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Serum proteomic analysis of sex differences during an acute low back pain episode

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Dec 18, 2023 version files 50.77 GB

Abstract

Growing evidence suggests that pain and injury engage biological processes and systems that extend beyond the nervous system. The molecular processes driving the transition from acute to chronic low back pain (LBP) remain poorly understood. Here, we explore the serum proteomic profile of male and female participants during an acute LBP episode (N=59). Differential protein expression during the acute-stage of LBP was compared between participants with resolved LBP at three months and those with chronic or recurrent LBP at three-months. Proteome-wide analysis using mass-spectrometry identified 216 proteins confidently. Sex differences in protein abundance changes were evident upon inspection of fold changes. Multivariable data analysis identified 21 serum proteins during the acute episode that correctly classified 93% of males and 23 serum proteins that correctly classified 90% of females with ongoing LBP at three months. Most of the differentially expressed proteins during acute LBP were involved in immune, inflammatory, complement or coagulation responses. Overall, males who recovered from an acute LBP episode had a greater tendency to demonstrate an upregulated immune-driven inflammatory response during acute LBP, whilst women with pain resolution demonstrated a tendency towards a downregulated immune response. Taken together, this study provides data to suggest biological processes during an acute LBP episode may contribute to resolution, or persistence, of LBP symptoms at three months, however, these processes differ between sexes. This work provides an early foundation for future research exploring strategies targeting distinct immune system processes in men and women that may interfere with the transition from acute to chronic LBP.