Rev. Soc. Esp. Dolor. 2021; 28(1): 37-46 / DOI: 10.20986/resed.2021.3841/2020
Lidia Crespo, Yaiza Taboada
RESUMEN
Introducción: El dolor es una compleja interacción de sistemas, con un proceso que integra información sensorial, cognitiva y/o emocional proveniente de amenazas reales o potenciales. En el dolor crónico se ha observado una relación con otros síntomas somáticos y psicológicos como la depresión y la ansiedad, falta de sueño, fatiga y disminución de la capacidad cognitiva. Se ha demostrado que las citoquinas proinflamatorias y los síntomas asociados influyen en la probabilidad de padecer dolor crónico. El objetivo es analizar los niveles de los mediadores inflamatorios en patologías que cursan con dolor crónico y los trastornos relacionados para así comprender mejor el dolor de larga duración.
Material y métodos: Para la realización de este trabajo se realizó una revisión de la literatura científica mediante una búsqueda sistematizada en enero de 2020 en las bases de datos Pubmed, CINHAL, Medline, Scopus y Web of Sciencie. Se aplicaron como criterios de inclusión: ser documentos publicados en los últimos 5 años y estar escritos en inglés o castellano. Como criterios de exclusión: estudios de revisión, artículos repetidos en otras bases o que trataran sobre otro tema.
Resultados: 13 artículos fueron seleccionados tras aplicar los criterios de inclusión y exclusión. Todas las publicaciones son estudios observacionales. Se compararon los valores de citoquinas proinflamatorias en pacientes con dolor crónico, teniendo en cuenta el insomnio, la tolerancia al dolor, el catastrofismo, el género y el índice de masa corporal.
Conclusión: El dolor crónico está condicionado por múltiples factores, por lo que se debe conocer la fisiopatología del mismo. De esta manera, la medición de la proteína C reactiva y de citoquinas proinflamatorias podría suponer un avance en la evaluación y seguimiento del paciente con dolor crónico.
ABSTRACT
Introduction: Pain is a complex interaction of systems, with a process that integrates sensory, cognitive and/or emotional information that comes from real or potential threats. It has been observed a connection in the chronic pain with other somatic and psychological symptoms, such as depression, anxiety, lack of sleep, fatigue and reduction of cognitive capacity. It has been demonstrated that proinflammatory cytokines and associated symptoms influence in the probability of suffering chronic pain. The objective is to analyze the levels of the inflammatory mediators in diseases with chronic pain and with related disorders, so that we can better understand long-term pain.
Material and methods: To make this dissertation, a review of the scientific literature was carried out by a systematized search in the Pubmed, CINHAL, Medline, Scopus and Web of Science databases, in January 2020. The inclusion criteria were: to be documents written in English or Spanish and published in the last 5 years. The exclusion criteria were: review studies, and articles repeated in other databases or that addressed other topics.
Results: 13 articles were selected after applying inclusion and exclusion criteria. All publications were observational studies. Proinflammatory cytokine values were compared in patients with chronic pain, taking into account insomnia, pain tolerance, catastrophism, gender and body mass index.
Conclusion: Chronic pain is conditioned by multiple factors, so its physiopathology must be known. In this way, the measurement of the C-reactive protein and the proinflammatory cytokines could mean an advance in the evaluation and monitoring of the patient with chronic pain.
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Bibliografía
1. Wall PD, McMahon SB. Microneuronography and Its Relation to Perceived Sensation. A Critical Review. Pain. 1985;21(3):209-29. DOI: 10.1016/0304-3959(85)90086-7.
2. Raja S, Carr D, Cohen M, Finnerup N, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020;161(9):1976-82. DOI: 10.1097/j.pain.0000000000001939.
3. Backonja MM. Defining Neuropathic Pain. Anesth Analg. 2003;97(3):785-90. DOI: 10.1213/01.ane.0000062826.70846.8d.
4. National Institute for Health and Clinical Excellence. Neuropathic Pain: The Pharmacological Management of Neuropathic Pain in Adults in Non-Specialist Settings. Clinical Guildeline 96. London: NICE; 2010.
