Decreased Pain Sensitivity and Alterations of Cerebrospinal Fluid and Plasma Inflammatory Mediators After Total Hip Arthroplasty in Patients with Disabling Osteoarthritis
Flores Bjurström, Martin LU ; Bodelsson, Mikael LU ; Irwin, Michael R. ; Orbjörn, Camilla LU ; Hansson, Oskar LU
and Mattsson-Carlgren, Niklas
LU
(2022)
In Pain Practice
22(1).
p.66-82
- Abstract
- Background: Proinflammatory mechanisms are implicated in pain states. Recent research indicates that patients with osteoarthritis (OA) with signs of central sensitization exhibit elevated cerebrospinal fluid (CSF) levels of interferon gamma-induced protein 10 (IP-10), Fms-related tyrosine kinase 1 (Flt-1), and monocyte chemoattractant protein 1 (MCP-1).
Methods: The current prospective cohort study, including 15 patients with OA, primarily aimed to evaluate associations among alterations in CSF IP-10, Flt-1, MCP-1, and pain sensitization following total hip arthroplasty (THA). Participants provided CSF and blood samples for analysis of 10 proinflammatory mediators, and underwent detailed clinical examination and quantitative sensory... (More) - Background: Proinflammatory mechanisms are implicated in pain states. Recent research indicates that patients with osteoarthritis (OA) with signs of central sensitization exhibit elevated cerebrospinal fluid (CSF) levels of interferon gamma-induced protein 10 (IP-10), Fms-related tyrosine kinase 1 (Flt-1), and monocyte chemoattractant protein 1 (MCP-1).
Methods: The current prospective cohort study, including 15 patients with OA, primarily aimed to evaluate associations among alterations in CSF IP-10, Flt-1, MCP-1, and pain sensitization following total hip arthroplasty (THA). Participants provided CSF and blood samples for analysis of 10 proinflammatory mediators, and underwent detailed clinical examination and quantitative sensory testing, immediately preoperative and 18 months after surgery.
Results: Neurophysiological measures of pain showed markedly reduced pain sensitivity long-term postoperative. Increases in remote site pressure pain detection thresholds (PPDTs) and decreased temporal summation indicated partial resolution of previous central sensitization. Compared to preoperative, CSF concentrations of IP-10 were increased (p = 0.041), whereas neither Flt-1 (p = 0.112) nor MCP-1 levels changed (p = 0.650). Compared to preoperative, plasma concentrations of IP-10 were increased (p = 0.006), whereas interleukin (IL)-8 was decreased (p = 0.023). Subjects who exhibited increases in arm PPDTs above median showed greater increases in CSF IP-10 compared to those with PPDT increases below median (p = 0.028). Analyses of plasma IP-10 and IL-8 indicated higher levels of peripheral inflammation were linked to decreased pressure pain thresholds (unadjusted β = -0.79, p = 0.006, and β = -118.1, p = 0.014, respectively).
Conclusions: THA leads to long-term decreases in pain sensitivity, indicative of resolution of sensitization processes. Changes in CSF and plasma levels of IP-10, and plasma IL-8, may be associated with altered pain phenotype.
(Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/022bdd3a-98cb-40eb-b88b-0ac27c8d34bf
- author
- Flores Bjurström, Martin
LU
; Bodelsson, Mikael
LU
; Irwin, Michael R.
; Orbjörn, Camilla
LU
; Hansson, Oskar
LU
and Mattsson-Carlgren, Niklas
LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Pain Practice
- volume
- 22
- issue
- 1
- pages
- 66 - 82
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:34143556
- scopus:85111146994
- ISSN
- 1533-2500
- DOI
- 10.1111/papr.13051
- language
- English
- LU publication?
- yes
- id
- 022bdd3a-98cb-40eb-b88b-0ac27c8d34bf
- date added to LUP
- 2021-09-17 10:37:43
- date last changed
- 2023-12-07 17:22:28
@article{022bdd3a-98cb-40eb-b88b-0ac27c8d34bf,
abstract = {{Background: Proinflammatory mechanisms are implicated in pain states. Recent research indicates that patients with osteoarthritis (OA) with signs of central sensitization exhibit elevated cerebrospinal fluid (CSF) levels of interferon gamma-induced protein 10 (IP-10), Fms-related tyrosine kinase 1 (Flt-1), and monocyte chemoattractant protein 1 (MCP-1).<br/>Methods: The current prospective cohort study, including 15 patients with OA, primarily aimed to evaluate associations among alterations in CSF IP-10, Flt-1, MCP-1, and pain sensitization following total hip arthroplasty (THA). Participants provided CSF and blood samples for analysis of 10 proinflammatory mediators, and underwent detailed clinical examination and quantitative sensory testing, immediately preoperative and 18 months after surgery.<br/>Results: Neurophysiological measures of pain showed markedly reduced pain sensitivity long-term postoperative. Increases in remote site pressure pain detection thresholds (PPDTs) and decreased temporal summation indicated partial resolution of previous central sensitization. Compared to preoperative, CSF concentrations of IP-10 were increased (p = 0.041), whereas neither Flt-1 (p = 0.112) nor MCP-1 levels changed (p = 0.650). Compared to preoperative, plasma concentrations of IP-10 were increased (p = 0.006), whereas interleukin (IL)-8 was decreased (p = 0.023). Subjects who exhibited increases in arm PPDTs above median showed greater increases in CSF IP-10 compared to those with PPDT increases below median (p = 0.028). Analyses of plasma IP-10 and IL-8 indicated higher levels of peripheral inflammation were linked to decreased pressure pain thresholds (unadjusted β = -0.79, p = 0.006, and β = -118.1, p = 0.014, respectively).<br/>Conclusions: THA leads to long-term decreases in pain sensitivity, indicative of resolution of sensitization processes. Changes in CSF and plasma levels of IP-10, and plasma IL-8, may be associated with altered pain phenotype.<br/>}},
author = {{Flores Bjurström, Martin and Bodelsson, Mikael and Irwin, Michael R. and Orbjörn, Camilla and Hansson, Oskar and Mattsson-Carlgren, Niklas}},
issn = {{1533-2500}},
language = {{eng}},
number = {{1}},
pages = {{66--82}},
publisher = {{Wiley-Blackwell}},
series = {{Pain Practice}},
title = {{Decreased Pain Sensitivity and Alterations of Cerebrospinal Fluid and Plasma Inflammatory Mediators After Total Hip Arthroplasty in Patients with Disabling Osteoarthritis}},
url = {{http://dx.doi.org/10.1111/papr.13051}},
doi = {{10.1111/papr.13051}},
volume = {{22}},
year = {{2022}},
}