Abstract：
Proinflammatory cytokines play a critical role in chronic inflammation and pain and contribute to behavioral symptoms (depressive symptoms, anxiety, fatigue, sleep disturbance) and comorbidities (diabetes, cardiac diseases, cancer). Evidence is lacking on the specific proinflammatory cytokines associated with these behavioral symptoms/comorbidities co-occurring with axial low back pain (aLBP). This review aimed to systematically analyze the following: (1) specific proinflammatory cytokines associated with aLBP in adults, (2) associations among proinflammatory cytokines and behavioral symptoms in aLBP, and (3) relationships among proinflammatory cytokines and comorbidities in aLBP, to develop a new clinical framework for future diagnostic and intervention targets for patients with aLBP.
Electronic databases, including PubMed/MEDLINE, ProQuest Nursing & Allied Health Source, and CINAHL Complete (EBSCO) were searched for the period January 2012 to February 2023. Eligible studies included cross-sectional, case-control, longitudinal, and cohort studies in which proinflammatory cytokines were reported in adults above 18 years with aLBP. Intervention studies and randomized controlled trails were excluded. The Joanna Briggs Institute (JBI) criteria were used for quality evaluation.
Findings from 11 studies showed 3 proinflammatory cytokines associated with pain intensity in adult patients with aLBP: C-Reactive Protein (CRP), Tumor Necrosis Factor (TNF-α), and Interleukin (IL-6). Some studies assessed associations between proinflammatory cytokines and depressive symptoms; none explored the association of proinflammatory cytokines with fatigue, anxiety, sleep disturbance, or comorbidities (diabetes, cardiac diseases, and cancer) in aLBP.
Proinflammatory cytokines in aLBP can serve as composite biomarkers for pain, associated symptoms, and comorbidities and may serve as a target for future interventions. There is need for well-designed studies assessing associations among chronic inflammation, behavioral symptoms, and comorbidities.
Electronic databases, including PubMed/MEDLINE, ProQuest Nursing & Allied Health Source, and CINAHL Complete (EBSCO) were searched for the period January 2012 to February 2023. Eligible studies included cross-sectional, case-control, longitudinal, and cohort studies in which proinflammatory cytokines were reported in adults above 18 years with aLBP. Intervention studies and randomized controlled trails were excluded. The Joanna Briggs Institute (JBI) criteria were used for quality evaluation.
Findings from 11 studies showed 3 proinflammatory cytokines associated with pain intensity in adult patients with aLBP: C-Reactive Protein (CRP), Tumor Necrosis Factor (TNF-α), and Interleukin (IL-6). Some studies assessed associations between proinflammatory cytokines and depressive symptoms; none explored the association of proinflammatory cytokines with fatigue, anxiety, sleep disturbance, or comorbidities (diabetes, cardiac diseases, and cancer) in aLBP.
Proinflammatory cytokines in aLBP can serve as composite biomarkers for pain, associated symptoms, and comorbidities and may serve as a target for future interventions. There is need for well-designed studies assessing associations among chronic inflammation, behavioral symptoms, and comorbidities.
摘要：
目的：促炎细胞因子在慢性炎症和疼痛中起关键作用，并有助于行为症状（抑郁症状，焦虑,疲劳,睡眠障碍)和合并症(糖尿病，心脏病,cancer).缺乏与这些行为症状/合并症与轴向下腰痛（aLBP）相关的特定促炎细胞因子的证据。本综述旨在对以下方面进行系统的分析:(1)成人与aLBP相关的特异性促炎细胞因子,(2)aLBP中促炎细胞因子与行为症状之间的关系，(3)aLBP中促炎细胞因子与合并症的关系，为aLBP患者的未来诊断和干预目标开发新的临床框架。
方法：电子数据库，包括PubMed/MEDLINE,ProQuest护理和相关健康来源，在2012年1月至2023年2月期间搜索了和CINAHLComplete（EBSCO）。符合条件的研究包括横断面，病例控制，纵向,以及队列研究，其中在18岁以上的aLBP成人中报道了促炎细胞因子。干预研究和随机对照试验被排除在外。JoannaBriggs研究所（JBI）标准用于质量评估。
结果：来自11项研究的结果显示，成人aLBP患者中3种与疼痛强度相关的促炎细胞因子：C反应蛋白（CRP），肿瘤坏死因子(TNF-α),和白细胞介素（IL-6）。一些研究评估了促炎细胞因子与抑郁症状之间的关联；没有一项研究探讨了促炎细胞因子与疲劳的关联。焦虑,睡眠障碍,或合并症（糖尿病，心脏病,和癌症）在ALBP中。
结论：aLBP中的促炎细胞因子可以作为疼痛的复合生物标志物，相关症状,和合并症，并可能作为未来干预的目标。需要精心设计的研究来评估慢性炎症之间的关联，行为症状,和合并症。
方法：电子数据库，包括PubMed/MEDLINE,ProQuest护理和相关健康来源，在2012年1月至2023年2月期间搜索了和CINAHLComplete（EBSCO）。符合条件的研究包括横断面，病例控制，纵向,以及队列研究，其中在18岁以上的aLBP成人中报道了促炎细胞因子。干预研究和随机对照试验被排除在外。JoannaBriggs研究所（JBI）标准用于质量评估。
结果：来自11项研究的结果显示，成人aLBP患者中3种与疼痛强度相关的促炎细胞因子：C反应蛋白（CRP），肿瘤坏死因子(TNF-α),和白细胞介素（IL-6）。一些研究评估了促炎细胞因子与抑郁症状之间的关联；没有一项研究探讨了促炎细胞因子与疲劳的关联。焦虑,睡眠障碍,或合并症（糖尿病，心脏病,和癌症）在ALBP中。
结论：aLBP中的促炎细胞因子可以作为疼痛的复合生物标志物，相关症状,和合并症，并可能作为未来干预的目标。需要精心设计的研究来评估慢性炎症之间的关联，行为症状,和合并症。