5. Moseley GL. A Pain Neuromatrix Approach to Patients with Chronic Pain. Man Ther. 2003;8(3):130-40. DOI: 10.1016/s1356-689x(03)00051-1.
6. García-Andreu J. Manejo Básico Del Dolor Agudo y Crónico. Anest Mex. 2017;29(1).
7. Zegarra JW. Bases Fisiopatológicas Del Dolor. Acta Med Per. 2007;24(2):35-8.
8. Jussila L, Paananen M, Näyhä S, Taimela S, Tammelin T, Auvinen J, et al. Psychosocial and Lifestyle Correlates of Musculoskeletal Pain Patterns in Adolescence: A 2-Year Follow-up Study. Eur J Pain. 2014;18(1):139-46. DOI: 10.1002/j.1532-2149.2013.00353.x.
9. Langley PC, Ruiz-Iban MA, Molina JT, De Andres J, Castellón JR, et al. The Prevalence, Correlates and Treatment of Pain in Spain. J Med Econ. 2011;14(3):367-80. DOI: 10.3111/13696998.2011.583303.
10. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of Chronic Pain in Europe: Prevalence, Impact on Daily Life, and Treatment. Eur J Pain. 2006;10(4):287-333. DOI: 10.1016/j.ejpain.2005.06.009.
11. Gerdle B, Ghafouri B, Ghafouri N, Bäckryd E, Gordh T. Signs of Ongoing Inflammation in Female Patients with Chronic Widespread Pain: A Multivariate, Explorative, Cross-Sectional Study of Blood Samples. Medicine. 2017;96(9): e6130. DOI: 10.1097/MD.0000000000006130.
12. Brosschot JF. Cognitive-Emotional Sensitization and Somatic Health Complaints. Scand J Psychol. 2002;43(2):113-21. DOI: 10.1111/1467-9450.00276.
13. Allen KD, Renner JB, Devellis B, Helmick CG, Jordan JM. Osteoarthritis and Sleep: The Johnston Country Osteoarthritis Project. J Rheumatol. 2008;35(6):1102-107.
14. Burgos I, Richter L, Klein T, Fiebich B, Feige B, Lieb K, et al. Increased Nocturnal Interleukin-6 Excretion in Patients with Primary Insomnia: A Pilot Study. Brain Behav. Immun. 2006;20(3):246-53. DOI: 10.1016/j.bbi.2005.06.007.
15. Prather AA, Puterman E, Epel ES, Dhabhar FS. Poor Sleep Quality Potentiates Stress-Induced Cytokine Reactivity in Postmenopausal Women with High Visceral Abdominal Adiposity. Brain. Behav. Immun. 2014;35:155-62. DOI: 10.1016/j.bbi.2013.09.010.
16. Blyth FM, March LM, Brnabic AJ, Cousins MJ. Chronic Pain and Frequent Use of Health Care. Pain. 2004;111(1-2):51-8. DOI: 10.1016/j.pain.2004.05.020.
17. Chatkoff DK, Leonard MT, Maier KJ. Pain Catastrophizing Differs Between and Within West Haven-Yale Multidimensonal Pain Inventory (MPI) Pain Adjustment Classifications. Clin J Pain. 2015;31(4):349-54. DOI: 10.1097/AJP.0000000000000117.
18. Kaunisto MA, Jokela R, Tallgren M, Kambur O, Tikkanen E, Tasmuth T, et al. Pain in 1,000 Women Treated for Breast Cancer: A Prospective Study of Pain Sensitivity and Postoperative Pain. Anesthesiology. 2013;119(6):1410-21. DOI: 10.1097/ALN.0000000000000012.
19. Afari N, Mostoufi S, Noonan C, Poeschla B, Succop A, Chopko L, et al. C-Reactive Protein and Pain Sensitivity: Findings from Female Twins. Ann Behav Med. 2011;42(2):277-83. DOI: 10.1007/s12160-011-9297-6.
