Inflammatory Blood Signature Related to Common Psychological Comorbidity in Chronic Pain

Author:

Karshikoff Bianka12,Wåhlén Karin23,Åström Jenny24ORCID,Lekander Mats25,Holmström Linda24,Wicksell Rikard K.26

Affiliation:

1. Department of Social Studies, University of Stavanger, 4036 Stavanger, Norway

2. Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden

3. Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, 58183 Linköping, Sweden

4. Medical Unit Medical Psychology, Theme Women’s Health and Allied Health Professionals, Karolinska University Hospital, 17176 Solna, Sweden

5. Stress Research Institute, Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden

6. Pain Clinic, Capio St. Göran Hospital, 11219 Stockholm, Sweden

Abstract

Chronic pain is characterized by high psychological comorbidity, and diagnoses are symptom-based due to a lack of clear pathophysiological factors and valid biomarkers. We investigate if inflammatory blood biomarker signatures are associated with pain intensity and psychological comorbidity in a mixed chronic pain population. Eighty-one patients (72% women) with chronic pain (>6 months) were included. Patient reported outcomes were collected, and blood was analyzed with the Proseek Multiplex Olink Inflammation Panel (Bioscience Uppsala, Uppsala, Sweden), resulting in 77 inflammatory markers included for multivariate data analysis. Three subgroups of chronic pain patients were identified using an unsupervised principal component analysis. No difference between the subgroups was seen in pain intensity, but differences were seen in mental health and inflammatory profiles. Ten inflammatory proteins were significantly associated with anxiety and depression (using the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Patient Health Questionnaire (PHQ-9): STAMBP, SIRT2, AXIN1, CASP-8, ADA, IL-7, CD40, CXCL1, CXCL5, and CD244. No markers were related to pain intensity. Fifteen proteins could differentiate between patients with moderate/high (GAD-7/PHQ-9 > 10) or mild/no (GAD-7/PHQ-9 < 10) psychological comorbidity. This study further contributes to the increasing knowledge of the importance of inflammation in chronic pain conditions and indicates that specific inflammatory proteins may be related to psychological comorbidity.

Funder

AFA Insurance

Swedish Research Council

Swedish Society of Medicine

Heart-Lung Foundation

Sweden-America Foundation

Fulbright Sweden

Stockholm County Council ALF

Medical Unit Medical Psychology at the Karolinska University Hospital

Publisher

MDPI AG

Subject

General Biochemistry, Genetics and Molecular Biology,Medicine (miscellaneous)

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