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Radiographic aspects in individuals infected by human T-lymphotropic virus type 1 (HTLV-1) with joint pain
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Carvalho, João Marcos da Silva

; Campos, Eugênia Maria Teixeira de Araújo

; Ferreira, José Luiz Nunes

; Carvalho, Huliana Mourão

; Carneiro Neto, José Abraão

; Carneiro, Tássila de Oliveira

; Carvalho, Edgar Marcelino

Advances in Rheumatology

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2022, Volume 62 elocation 31

Resumo: En | Texto: En | PDF: En

Abstract Background: Joint pain in the absence or with little synovitis is observed in a large percentage of HTLV-1 infected subjects. As the virus infect CD4 +and CD8 +positive, macrophages and B cells an exaggerated production of pro-inflammatory cytokines is detected in these patients. However, the possible association of HTLV-1 infection with autoimmune diseases has not been documented definitively and the clinical characteristics of HTLV-1 associated arthropathy has not been defined. The objective this study is to describe clinic and radiographic features in HTLV-1-infected individuals with complaints of joint pain. Methods: Cross-sectional study enrolling HTLV-1-infected individuals with chronic joint pain, aged up to 75 years, both genders and seronegative controls with osteoarthritis. All participants underwent conventional radiography of the hips, knees and ankles. Results: Eighty-one HTLV-1 infected patients and 30 subjects with osteoarthritis participated in the study. Polyarticular and symmetrical arthritis prevailed in the HTLV-1 positive group (54%), while oligoarticular and asymmetrical (44%) were more common in controls ( p < 0.05). The frequency of enthesophytes (90%) in HTLV-1-infected patients was greater than in the control group (73%) ( p < 0.05). Radiographic features were similar in HTLV-1 carriers and in patients with probable or definite HTLV-1 associated myelopathy. The presence of enthesophytes in the absence of joint space reduction or osteophytes was only observed in HTLV-1-infected individuals ( p < 0.001). Magnetic resonance imaging of the ankles of five HTLV-1-infected patients and five controls demonstrated a higher frequency of enthesitis, bursitis and osteitis in the HTLV-1 infected group. Conclusion: HTLV-1-associated arthropathy is clinically characterized by symmetrical polyarthralgia and the main radiological finding is the presence of enthesophytes in the absence of osteophytes and joint space narrowing.

https://doi.org/10.1186/s42358-022-00259-y

Prevalence of Bowel Symptoms in Patients Infected with Human T-Lymphotropic type 1 Virus
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Oliveira, Tatiane Souza Soares

; Andrade, Rosana Cristina Pereira de

; Santos, Dislene Nascimento dos

; Orrico, Keith Froes

; Abraão Neto, José

; Oliveira, Cassius José Vitor de

; Rocha, Paulo Novis

; Carvalho, Edgar Marcelino de

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20180486

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: Bowel dysfunction is frequent in patients with spinal cord diseases, but little is known about the prevalence of bowel symptoms in human T-lymphotropic virus-(HTLV-1) infected individuals. The purpose of this study is to determine the frequency of bowel symptoms in HTLV-1 infected individuals and their correlation with the degree of neurologic disease. METHODS: This is a cross-sectional study comparing the frequency of bowel symptoms in HTLV-1-infected individuals* and seronegative donors (controls). Patients answered a questionnaire, the Rome III Criteria was applied, and stool consistency was evaluated by the Bristol Stool Form Scale. The individuals were classified as HTLV-1 carriers, probable HTLV-1 myelopathy and definitive HTLV-1 associated myelopathy or tropical spastic paraparesis (definitive HAM / TSP)**. RESULTS: We studied 72 HTLV-1 infected individuals and 72 controls with equal age and gender distribution. Constipation was the most frequent complaint, occurring in 38 % of HTLV-1 individuals and in 15 % of the controls. In comparison to the seronegative controls, the probability of constipation occurrence was approximately 18 times higher in definitive HAM / TSP patients. Straining, lumpy or hard stools, sensation of anorectal obstruction/blockage, fewer than 3 defecations per week, flatulence, soiling, evacuation pain, and bleeding were also more frequent in the HTLV-1 patients than in the controls. Moreover, bowel symptoms were more frequent in patients with definitive or probable HAM / TSP than in carriers. CONCLUSIONS: Bowel symptoms were more frequent in HTLV-1-infected patients than in seronegative controls and the frequency of bowel symptoms correlated with the severity of neurologic disease.