20. Xie WR, Deng H, Li H, Bowen TL, Strong JA, Zhang JM. Robust increase of cutaneous sensitivity, cytokine production and sympathetic sprouting in rats with localized inflammatory irritation of the spinal ganglia. Neuroscience. 2006;142(3):809-22. DOI: 10.1016/j.neuroscience.2006.06.045.
21. Zhang JM, Jianxiong A. Cytokines, Inflammation and Pain. Int Anesthesiol Clin. 2007;45(2):27-37. DOI: 10.1097/AIA.0b013e318034194e.
22. Jabs WJ, Lögering BA, Gerke P, Kreft B, Wolber EM, Flinger MHF, et al. The Kidney as a Second Site of Human C-Reactive Protein Formation in Vivo. Eur J Immunol. 2003;33(1):152-61. DOI: 10.1002/immu.200390018.
23. Ramage L, Proudfoot L, Guy K. Expression of C-Reative Protein in Human Lung Epithelial Cells and Upregulation by Cytokines and Carbon Particles. Inhal Toxicol. 2004;16(9):607-13.
24. Yasojima K, Schwab C, McGeer EG, McGeer PL. Human Neurons Generate C-Reactive Protein and Amyloid P: Upregulation in Alzheimer’s Disease. Brain Res. 2000;887(1):80-9. DOI: 10.1016/s0006-8993(00)02970-x.
25. Calabro P, Chang DW, Willerson JT, Yeh ET. Release of C-Reactive Protein in Response to Inflammatory Cytokines by Human Adipocytes: Linking Obesity to Vascular Inflammation. J Am Coll Cardiol. 2005;46(6):1112-3. DOI: 10.1016/j.jacc.2005.06.017.
26. Kuta AE, Baum LL. C-Reactive Protein Is Produced by a Small Number of Normal Human Peripheral Blood Lymphocytes. J Exp Med. 1986;164(1):321-6. DOI: 10.1084/jem.164.1.321.
27. Du Clos TW, Mold C. C-Reactive Protein: An Activator of Innate Immunity and a Modulator of Adaptive Immunity. Immun Res. 2004;30(3):261-77. DOI: 10.1385/IR:30:3:261.
28. Sibille KT, Steingrímsdóttir OA, Fillingim RB, Stubhaug A, Schirmer H, Chen H, et al. Investigating the Burden of Chronic Pain: An Inflammatory and Metabolic Composite. Pain Res. 2016;2016:7657329. DOI: 10.1155/2016/7657329.
29. Feinberg T, Sambamoorthi U, Lilly C, Innes KK. Potential Mediators between Fibromyalgia and C-Reactive Protein: Results from a Large U.S. Community Survey. BMC Musculoskelet. Disord. 2017;18(1):294. DOI: 10.1186/s12891-017-1641-y.
30. Bäckryd E, Ghafouri B, Larsson B, Gerdle B. Plasma Pro-Inflammatory Markers in Chronic Neuropathic Pain: A Multivariate, Comparative, Cross-Sectional Pilot Study. Scand J Pain. 2016;10(1):1-5. DOI: 10.1016/j.sjpain.2015.06.006.
31. Teodorczyk-Injeyan JA, Triano JJ, Injeyan HS. Nonspecific Low Back Pain: Inflammatory Profiles of Patients With Acute and Chronic Pain Clin J Pain. 2019;35(10):818-25. DOI: 10.1097/AJP.0000000000000745.
32. Hysing EB, Smith L, Thulin M, Karlsten R, Bothelius K, Gordh T. Detection of Systemic Inflammation in Severely Impaired Chronic Pain Patients and Effects of a Multimodal Pain Rehabilitation Program. Scand J Pain. 2019;19(2):235-44. DOI: 10.1515/sjpain-2018-0340.
33. Lasselin J, Kemani MK, Kanstrup M, Olsson GL, Axelsson J, Andreasson A, et al. Low-Grade Inflammation May Moderate the Effect of Behavioral Treatment for Chronic Pain in Adults. J Behav Med. 2016;39(5):916-24. DOI: 10.1007/s10865-016-9769-z.
