BACKGROUND Low back pain (LBP) is one of the greatest contributors to disability in the world and there is growing interest on the role of biomarkers in LBP. To purpose of this review was to analyze available evidence on the relationship between inflammatory biomarkers, clinical presentation, and outcomes in patients with acute, subacute and chronic non-specific low back pain (NSLBP). METHODS A search was performed in Medline, Embase, Cinahl and Amed databases. Studies which measured levels of inflammatory biomarkers in participants with NSLBP were included. Two reviewers independently screened titles and abstracts, full-texts, and extracted data from included studies. Methodological quality was assessed using the Newcastle Ottawa Quality Assessment Scale. Level of evidence was assessed using the modified GRADE approach for prognostic studies. RESULTS Seven primary studies were included in this review. All results assessed using the modified GRADE demonstrated low to very low quality evidence given the small number of studies and small sample. Three studies examined C-reactive protein (CRP), one of which found significantly higher CRP levels in an acute NSLBP group than in controls and an association between high pain intensity and elevated CRP. Three studies examined tumor necrosis factor alpha (TNF-α), two of which found elevated TNF-α in chronic NSLBP participants compared to controls. Two studies examined interleukin 6 (IL-6), none of which found a significant difference in IL-6 levels between NSLBP groups and controls. Two studies examined interleukin 1 beta (IL-β), none of which found a significant difference in IL-β levels between NSLBP groups and controls. CONCLUSIONS This review found evidence of elevated CRP in individuals with acute NSLBP and elevated TNF-Α in individuals with chronic NSLBP. There are a limited number of high-quality studies evaluating similar patient groups and similar biomarkers, which limits the conclusion of this review.

中文翻译：

---

炎性生物标志物在急性，亚急性和慢性非特异性下腰痛中的作用的系统综述。

背景技术腰痛（LBP）是世界上导致残疾的最大原因之一，并且对生物标志物在LBP中的作用越来越感兴趣。这篇综述的目的是分析有关急性，亚急性和慢性非特异性下背痛（NSLBP）患者炎症生物标志物，临床表现和预后之间关系的现有证据。方法在Medline，Embase，Cinahl和Amed数据库中进行搜索。包括测量NSLBP参与者炎症生物标志物水平的研究。两名审稿人独立筛选标题和摘要，全文，并从纳入研究中提取数据。使用纽卡斯尔渥太华质量评估量表评估方法学质量。使用改进的GRADE方法评估预后研究的证据水平。结果本评价纳入了七项主要研究。鉴于研究数量少和样本量少，使用改良GRADE评估的所有结果均显示出低至极低的质量证据。三项研究检查了C反应蛋白（CRP），其中一项发现急性NSLBP组的CRP水平明显高于对照组，并且高疼痛强度和CRP升高之间存在关联。三项研究检查了肿瘤坏死因子α（TNF-α），其中两项发现与对照组相比，慢性NSLBP参与者的TNF-α升高。两项研究检查了白介素6（IL-6），但没有发现NSLBP组与对照组的IL-6水平有显着差异。两项研究检查了白介素1β（IL-β），但没有一项研究发现NSLBP组与对照组的IL-β水平存在显着差异。结论本评价发现急性NSLBP患者CRP升高和慢性NSLBP患者TNF-A升高的证据。评估相似患者组和相似生物标志物的高质量研究数量有限，这限制了本评价的结论。