https://doi.org/10.1590/0037-8682-0486-2018 926 downloads

Polymorphism in the interleukin-10 gene is associated with overactive bladder phenotype associated with HTLV-1 infection
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Braz, Marcos

; Oliveira, Joyce Moura

; Rêgo, Jamile Leão

; Carvalho, Edgar Marcelino de

; Santos, Silvane Maria Braga

; Castellucci, Léa Cristina

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20180481

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION Human T-cell lymphotropic virus type 1 (HTLV-1)-associated inflammatory diseases are not well understood; however, their clinical manifestations may be influenced by the host genetic background. METHODS We genotyped 298 individuals with HTLV-1 and 380 controls for interleukin-10 (IL10) gene variants-rs3024496, rs1800871, rs1800896-and used logistic regression analysis to determine their association with clinical phenotypes. RESULTS No association with HTLV-1 infection was observed. However, allele A of rs1800896 (1082bp upstream) was associated with protection against neurological impairment, specifically overactive bladder (OR=0.447, 95% CI 0.28-0.70, p=0.001). CONCLUSIONS Our data suggests that IL10 regulation ameliorates neurological damage in HTLV-1 infections.

https://doi.org/10.1590/0037-8682-0481-2018 637 downloads

Increasing awareness of human T-lymphotropic virus type-1 infection: a serious, invisible, and neglected health problem in Brazil
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Puccioni-Sohler, Marzia

; Grassi, Maria Fernanda Rios

; Galvão-Castro, Bernardo

; Caterino, Adele

; Proietti, Anna Bárbara de Freitas Carneiro

; Vicente, Ana Carolina Paulo

; Galvão-Castro, Ana Verena

; Vallinoto, Antonio Carlos

; Paiva, Arthur

; Penalva, Augusto

; Rosadas, Carolina

; Miyashiro, Denis

; Barbosa, Edel Figueiredo

; Carvalho, Edgar Marcelino de

; Batista, Everton da Silva

; Smid, Jerusa

; Casseb, Jorge

; Vidal, Jose

; Sousa, Maisa Silva

; Viana, Maria Graça de Castro

; Bastos, Michele de Souza

; Lírio, Monique

; Boa-Sorte, Ney

; Ferreira Jr, Orlando C.

; Takayanagui, Osvaldo

; Moura, Patrícia

; Rocco, Regina

; Cunha, Rodrigo Guimaraes

; Haddad, Simone Kashima

; Assone, Tatiane

; Araújo, Thessika Hialla Almeida

Revista da Sociedade Brasileira de Medicina Tropical

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2019, Volume 52 elocation e20190343

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/0037-8682-0343-2019 953 downloads

The relationship between atopy and neurological manifestations in HTLV-1 infection
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Verde, Raquel Crisóstomo Lima

; Carneiro Neto, José Abraão

; Santos, Silvane Maria Braga

; Carvalho, Edgar Marcelino

; Lessa, Marcus Miranda

Revista da Sociedade Brasileira de Medicina Tropical

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Abr 2018, Volume 51 Nº 2 Páginas 207 - 211

Resumo: En | Texto: En | PDF: En

Abstract INTRODUCTION: Human T-cell lymphotropic virus type 1 (HTLV-1)induces exaggerated Th1 responses, whereas atopy is associated with exacerbated Th2 responses. METHODS: Here, a cross-sectional study compared the prevalence of atopy in HTLV-1 carriers and HAM/TSP patients. It also compared the spontaneous cytokine production in HTLV-1-infected individuals. A retrospective cohort study evaluated the development of neurological manifestations in atopic and non-atopic carriers. RESULTS: Atopic HAM/TSP patients with high IFN-γ production exhibited higher IL-5 levels than non-atopic patients. Allergic rhinitis accelerated the development of Babinski signals and overactive bladders. CONCLUSIONS: Abnormal Th1 and Th2 responses coexist in HTLV-1-infected individuals and allergic diseases may worsen the clinical course of HTLV-1 infections.

https://doi.org/10.1590/0037-8682-0162-2017 847 downloads

Mucosal leishmaniasis: urgent need for more research
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Carvalho, Edgar Marcelino

; Llanos-Cuentas, Alejandro

; Romero, Gustavo Adolfo Sierra

Revista da Sociedade Brasileira de Medicina Tropical

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Fev 2018, Volume 51 Nº 1 Páginas 120 - 121

