PMID: 38896989 DOI: 10.1016/j.psyneuen.2024.107094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/02/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES Approximately one in five adults experiences chronic pain, often in co-occurrence with depression, insomnia, anxiety, and lower self-rated health. Elevated levels of cytokines, e.g. tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), interleukin 8 (IL-8), and interleukin 10 (IL-10), have been identified in patients with chronic pain. Depression, insufficient sleep, poor self-rated health, and pain intensity have also been associated with inflammatory biomarkers. This study aimed to investigate the interrelationships between inflammatory biomarkers and depression, insomnia, anxiety, self-rated health, sickness behavior, and pain intensity in patients with chronic pain. METHODS Self-report questionnaires and blood samples analyzed for plasma levels of inflammatory biomarkers were collected from 80 adult patients with chronic pain. Associations between inflammatory biomarkers (TNF-α, IL-6, IL-8, IL-10, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)) and depression, insomnia, anxiety, self-rated health, sickness behavior, and pain intensity, were analyzed using bivariate Spearman rank correlation coefficients and regression analyses. RESULTS Participants were mainly women (72.5 %), with a mean age of 50.8 years, and a reported mean pain duration of 16.7 years. There were significant correlations between insomnia and CRP (rs =.26, p <.05); sex and ESR (rs =.29, p <.05); age and IL-6 (rs =.29, p <.05) and IL-8 (rs =.30, p <.05); BMI and IL-6 (rs =.50, p <.001), CRP (rs =.63, p <.001) and ESR (rs =.42, p <.001). Ratings of depression were positively and significantly related to ratings of sickness behavior and anxiety (β =.32 and β =.40, respectively), explaining 49 % of the total variance in depression ratings. Insomnia was positively and significantly related to sickness behavior (β =.37) explaining 31 % of the total variance in insomnia ratings. Inflammatory biomarkers, however, did not contribute significantly to the models. CONCLUSIONS Participants reported high levels of symptoms, yet the associations between these ratings and the inflammatory biomarkers were either absent or weak. Also, despite high levels of self-reported sickness behavior, overall the inflammatory status remained within the normal range. Ratings of sickness behavior contributed more than inflammatory markers in explaining ratings of depression and insomnia. The present results point to the complexity of chronic pain, and the challenges of identifying biomarkers that explain symptomatology.
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Affiliation(s)
- Jenny L M Åström Reitan
- Behavioral Medicine, Theme Women's Health and Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Bianka Karshikoff
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Social Studies, University of Stavanger, Stavanger, Norway
| | - Linda Holmström
- Behavioral Medicine, Theme Women's Health and Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Mike K Kemani
- Behavioral Medicine, Theme Women's Health and Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
| | - Rikard K Wicksell
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Pain Clinic, Capio S:t Görans Hospital, Stockholm, Sweden
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Rosenström AH, Ahmed AS, Kultima K, Freyhult E, Berg S, Bersellini Farinotti A, Palada V, Svensson CI, Kosek E. 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. Pain 2024; 165:e65-e79. [PMID: 38900144 PMCID: PMC11190896 DOI: 10.1097/j.pain.0000000000003175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/06/2023] [Accepted: 11/28/2023] [Indexed: 06/21/2024]
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.
