Longitudinal changes of serum cytokines in patients with chronic low back pain and Modic changes
Gjefsen, Elisabeth; Gervin, Kristina; Bråten, Lars Christian Haugli; Goll, Guro Løvik; Aass, Hans Christian; Schistad, Elina Iordanova; Wigemyr, Monica; Pedersen, Linda Margareth; Skouen, Jan Sture; Vigeland, Maria Dehli; Selmer, Kaja Kristine; Storheim, Kjersti; Zwart, John Anker Henrik
Peer reviewed, Journal article
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Date
2023Metadata
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Abstract
Objectives: To explore serum cytokine levels over time in patients with chronic low back pain (cLBP) and
Modic changes (MCs), difference in change between treatment groups in the Antibiotics in Modic
Changes (AIM) study and associations between change in cytokines and low back pain.
Methods: Serum concentrations of 39 cytokines were measured at baseline and 1 year from 73 partic-
ipants in the AIM study; 30 randomized to placebo, 43 to Amoxicillin. Low back pain intensity was
measured by numeric rating scale. Change in cytokine levels over time were assessed by paired t-tests.
Difference in change in cytokine levels between treatment groups and associations between changes in
LBP and cytokine levels were assessed by linear regression models. Networks of cytokine changes in each
treatment groups were explored by Pearson's correlations.
Results: Five cytokines changed from baseline to 1 year, (mean change, log transformed values with CI)
C-X-C motif chemokine ligand (CXCL) 10 (IP-10) (0.11 (0.01e0.20)), CXCL13 (0.61 (0.00e0.12)), C-C motif
chemokine ligand (CCL)26 (0.05 (0.01e0.1)), granulocyte macrophage-colony stimulating factor (GM-
CSF) ( 0.12 ( 0.23 to 0.00)) and CXCL11 (0.12 (0.03e0.22)). Treatment group only influenced change in
CCL21 (b 0.07 (0.01e0.12)), and IL-6 (b 0.17 ( 0.30 to 0.03)). Change in CXCL13 (b 2.43 (0.49e4.38)),
CCL27 (b 3.07 (0.46e5.69)), IL-8 (b 1.83 (0.08e3.58)) and CCL19 (b 3.10 (0.86e5.43)) were associated with
change in LBP. The correlation networks of cytokine changes demonstrate small differences between
treatment groups.
Conclusions: Cytokine levels are relatively stable over time in our sample, with little difference between
treatment groups. Some cytokines may be associated with LBP intensity. The differences between the
correlation networks suggest that long-term Amoxicillin-treatment may have longstanding effects to be
further explored.