Basal inflammation and innate immune response in chronic multisite musculoskeletal pain

Ellen Generaal, Nicole Vogelzangs, Gary J Macfarlane, Rinie Geenen, Johannes H Smit, Joost Dekker, Brenda W J H Penninx

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26 Citations (Scopus)

Abstract

Dysregulation of the immune system may play a role in chronic pain, although study findings are inconsistent. This cross-sectional study examined whether basal inflammatory markers and the innate immune response are associated with the presence and severity of chronic multisite musculoskeletal pain. Data were used on 1632 subjects of the Netherlands Study of Depression and Anxiety. The Chronic Pain Grade questionnaire was used to determine the presence and severity of chronic multisite musculoskeletal pain. Subjects were categorized in a chronic multisite musculoskeletal pain group (n=754) and a control group (n=878). Blood levels of the basal inflammatory markers C-reactive protein, interleukin-6, and tumor necrosis factor-alpha were determined. To obtain a measure of the innate immune response, 13 inflammatory markers were assessed after lipopolysaccharide (LPS) stimulation in a subsample (n=707). Subjects with chronic multisite musculoskeletal pain showed elevated levels of basal inflammatory markers compared with controls, but statistical significance was lost after adjustment for lifestyle and disease variables. For some LPS-stimulated inflammatory markers, we did find elevated levels in subjects with chronic multisite musculoskeletal pain both before and after adjustment for covariates. Pain severity was not associated with inflammation within chronic pain subjects. An enhanced innate immune response in chronic multisite musculoskeletal pain may be examined as a potential biomarker for the onset or perpetuation of chronic pain.

Original languageEnglish
Pages (from-to)1605-1612
Number of pages8
JournalPain
Volume155
Issue number8
Early online date9 May 2014
DOIs
Publication statusPublished - Aug 2014

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Keywords

  • immune system
  • c-reactive protein
  • cytokines
  • lipopolysaccharide
  • innate immune response
  • chronic pain
  • central sensitization

Cite this

Generaal, E., Vogelzangs, N., Macfarlane, G. J., Geenen, R., Smit, J. H., Dekker, J., & Penninx, B. W. J. H. (2014). Basal inflammation and innate immune response in chronic multisite musculoskeletal pain. Pain, 155(8), 1605-1612. https://doi.org/10.1016/j.pain.2014.05.007