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Affiliation(s)
| | - Aisha Siddiqah Ahmed
- Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Kim Kultima
- Department of Medical Sciences, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden
- Department of Physiology and Pharmacology, Karolinska Institute, Karolinska Institutet, Stockholm, Sweden
| | - Eva Freyhult
- Department of Cell and Molecular Biology, Uppsala University, Uppsala, Sweden
| | - Svante Berg
- Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
| | - Alex Bersellini Farinotti
- Department of Physiology and Pharmacology, Karolinska Institute, Karolinska Institutet, Stockholm, Sweden
| | - Vinko Palada
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. Palada is now with the Department of Physiology, University of Helsinki, Helsinki, Finland
| | - Camilla I. Svensson
- Department of Physiology and Pharmacology, Karolinska Institute, Karolinska Institutet, Stockholm, Sweden
| | - Eva Kosek
- Department of Surgical Sciences, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden. Palada is now with the Department of Physiology, University of Helsinki, Helsinki, Finland
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Lassen J, Leypoldt F, Hüllemann P, Janssen M, Baron R, Gierthmühlen J. The role of cytokines and chemokines in the maintenance of chronic pain-a pilot study. Pain Rep 2024; 9:e1135. [PMID: 38352023 PMCID: PMC10863945 DOI: 10.1097/pr9.0000000000001135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 02/16/2024] Open
Abstract
Introduction The immune system is believed to be important in the initiation and maintenance of chronic pain. Objectives The aim was to investigate whether patients with chronic painful polyneuropathy (PP) differ in cytokine profiles of serum and/or cerebrospinal fluid (CSF) compared with pain-free controls. Methods Thirty-nine patients (16 women and 23 men, mean age, 69.2 ± 12.7 years, range 41-92 years) with PP (mean duration 43 ± 48.3 months) were phenotyped with quantitative sensory testing and electroneurography, and serum and CSF samples were analyzed by 40-multiplexed, bead-based cytokine immunoassays. Results were compared with 36 age- and gender-matched patients with normal pressure hydrocephalus and absence of abnormal CSF findings. Results Compared with controls, patients with PP had lower concentrations of several proinflammatory and anti-inflammatory chemokines and cytokines in CSF, and others showed the same tendency, among these were tumor necrosis factor-α (14.1 ± 10.0 vs 23.9 ± 16.4 pg/mL, P < 0.005), interleukin (IL)-2 (0.6 ± 0.4 vs 1.2 ± 0.6 pg/mL, P < 0.0001), IL-6 (4.7 ± 6.8 vs 7.3 ± 9 pg/mL, P = 0.001), and IL-10 (7.5 ± 6.8 vs 16.8 ± 19.2 pg/mL, P < 0.01), whereas no differences were observed in serum. Conclusion Results suggest that (1) inflammatory mediators play a minor role in the maintenance of chronic pain in contrast to initiation of acute pain, (2) chemokines/cytokines are downregulated in chronic pain, or (3) chemokines/cytokines have a protective role for nerve regeneration that is disturbed in patients with chronic pain.
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Affiliation(s)
- Josephine Lassen
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Frank Leypoldt
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel/Lübeck, Germany
| | - Philipp Hüllemann
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Maren Janssen
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ralf Baron
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Janne Gierthmühlen
- Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Department for Anesthesiology and Surgical Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Uzunel E, Kronhed ACG, Alin CK, Ahmed AS, Wändell P, Salminen H. The Effect of Group Training or Spinal Orthosis on Quality of Life and Potential Plasma Markers of Pain in Older Women With Osteoporosis. A Randomized Controlled Trial. Arch Rehabil Res Clin Transl 2023; 5:100297. [PMID: 38163036 PMCID: PMC10757196 DOI: 10.1016/j.arrct.2023.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Objective Primary purpose was to examine the effects of exercise and use of a spinal orthosis on quality of life (QoL). Secondary, to explore the effects of above-mentioned interventions on plasma levels of potential markers of pain: substance P (SP), calcitonin gene-related peptide (CGRP), and interleukin-6 (IL-6). Design Randomized controlled trial. Setting Community-dwelling women in Stockholm. Participants A total of 113 women aged 60-93 years suffering from back pain and self-reported osteoporosis (n=113). Interventions The randomized controlled trial was 3-armed: participation in an equipment exercise group, treatment with an activating spinal orthosis or controls. The intervention time was 6 months. Main Outcome Measures QoL (QUALEFFO-41 and SF-36), plasma levels of SP, CGRP, and IL-6 measured at baseline and after 6 months in all 3 arms. Results No improvement of QoL was found. Comparing change in mobility (QUALEFFO-41), the effect in least squares means was lower in the spinal orthosis group compared with controls. In the exercise group, the role emotional score (SF-36) deteriorated during the intervention. Effect size varied between 0.02 and 0.6. There was no change in the levels of CGRP or SP, while IL-6 levels were lower at 6 months in the spinal orthosis group compared with the other groups. At least 1 previous vertebral fracture was verified by X-ray in 46 women. Conclusion The interventions showed none or negative effect on QoL, which was unexpected. The modest effect size may prompt a cautious interpretation. We found a lowering of IL-6 levels in the spinal orthosis group, but more studies are needed.