Resumo: En | Texto: En | PDF: En

https://doi.org/10.1590/0037-8682-0463-2017 1884 downloads

Inflammatory and immunological profiles in patients with COPD: relationship with FEV 1 reversibility
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Queiroz, Cleriston Farias

; Lemos, Antonio Carlos Moreira

; Bastos, Maria de Lourdes Santana

; Neves, Margarida Célia Lima Costa

; Camelier, Aquiles Assunção

; Carvalho, Natália Barbosa

; Carvalho, Edgar Marcelino de

Jornal Brasileiro de Pneumologia

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Ago 2016, Volume 42 Nº 4 Páginas 241 - 247

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Determinar se a gravidade da DPOC se correlaciona com a contagem de células no escarro, atopia e asma. Métodos: Estudo transversal com 37 pacientes com DPOC e 22 indivíduos saudáveis com função pulmonar normal (controles). As contagens de células no escarro foram determinadas por microscopia após a centrifugação das amostras. Foram realizados testes cutâneos de puntura, e as citocinas séricas foram determinadas por ELISA. Resultados: Os pacientes foram estratificados pela resposta ao broncodilatador: o grupo de limitação ao fluxo aéreo não reversível (LFAnr) envolveu 24 pacientes sem alteração significativa do VEF1 pós-broncodilatador, e o grupo de limitação ao fluxo aéreo parcialmente reversível (LFApr) envolveu 13 pacientes com reversibilidade do VEF1 (aumento do VEF1 pós-broncodilatador ≥ 12%). A proporção de eosinófilos no escarro foi maior no grupo LFApr do que no LFAnr (p < 0,01), e houve uma correlação inversa entre a proporção de eosinófilos e VEF1 (p < 0,05). Entretanto, nenhum dos pacientes apresentou histórico de asma e os resultados dos testes cutâneos não diferiram entre os dois grupos. Nas amostras de escarro dos pacientes, os neutrófilos predominaram. Os níveis séricos de TNF, IL-6, IL-8 e RANTES (CCL5) foram maiores nos pacientes que nos controles (p < 0,001), mas não diferiram entre os dois grupos de pacientes. Conclusões: Pacientes com DPOC e reversibilidade parcial do VEF1 parecem apresentar maiores contagens de eosinófilos no escarro e maior hiper-responsividade das vias aéreas que aqueles sem reversibilidade do VEF1. Entretanto, a gravidade da DPOC não se correlacionou com atopia ou perfil das citocinas.

ABSTRACT Objective: To determine whether COPD severity correlates with sputum cell counts, atopy, and asthma. Methods: This was a cross-sectional study involving 37 patients with COPD and 22 healthy subjects with normal lung function (controls). Sputum cell counts were determined by microscopy after centrifugation of samples. Skin prick tests were performed, and serum cytokines were determined by ELISA. Results: Patients were stratified by bronchodilator response: a non-reversible airflow limitation (nonRAL) group comprised 24 patients showing no significant post-bronchodilator change in FEV1; and a partially reversible airflow limitation (partialRAL) group comprised 13 patients showing FEV1 reversibility (post-bronchodilator FEV1 increase ≥ 12%). The proportion of eosinophils in sputum was higher in the partialRAL group than in the nonRAL group (p < 0.01), and there was an inverse correlation between the proportion of eosinophils and FEV1 (p < 0.05). However, none of the patients had a history of asthma and skin prick test results did not differ between the two groups. In the patient sputum samples, neutrophils predominated. Serum levels of TNF, IL-6, IL-8, and RANTES (CCL5) were higher in patients than in controls (p < 0.001) but did not differ between the two patient groups. Conclusions: COPD patients with partial FEV1 reversibility appear to have higher sputum eosinophil counts and greater airway hyperresponsiveness than do those with no FEV1 reversibility. However, we found that COPD severity did not correlate with atopy or with the cytokine profile.

https://doi.org/10.1590/s1806-37562015000000122 5621 downloads

The use of botulinum toxin type A in the treatment of HTLV-1-associated overactive bladder refractory to conventional therapy
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Carneiro Neto, José Abraão

; Bittencourt, Valéria Gusmão

; de Oliveira, Cassius

; Andrade, Rosana

; de Carvalho, Edgar Marcelino

Revista da Sociedade Brasileira de Medicina Tropical

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Ago 2014, Volume 47 Nº 4 Páginas 528 - 532