34. Bäckryd E, Lind AL, Thulin M, Larsson A, Gerdle B, Gordh T. High Levels of Cerebrospinal Fluid Chemokines Point to the Presence of Neuroinflammation in Peripheral Neuropathic Pain: A Cross-Sectional Study of 2 Cohorts of Patients Compared with Healthy Controls. Pain. 2017;158(12):2487-95. DOI: 10.1097/j.pain.0000000000001061.
35. Chamessian A, Van de Ven T, Buchheit T, Hsia HL, McDuffie M, Gamazon ER, et al. Differential Expression of Systemic Inflammatory Mediators in Amputees with Chronic Residual Limb Pain. Pain. 2017;158(1):68-74. DOI: 10.1097/j.pain.0000000000000728.
36. Schistad EI, Stubhaug A, Furberg AS, Engdahl BL, Nielsen CS. C-Reactive Protein and Cold-Pressor Tolerance in the General Population: The Tromsø Study. Pain. 2017;158(7):1280-8. DOI: 10.1097/j.pain.0000000000000912.
37. Skarpsno ES, Mork PJ, Nilsen TI, Steingrímsdóttir ÓA, Zwart JA, Nilsen KB. The Interplay between Sleeplessness and High-Sensitivity C-Reactive Protein on Risk of Chronic Musculoskeletal Pain: Longitudinal Data from the Tromsø Study. Sleep. 2019;42(9):127. DOI: 10.1093/sleep/zsz127.
38. Heffner KL, France CR, Ashrafioun L, Quiñones M, Walsh P, Maloney MD, et al. Clinical Pain-Related Outcomes and Inflammatory Cytokine Response to Pain Following Insomnia Improvement in Adults With Knee Osteoarthritis. Clin J Pain. 2018;34(12):1133-40. DOI: 10.1097/AJP.0000000000000644.
39. Park J, Chung J. Inflammatory Cytokines and Sleep Disturbance in Patients with Temporomandibular Disorders. Oral Facial Pain Headache. 2016;30(1):27-33. DOI: 10.11607/ofph.1367.
40. De Leo JA, Colburn RW. The Role of Cytokines in Nociception and Chronic Pain. In: Weinstein JN, Gordon SL, Editors. Low Back Pain: A Scientific and Clinical Overview. Illinois: American Academy of Orthopaedic Surgeons; 1995. p. 163-85.
41. Ramer MS, Murphy PG, Richardson PM, Bisby MA. Spinal Nerve Lesion-Induced Mechanoallodynia and Adrenergic Sprouting in Sensory Ganglia Are Attenuated in Interleukin-6 Knockout Mice. Pain. 1998;78(2):115-21. DOI: 10.1016/s0304-3959(98)00121-3.
42. Old EA, Clark AK, Malcangio M. The Role of Glia in the Spinal Cord in Neuropathic and Inflammatory Pain. Handb Exp Pharmacol. 2015;227:145-70. DOI: 10.1007/978-3-662-46450-2_8.
43. Yao ZY, Zhang Y, Wu H. Regulation of C-reactive protein conformation in inflammation. Inflammation Research. 2019;68(10):815-23. DOI: 10.1007/s00011-019-01269-1.
44. Boka G, Anglade P, Wallach D, Javoy-Agid F, Agid Y, Hirsch EC. Immunocytochemical Analysis of Tumor Necrosis Factor and Its Receptors in Parkinson’s Disease. Neuroscience Letters. 1994;172(1-2):151-4. DOI: 10.1016/0304-3940(94)90684-x.
45. Grässel S, Muschter D. Peripheral Nerve Fibers and Their Neurotransmitters in Osteoarthritis Pathology. Int J Mol Sci. 2017;18(5):931. DOI: 10.3390/ijms18050931.
46. Smith MT, Wickwire EM, Grace EG, Edwards RR, Buenaver LF, Peterson S, et al. Sleep Disorders and Their Association with Laboratory Pain Sensitivity in Temporomandibular Join Disorder. Sleep. 2009;32(6):779-90. DOI: 10.1093/sleep/32.6.779.