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Affiliation(s)
- Elin Uzunel
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Academic Primary Health Care Centre, Stockholm, Sweden
| | - Ann-Charlotte Grahn Kronhed
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Christina Kaijser Alin
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Aisha Siddiqah Ahmed
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Per Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Helena Salminen
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Academic Primary Health Care Centre, Stockholm, Sweden
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Kato J, Murase R, Minoshima R, Lu F, Toramaru T, Niki Y, Kosugi S, Morisaki H. Levels of preoperative cerebrospinal fluid pro-inflammatory mediators and chronic pain after total knee arthroplasty surgery. Acta Anaesthesiol Scand 2023; 67:1091-1101. [PMID: 37193632 DOI: 10.1111/aas.14278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 04/16/2023] [Accepted: 05/06/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Patients undergoing total knee arthroplasty (TKA) surgery are at high risk of chronic postsurgical pain (CPSP). Accumulating evidence suggests an active role of neuroinflammation in chronic pain. However, its role in the progression to CPSP following TKA surgery remains unanswered. Here, we examined the associations between preoperative neuroinflammatory states and pre- and postsurgical chronic pain in TKA surgery. METHODS The data of 42 patients undergoing elective TKA surgery for chronic knee arthralgia at our hospital were analyzed in this prospective study. Patients completed the following questionnaires: brief pain inventory (BPI), hospital anxiety and depression scale, painDETECT, and pain catastrophizing scale (PCS). Cerebrospinal fluid (CSF) samples were collected preoperatively and concentrations of IL-6, IL-8, TNF, fractalkine, and CSF-1 were measured by electrochemiluminescence multiplex immunoassay. CPSP severity was ascertained, using the BPI, 6 months postsurgery. RESULTS While no significant correlation was observed between the preoperative CSF mediator levels and preoperative pain profiles, the preoperative fractalkine level in the CSF showed a significant correlation with CPSP severity (Spearman's rho = -0.525; p = .002). Furthermore, multivariate linear regression analysis revealed that the preoperative PCS score (standardized β coefficient [β]: .11; 95% confidence interval [CI]: 0.06-0.16; p < .001) and CSF fractalkine level (β: -.62; 95% CI: -1.10 to -0.15; p = .012) were independent predictors of CPSP severity 6 months after TKA surgery. CONCLUSIONS We identified the CSF fractalkine level as a potential predictor for CPSP severity following TKA surgery. In addition, our study provided novel insights into the potential role of neuroinflammatory mediators in the pathogenesis of CPSP.
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Affiliation(s)
- Jungo Kato
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
| | - Reiko Murase
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
| | - Rie Minoshima
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
| | - Fanglin Lu
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
- Doctoral Program, Keio University Graduate School of Medicine, Tokyo, Japan
| | - Tomoko Toramaru
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuo Niki
- Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shizuko Kosugi
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Morisaki
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
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Inflammatory Blood Signature Related to Common Psychological Comorbidity in Chronic Pain. Biomedicines 2023; 11:biomedicines11030713. [PMID: 36979692 PMCID: PMC10045222 DOI: 10.3390/biomedicines11030713] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 03/02/2023] Open
Abstract
Chronic pain is characterized by high psychological comorbidity, and diagnoses are symptom-based due to a lack of clear pathophysiological factors and valid biomarkers. We investigate if inflammatory blood biomarker signatures are associated with pain intensity and psychological comorbidity in a mixed chronic pain population. Eighty-one patients (72% women) with chronic pain (>6 months) were included. Patient reported outcomes were collected, and blood was analyzed with the Proseek Multiplex Olink Inflammation Panel (Bioscience Uppsala, Uppsala, Sweden), resulting in 77 inflammatory markers included for multivariate data analysis. Three subgroups of chronic pain patients were identified using an unsupervised principal component analysis. No difference between the subgroups was seen in pain intensity, but differences were seen in mental health and inflammatory profiles. Ten inflammatory proteins were significantly associated with anxiety and depression (using the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Patient Health Questionnaire (PHQ-9): STAMBP, SIRT2, AXIN1, CASP-8, ADA, IL-7, CD40, CXCL1, CXCL5, and CD244. No markers were related to pain intensity. Fifteen proteins could differentiate between patients with moderate/high (GAD-7/PHQ-9 > 10) or mild/no (GAD-7/PHQ-9 < 10) psychological comorbidity. This study further contributes to the increasing knowledge of the importance of inflammation in chronic pain conditions and indicates that specific inflammatory proteins may be related to psychological comorbidity.