Resumo: En | Texto: En | PDF: En

Urinary symptoms occur in 19% of human T-cell lymphotropic virus type 1 (HTLV-1)-infected patients who do not fulfill criteria for HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and in almost 100% of HAM/TSP patients. Few studies have evaluated therapies for overactive bladder (OAB) caused by HTLV-1 infection. This case report describes the effect of onabotulinum toxin A on the urinary manifestations of three patients with HAM/TSP and OAB symptoms. The patients were intravesically administered 200 units of Botox®. Their incontinence episodes improved, and their OAB symptoms scores (OABSS) reduced significantly. These data indicate that Botox® should be a treatment option for OAB associated with HTLV-1 infection.

https://doi.org/10.1590/0037-8682-0029-2014 2601 downloads

Host genetic factors in American cutaneous leishmaniasis: a critical appraisal of studies conducted in an endemic area of Brazil
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Castellucci, Léa Cristina

; Almeida, Lucas Frederico de

; Jamieson, Sarra Elisabeth

; Fakiola, Michaela

; Carvalho, Edgar Marcelino de

; Blackwell, Jenefer Mary

Memórias do Instituto Oswaldo Cruz

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Jun 2014, Volume 109 Nº 3 Páginas 279 - 288

Resumo: En | Texto: En | PDF: En

American cutaneous leishmaniasis (ACL) is a vector-transmitted infectious disease with an estimated 1.5 million new cases per year. In Brazil, ACL represents a significant public health problem, with approximately 30,000 new reported cases annually, representing an incidence of 18.5 cases per 100,000 inhabitants. Corte de Pedra is in a region endemic for ACL in the state of Bahia (BA), northeastern Brazil, with 500-1,300 patients treated annually. Over the last decade, population and family-based candidate gene studies were conducted in Corte de Pedra, founded on previous knowledge from studies on mice and humans. Notwithstanding limitations related to sample size and power, these studies contribute important genetic biomarkers that identify novel pathways of disease pathogenesis and possible new therapeutic targets. The present paper is a narrative review about ACL immunogenetics in BA, highlighting in particular the interacting roles of the wound healing gene FLI1 with interleukin-6 and genes SMAD2 and SMAD3 of the transforming growth factor beta signalling pathway. This research highlights the need for well-powered genetic and functional studies on Leishmania braziliensis infection as essential to define and validate the role of host genes in determining resistance/susceptibility regarding this disease.

https://doi.org/10.1590/0074-0276140028 2455 downloads Citado 2 vezes em SciELO

10.

Inflammation in disseminated lesions: an analysis of CD4+, CD20+, CD68+, CD31+ and vW+ cells in non-ulcerated lesions of disseminated leishmaniasis
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Mendes, Dayana Santos

; Dantas, Marina Loyola

; Gomes, Juliana Menezes

; Santos, Washington Luis Conrado dos

; Silva, Adriano Queiroz

; Guimarães, Luiz Henrique

; Machado, Paulo R

; Carvalho, Edgar Marcelino de

; Arruda, Sérgio

Memórias do Instituto Oswaldo Cruz

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Fev 2013, Volume 108 Nº 1 Páginas 18 - 22

Resumo: En | Texto: En | PDF: En

Disseminated leishmaniasis (DL) differs from other clinical forms of the disease due to the presence of many non-ulcerated lesions (papules and nodules) in non-contiguous areas of the body. We describe the histopathology of DL non-ulcerated lesions and the presence of CD4-, CD20-, CD68-, CD31- and von Willebrand factor (vW)-positive cells in the inflamed area. We analysed eighteen biopsies from non-ulcerated lesions and quantified the inflamed areas and the expression of CD4, CD20, CD68, CD31 and vW using Image-Pro software (Media Cybernetics). Diffuse lymphoplasmacytic perivascular infiltrates were found in dermal skin. Inflammation was observed in 3-73% of the total biopsy area and showed a significant linear correlation with the number of vW+ vessels. The most common cells were CD68+ macrophages, CD20+ B-cells and CD4+ T-cells. A significant linear correlation between CD4+ and CD20+ cells and the size of the inflamed area was also found. Our findings show chronic inflammation in all DL non-ulcerated lesions predominantly formed by macrophages, plasmacytes and T and B-cells. As the inflamed area expanded, the number of granulomas and extent of the vascular framework increased. Thus, we demonstrate that vessels may have an important role in the clinical evolution of DL lesions.

2489 downloads Citado 1 vez em SciELO

11.

