Biomarker of Urinary Malondialdehyde and Tumor Necrosis Factor-Alpha with Pain Progress in a Patient with Low Back Pain

Hosein Seydi | Majid Hassanpour-Ezatti

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URL :   http://research.shahed.ac.ir/WSR/WebPages/Report/PaperView.aspx?PaperID=169758
Date :  2022/09/10
Publish in :    Interventional Pain Medicine and Neuromodulation
DOI :  https://doi.org/ 10.5812/ipmn-129275
Link :  http://dx.doi.org/ 10.5812/ipmn-129275
Keywords :Back Pain, Tumor Necrosis Factor-Alpha, Malondialdehyde, Oxidative Stress

Abstract :

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Introduction: This study aims to determine the urine concentrations of MDA, and TNF-α biomarkers with pain intensity in a patient with low back pain (LBP) compared to healthy controls. Also, the correlation between these biomarkers and clinical findings of pain intensity was determined during 25 weeks to find a molecular diagnostic factor of disease progression. Case Presentation: Participants in this case study are students at Shahed University, Iran. A 22-year-old man patient with a threemonth history of progressive LBH and gait instability and an age, sex, and body mass index (BMI) matched healthy man was enrolled for 25 weeks. Spinal MRI (Siemens 1.5 T) revealed disc degeneration and displacement. LBP symptoms were diagnosed by a neurologist using ICD-9 diagnostic codes. Other diseases that affect the urine levels of MDA and TNF-α in the patient, such as allergic or infectious diseases, have been ruled out. After collecting demographic information, the facial pain scale (FPS) and numerical rating scale (NRS) for pain and 24-hour urine samples of a healthy person and a patient were collected weekly for 25 weeks. Samples were analyzed for malondialdehyde (MDA) and tumor necrosis factor-alpha (TNF-α). Conclusions: During the experiment, urinary MDA levels were significantly elevated while TNF-α levels were not changed in LBP patients compared to control individuals (P ≤ 0.001). Furthermore, the assessment of LBP by the facial pain scale (FPS) and numerical rating scale (NRS) pain scores was only correlated with urinary MDA levels, and urinary TNF-α levels did not change during the experiment. Pearson correlation analysis revealed a positive correlation between pain scores during 25 weeks and urine concentrations of MDA (r = 0.60, P-value 0.001). According to the present study, chronic LBP patients had higher levels of MDA in their urine than those who did not have chronic LBP. There was a significant positive association between urine MDA level and pain intensity progression.