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Lötsch J, Mustonen L, Harno H, Kalso E. Machine-Learning Analysis of Serum Proteomics in Neuropathic Pain after Nerve Injury in Breast Cancer Surgery Points at Chemokine Signaling via SIRT2 Regulation. Int J Mol Sci 2022; 23:3488. [PMID: 35408848 PMCID: PMC8998280 DOI: 10.3390/ijms23073488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/14/2022] [Accepted: 03/19/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Persistent postsurgical neuropathic pain (PPSNP) can occur after intraoperative damage to somatosensory nerves, with a prevalence of 29-57% in breast cancer surgery. Proteomics is an active research field in neuropathic pain and the first results support its utility for establishing diagnoses or finding therapy strategies. METHODS 57 women (30 non-PPSNP/27 PPSNP) who had experienced a surgeon-verified intercostobrachial nerve injury during breast cancer surgery, were examined for patterns in 74 serum proteomic markers that allowed discrimination between subgroups with or without PPSNP. Serum samples were obtained both before and after surgery. RESULTS Unsupervised data analyses, including principal component analysis and self-organizing maps of artificial neurons, revealed patterns that supported a data structure consistent with pain-related subgroup (non-PPSPN vs. PPSNP) separation. Subsequent supervised machine learning-based analyses revealed 19 proteins (CD244, SIRT2, CCL28, CXCL9, CCL20, CCL3, IL.10RA, MCP.1, TRAIL, CCL25, IL10, uPA, CCL4, DNER, STAMPB, CCL23, CST5, CCL11, FGF.23) that were informative for subgroup separation. In cross-validated training and testing of six different machine-learned algorithms, subgroup assignment was significantly better than chance, whereas this was not possible when training the algorithms with randomly permuted data or with the protein markers not selected. In particular, sirtuin 2 emerged as a key protein, presenting both before and after breast cancer treatments in the PPSNP compared with the non-PPSNP subgroup. CONCLUSIONS The identified proteins play important roles in immune processes such as cell migration, chemotaxis, and cytokine-signaling. They also have considerable overlap with currently known targets of approved or investigational drugs. Taken together, several lines of unsupervised and supervised analyses pointed to structures in serum proteomics data, obtained before and after breast cancer surgery, that relate to neuroinflammatory processes associated with the development of neuropathic pain after an intraoperative nerve lesion.
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Affiliation(s)
- Jörn Lötsch
- Institute of Clinical Pharmacology, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Laura Mustonen
- Pain Clinic, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland; (L.M.); (H.H.); (E.K.)
- Clinical Neurosciences, Neurology, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland
| | - Hanna Harno
- Pain Clinic, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland; (L.M.); (H.H.); (E.K.)
- Clinical Neurosciences, Neurology, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland
- SleepWell Research Programme, University of Helsinki, 00014 Helsinki, Finland
| | - Eija Kalso
- Pain Clinic, Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland; (L.M.); (H.H.); (E.K.)
- SleepWell Research Programme, University of Helsinki, 00014 Helsinki, Finland
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Blanco JR, Cobos-Ceballos MJ, Navarro F, Sanjoaquin I, Armiñanzas C, Bernal E, Buzon-Martin L, Viribay M, Pérez-Martínez L, Espejo-Pérez S, Valencia B, Guzman-Aguilar J, Ruiz-Cubillan JJ, Alcalde C, Gutierrez-Herrero FG, Olalla J, Andres-Esteban EM, Jurado-Gamez B, Ugedo J. Elevated levels of serum CDCP1 in individuals recovering from severe COVID-19 disease. Aging (Albany NY) 2022; 14:1597-1610. [PMID: 35172279 PMCID: PMC8908919 DOI: 10.18632/aging.203898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/08/2022] [Indexed: 11/25/2022]
Abstract
Background: COVID-19 survivors report residual lung abnormalities after discharge from the hospital. The aim of this study was to identify biomarkers in serum and induced sputum samples from patients after hospitalization for COVID-19. Methods: Patients admitted to hospitals in Spain with laboratory-confirmed COVID-19 were recruited for this study. SARS-CoV-2-infected patients were divided into groups with mild/moderate and severe disease according to the severity of their symptoms during hospitalization. Levels of 92 biomarkers were measured in serum and induced sputum samples. Results: A total of 108 patients (46.2% severe cases) were included in this study. The median number of days after the onset of symptoms was 104. A significant difference was observed in diffusing capacity for carbon monoxide (DLCO), an indicator of lung function, whereby DLCO <80% was significantly lower in severe cases (p <0.001). Differences in inflammatory biomarkers were observed between patients with mild/moderate and severe disease. For some biomarkers, correlations in serum and induced sputum levels were detected. Independent predictors of severe disease were DLCO <80% and the serum CDCP1 value. Conclusions: Higher levels of CDCP1 remain after hospital discharge and are associated with the severity of COVID-19. The possible prognostic implications warrant further investigation.
