背景:对神经性疼痛的理解仍然不完整,强调需要研究生物标志物以改善诊断和治疗。这篇综述的重点是确定血液和脑脊液中不同神经病理性疼痛的潜在生物标志物。
方法:在六个数据库中进行搜索:PubMed,WebofScience,Scopus,科克伦图书馆,EMBASE,和CINAHL。包括观察性研究,即横截面,队列,和病例控制,评估血液或脑脊液中的定量生物标志物。数据是定性合成的,使用R进行荟萃分析。该研究在PROSPERO注册,ID为CRD42022233769。
结果:文献检索导致16项定性研究和12项定量分析研究,涵盖18岁以上患有疼痛性神经病的患者。总共分析了1403名受试者,确定C反应蛋白(CRP)水平没有显着差异,白细胞介素-6(IL-6),和肿瘤坏死因子-α(TNF-α)在有和没有疼痛的患者之间。尽管评分者间的可靠性很高,而且有足够的偏差评估,结果表明,炎症生物标志物的差异可以忽略不计,由于研究中值得注意的发表偏倚和异质性,这表明需要进一步研究。
结论:我们的综述强调了神经性疼痛的复杂性和识别生物标志物的挑战,CRP没有显著差异,有疼痛和无疼痛患者之间的IL-6和TNF-α水平。尽管方法稳健,结果受到发表偏倚和异质性的限制.这强调需要进一步研究以发现确定的生物标志物,以改善神经性疼痛的诊断和个性化治疗。
BACKGROUND: The understanding of neuropathic pain remains incomplete, highlighting the need for research on biomarkers for improved diagnosis and treatment. This review focuses on identifying potential biomarkers in blood and cerebrospinal fluid for neuropathic pain in different neuropathies.
METHODS: Searches were performed in six databases: PubMed, Web of Science, Scopus, Cochrane Library, EMBASE, and CINAHL. Included were observational studies, namely cross-sectional, cohort, and case-control, that evaluated quantitative biomarkers in blood or cerebrospinal fluid. Data were qualitatively synthesized, and meta-analyses were conducted using R. The study is registered with PROSPERO under the ID CRD42022323769.
RESULTS: The literature search resulted in 16 studies for qualitative and 12 for quantitative analysis, covering patients over 18 years of age with painful neuropathies. A total of 1403 subjects were analyzed, identifying no significant differences in levels of C-Reactive Protein (CRP), Interleukin-6 (IL-6), and Tumor Necrosis Factor-alpha (TNF-alpha) between patients with and without pain. Despite the high inter-rater reliability and adequate bias assessment, the results suggest negligible differences in inflammatory biomarkers, with noted publication bias and heterogeneity among studies, indicating the need for further research.
CONCLUSIONS: Our review underscores the complex nature of neuropathic pain and the challenges in identifying biomarkers, with no significant differences found in CRP, IL-6, and TNF-alpha levels between patients with and without pain. Despite methodological robustness, the results are limited by publication bias and heterogeneity. This emphasizes the need for further research to discover definitive biomarkers for improved diagnosis and personalized treatment of neuropathic pain.