Immunopathogenesis and neurological manifestations associated to HTLV-1 infection
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Souza, Anselmo

; Tanajura, Davi

; Toledo-Cornell, Cristina

; Santos, Silvane

; Carvalho, Edgar Marcelino de

Revista da Sociedade Brasileira de Medicina Tropical

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Out 2012, Volume 45 Nº 5 Páginas 545 - 552

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

O vírus linfotrópico de células T humanas do tipo 1 (HTLV-1) foi o primeiro retrovírus humano identificado. O vírus é transmitido via relação sexual, transfusão de sangue, compartilhamento de agulhas ou seringas contaminadas ou da mãe para o filho, principalmente através da amamentação. Além da conhecida associação entre o HTLV-1 e a mielopatia associada ao HTLV-1 (HAM/TSP), várias doenças e manifestações neurológicas tem sido associadas com o vírus. Esta revisão de literatura foi conduzida através de pesquisa ao banco de dados do PubMed, com os termos HTLV-1, resposta imune e doenças neurológicas. Foram enfatizados os dados mais recentes sobre a patogênese e às manifestações clínicas na infecção pelo HTLV-1. O objetivo dessa revisão é analisar a resposta imune e a variedade de manifestações neurológicas associadas com a infecção pelo HTLV-1. Um total de 102 artigos foi analisado. A literatura mostra que grande porcentagem de indivíduos infectados pelo HTLV-1 apresenta sintomas neurológicos mesmo na ausência de HAM/TSP. Uma maior compreensão das várias manifestações clínicas associadas ao vírus, além da leucemia/linfoma de células T do adulto (ATLL) e HAM/TSP, auxilia a estabelecer que, na realidade, a infecção pelo vírus possui uma morbidade maior do que se pensava.

The human T lymphotropic virus type-1 (HTLV-1) was the first human retrovirus identified. The virus is transmitted through sexual intercourse, blood transfusion, sharing of contaminated needles or syringes and from mother to child, mainly through breastfeeding. In addition to the well-known association between HTLV-1 and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), several diseases and neurologic manifestations have been associated with the virus. This review was conducted through a PubMed search of the terms HTLV-1, immune response and neurological diseases. Emphasis was given to the most recent data regarding pathogenesis and clinical manifestations of HTLV-1 infection. The aim of the review is to analyze the immune response and the variety of neurological manifestations associated to HTLV-1 infection. A total of 102 articles were reviewed. The literature shows that a large percentage of HTLV-1 infected individuals have others neurological symptoms than HAM/TSP. Increased understanding of these numerous others clinical manifestations associated to the virus than adult T cell leukemia/lymphoma (ATLL) and HAM/TSP has challenged the view that HTLV-1 is a low morbidity infection.

6770 downloads Citado 3 vezes em SciELO

12.

Parasite, vectors and reservoirs as determinants of tegumentary leishmaniasis
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Carvalho, Edgar Marcelino

Revista da Sociedade Brasileira de Medicina Tropical

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Ago 2012, Volume 45 Nº 4 Páginas 423 - 424

Resumo: En | Texto: En | PDF: En

2889 downloads

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Franklin A. Neva (<img src="/img/revistas/rsbmt/v45n2/a34est.jpg" width="21" height="22"align="texttop">1922 †2011)
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Carvalho, Edgar Marcelino

Revista da Sociedade Brasileira de Medicina Tropical

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Abr 2012, Volume 45 Nº 2 Páginas 283 - 283

Resumo: En | Texto: En | PDF: En

1543 downloads

14.

Schistosoma mansoni antigens alter the cytokine response in vitro during cutaneous leishmaniasis
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Bafica, Aline Michelle Barbosa

; Cardoso, Luciana Santos

; Oliveira, Sérgio Costa

; Loukas, Alex

; Varela, Giuseppe Tittoni

; Oliveira, Ricardo Riccio

; Bacellar, Olívia

; Carvalho, Edgar Marcelino

; Araújo, Maria Ilma

Memórias do Instituto Oswaldo Cruz

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Nov 2011, Volume 106 Nº 7 Páginas 856 - 863

