The Role of TNF-[alpha] in Patients With Chronic Low Back Pain-A Prospective Comparative Longitudinal Study.
Wang, Haili MD; Schiltenwolf, Marcus MD, PhD; Buchner, Matthias MD, PhD
Clinical Journal of Pain.
24(3):273-278, March/April 2008.
(Format: HTML, PDF)
Objectives: In this prospective longitudinal clinical study with a matched-pair design, we evaluated the role of tumor necrosis factor-[alpha] (TNF-[alpha]) and its clinical relevance in patients with chronic low back pain.
Methods: One hundred twenty patients with chronic low back pain were matched to a healthy control group. Patients and controls were prospectively followed for 6 months. At 4 fixed time points (day 0, day 10, day 20, and 6 mo) blood samples were taken and TNF-[alpha] levels compared in the 2 groups, and correlations with pain level and clinical function were analyzed.
Results: At the beginning and at all other time points, there was a significantly higher proportion of TNF-[alpha] positive participants in the patients group than in the control group. The proportion of TNF-[alpha] positive patients decreased during the first 10 days of a multidisciplinary therapy in the patient group, but after this initial period, TNF-[alpha] levels remained constantly high with no further change until the final follow-up. In the healthy control group, the proportion of participants with positive TNF-[alpha] levels remained constant throughout the entire period. No significant correlation between TNF-[alpha] levels and pain or clinical function was detected.
Discussion: TNF-[alpha] seems to have a significant role in patients with chronic low back pain. However, the pathophysiology of this process, the clinical relevance of TNF-[alpha] and, especially, its part in a potential therapy regimen in these patients need to be more closely examined and defined in additional studies.
(C) 2008 Lippincott Williams & Wilkins, Inc.