47. Jeanjean AP, Moussaoui SM, Maloteaux JM, Laduron PM. Interleukin-1 Beta Induces Long-Term Increase of Axonally Transported Opiate Receptors and Substance P. Neuroscience. 1995;68(1):151-7. DOI: 10.1016/0306-4522(95)00106-s.
48. Irwin MR, Olmstead R, Judith E, CarrollJE. Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review an Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry. 2016;80(1):40-52. DOI: 10.1016/j.biopsych.2015.05.014.
49. Haack M, Sanchez E, Mullington JM. Elevated Inflammatory Markers in Response to Prolonged Sleep Restriction Are Associated with Increased Pain Experience in Healthy Volunteers. Sleep. 2007;30(9):1145-52. DOI: 10.1093/sleep/30.9.1145.
50. Irwin MR, Olmstead R, Carrillo C, Sadeghi N, Breen EC, Witarama T, et al. Cognitive Behavioral Therapy vs. Tai Chi for Late Life Insomnia and Inflammatory Risk: A Randomized Controlled Comparative Efficacy Trial. Sleep. 2014;37(9):1543-52. DOI: 10.5665/sleep.4008.
51. Irwin MR, Olmstead R, Breen EC, Witarama T, Carrillo C, Sadeghi N, et al. Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late Life Insomnia: A Randomized Controlled Trial. Biol Psychiatry. 2015;78(10):721-9. DOI: 10.1016/j.biopsych.2015.01.010.
52. Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinire M. A Systematic Literature Review of 10 Years of Research on Sex/Gender and Pain Perception - Part 2: Do Biopsychosocial Factors Alter Pain Sensitivity Differently in Women and Men? Pain. 2012;153(3):619-35. DOI: 10.1016/j.pain.2011.11.026.
53. Monica P, Christine L. Exploring Sex and Gender Differences in Sleep Health: A Society for Women’s Health Research Report. J Womens Health. 2014;23(7):553-62. DOI: 10.1089/jwh.2014.4816.
54. Regal AR, Amigo MC, Cebrian E. El Sueño y Mujer. Rev Neurology. 2009;49:376-82. DOI: 10.33588/rn.4907.2009041.
55. Prather AA, Epel ES, Cohen BE, Neylan TC, Whooley MA. Gender Differences in the Prospective Associations of Self-Reported Sleep Quality with Biomarkers of Systemic Inflammation and Coagulation: Findings from the Heart and Soul Study. J Psychiatr Res. 2013;47(9):1228-35. DOI: 10.1016/j.jpsychires.2013.05.004.
56. Dinan TG. Inflammatory Markers in Depression. Curr Opin Psychiatry. 2009;22(1):32-6. DOI: 10.1097/YCO.0b013e328315a561.
57. Rief W, Pilger F, Ihle D, Bosmans E, Egyed B, Maes M. Immunological Differences between Patients with Major Depression and Somatization Syndrome. Psychiatry Res. 2001;105(3):165-74. DOI: 10.1016/s0165-1781(01)00338-9.
58. Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK, et al. A Meta-Analysis of Cytokines in Major Depression. Biol Psychiatry. 2010;67(5):446-57. DOI: 10.1016/j.biopsych.2009.09.033.
59. Howren MB, Lamkin DM, Suls J. Associations of Depression with C-Reactive Protein, IL-1, and IL-6: A Meta-Analysis. Psychosom Med. 2009;71(2):171-86. DOI: 10.1097/PSY.0b013e3181907c1b.
60. Almeida OP, Alfonso H, Yeap BB, Hankey G, Flicker L. Complaints of Difficulty to Fall Asleep Increase the Risk of Depression in Later Life: The Health in Men Study. J Affect Disord. 2011;134(1-3):208-16. DOI: 10.1016/j.jad.2011.05.045.
61. Anisman H. Cascading Effects of Stressors and Inflammatory Immune System Activation: Implications for Major Depressive Disorder. J Psychiatry Neurosci. 2009;34(1):4-20.