Resumo: En | Texto: En | PDF: En

Schistosoma mansoni infection or associated products are able to down-modulate the type 1 CD4+ T cell inflammatory response characteristic of autoimmune diseases. In this study, we evaluated how S. mansoni antigens altered the immune response that was induced by the soluble Leishmania antigen (SLA) from cutaneous leishmaniasis (CL) patients. Cytokines were measured from the supernatants of peripheral blood mononuclear cell cultures stimulated with SLA. This was performed using the sandwich enzyme linked immunosorbent assay technique in the presence or absence of S. mansoni recombinant antigens Sm29, SmTSP-2 and PIII. The addition of S. mansoni antigens to the cultures resulted in the reduction of interferon gamma (IFN-γ) levels in 37-50% of patients. Although to a lesser extent, the antigens were also able to decrease the production of tumour necrosis factor-alpha (TNF-α). We compared patients that either had or did not have reduction in IFN-γ and TNF-α production in cultures stimulated with SLA in the presence of S. mansoni antigens. We found that there was no significant difference in the levels of interleukin (IL)-10 and IL-5 in response to S. mansoni antigens between the groups. The antigens used in this study down-modulated the in vitro proinflammatory response induced by SLA in a group of CL patients through a currently undefined mechanism.

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Serum cytokine levels in patients with chronic low back pain due to herniated disc: analytical cross-sectional study
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Kraychete, Durval Campos

; Sakata, Rioko Kimiko

; Issy, Adriana Machado

; Bacellar, Olívia

; Santos-Jesus, Rogério

; Carvalho, Edgar Marcelino

Sao Paulo Medical Journal

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2010, Volume 128 Nº 5 Páginas 259 - 262

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

CONTEXTO E OBJETIVO: A função da resposta imunológica e das citocinas pró-inflamatórias na patogênese da dor crônica tem tido interesse crescente. Para avaliar se há correlação entre hérnia de disco e aumento de citocinas, foi medida a concentração de citocinas em pacientes com lombalgia crônica e em indivíduos sadios. TIPO DE ESTUDO E LOCAL: Estudo transversal analítico realizado na Clínica de Dor da Universidade Federal da Bahia (UFBA). MÉTODO: As concentrações de citocinas foram medidas pela técnica de ELISA (enzyme linked immunosorbent assay) em 23 pacientes com lombalgia (G1) e 10 sadios (G2). RESULTADOS: As concentrações de fator-alfa de necrose tumoral [TNF-alpha] (G1 = 5.6 ± 2.3 pg/ml; G2 = 1.6 ± 0.5 pg/ml; P = 0,01) e interleucina-6 [IL-6] (G1 = 4.1 ± 3.0 pg/ml; G2 = 0.9 ± 0.4 pg/ml; P = 0,01) foram maiores no G1. Não houve diferença estatisticamente significante para interleucina-1 [IL-1] (G1 = 0.5 ± 0.3 pg/ml; G2 = 0.5 ± 0.1 pg/ml; P = 1) e receptor solúvel do factor de necrose tumoral [sTNF-R] (G1 = 572 pg/ml ± 36; G2 = 581 ± 50 pg/ml; P = 0,87). CONCLUSÃO: Os pacientes com lombalgia crônica por hérnia de disco apresentam concentrações maiores de TNF-alpha e IL-6, mas não de IL-1 ou sTNF-R.

CONTEXT AND OBJECTIVE: The role of immune response and proinflammatory cytokines in the pathogenesis of chronic pain has been of growing interest. In order to evaluate whether there is any association between disc herniation and elevated cytokine levels, we measured cytokine levels in patients with chronic low back pain and in healthy subjects. DESIGN AND SETTING: Analytical cross-sectional study at the Pain Clinic of Universidade Federal da Bahia (UFBA). METHODS: Cytokine levels were measured using the enzyme-linked immunosorbent assay (ELISA) technique on 23 patients with low back pain (G1) and on 10 healthy subjects (G2). RESULTS: The levels of tumor necrosis factor-alpha [TNF-alpha] (G1 = 5.6 ± 2.3 pg/ml; G2 = 1.6 ± 0.5 pg/ml; P = 0.01) and interleukin-6 [IL-6] (G1 = 4.1 ± 3.0 pg/ml; G2 = 0.9 ± 0.4 pg/ml; P = 0.01) were higher in G1. There were no statistically significant differences in relation to interleukin-1 [IL-1] (G1 = 0.5 ± 0.3 pg/ml; G2 = 0.5 ± 0.1 pg/ml; P = 1) or soluble tumor necrosis factor receptor [sTNF-R] (G1 = 572 pg/ml ± 36; G2 = 581 ± 50 pg/ml; P = 0.87). CONCLUSION: The patients with chronic low back pain due to disc herniation presented higher levels of TNF-alpha and IL-6, but not of IL-1 or sTNF-R.

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