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Affiliation(s)
- Jose-Ramon Blanco
- Servicio de Enfermedades Infecciosas, Hospital Universitario San Pedro, Logroño, La Rioja, Spain.,Centro de Investigación Biomédica de La Rioja, Logroño, La Rioja, Spain
| | - María-Jesús Cobos-Ceballos
- Instituto Maimónides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Córdoba, Spain.,Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Francisco Navarro
- Servicio de Medicina Interna, Hospital Costal de Sol, Marbella, Málaga, Spain
| | - Isabel Sanjoaquin
- Servicio de Enfermedades Infecciosas, HCU Lozano Blesa, Zaragoza, Spain
| | - Carlos Armiñanzas
- Servicio de Enfermedades Infecciosas, H Universitario Marqués de Valdecilla, Santander, Spain
| | - Enrique Bernal
- Unidad de Enfermedades Infecciosas, Hospital General Universitario Reina Sofía de Murcia, Murcia, Spain
| | - Luis Buzon-Martin
- Servicio de Medicina Interna, Hospital Universitario de Burgos, Burgos, Spain
| | | | | | - Simona Espejo-Pérez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Córdoba, Spain.,Servicio de Radiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Borja Valencia
- Servicio de Neumología, Hospital Costal de Sol, Marbella, Málaga, Spain
| | | | | | - Consuelo Alcalde
- Servicio de Neumología, Hospital General Universitario Reina Sofía de Murcia, Murcia, Spain
| | | | - Julian Olalla
- Servicio de Medicina Interna, Hospital Costal de Sol, Marbella, Málaga, Spain
| | - Eva-Maria Andres-Esteban
- Grupo PBM, Instituto de Investigación-IdiPaz, Madrid, Madrid, Spain.,Universidad Rey Juan Carlos, Madrid, Madrid, Spain
| | - Bernabe Jurado-Gamez
- Instituto Maimónides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Córdoba, Spain.,Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Javier Ugedo
- Servicio de Neumología, Hospital Universitario San Pedro, Logroño, La Rioja, Spain
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A Retrospective Analysis of Pain Etiology in Middle-Aged Patients with Peripheral Neuropathy. ACTA ACUST UNITED AC 2021; 57:medicina57080787. [PMID: 34440993 PMCID: PMC8399428 DOI: 10.3390/medicina57080787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/15/2021] [Accepted: 07/29/2021] [Indexed: 11/26/2022]
Abstract
Background and Objectives: Correct assessment and a multidisciplinary approach appear to be extremely important in preventing peripheral neuropathy and its complications. The purpose of this study was to find the correlations and dissimilarities between different types of peripheral neuropathy, the occurrence of pain, and laboratory results. Materials and Methods: This retrospective study assessed 124 patients who were hospitalized in our neurology department due to various types of sensory or motor disturbances. The patients were eventually diagnosed with peripheral neuropathy, based on the electrophysiological study, anamnesis, physical examination, and laboratory results. The whole group was subjected to statistical analysis. Results: The mean age of patients was over 56 years, with a slight woman predominance. A statistically significant (p < 0.05) relationship between the place of residence and gender was seen, where more men than women live in the rural area, while more women than men live in the urban area. Most often we observed symmetric, sensorimotor, demyelinating, inflammatory, and chronic neuropathy. More than 40% of patients reported pain. A statistically significant correlation between the evolution/severity and the occurrence of pain was seen in subacute type (p < 0.05) and small fibre neuropathy (p < 0.01). Conclusions: A higher incidence of peripheral neuropathy in middle-aged people will become essential in the aging society with lifestyle and chronic disorders. Peripheral neuropathy is slightly more common in women than men and its occurrence may be influenced by work performed or internal and external factors. In the study group, more than 40% of patients reported pain, therefore the pain measurement for each patient should be implemented and repeated at every visit. An assessment of sodium level and, in women, markers of neuroinflammation level in the various types of peripheral neuropathy may be an interesting direction for the future.
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