Elevated serum inflammatory markers in post-poliomyelitis syndrome.
OBJECTIVE
To determine (i) whether serum inflammatory markers TNFalpha, IL-1beta. IL-6, and leptin are increased in post-poliomyelitis syndrome (PPS) compared to healthy controls; and (ii) whether an association exists between elevated inflammatory markers and clinical parameters in PPS. The cause of PPS is unknown, but abnormal inflammatory responses have been implicated in several small studies.


METHODS
Serum inflammatory markers were measured (by Luminex) in 51 PPS patients and 26 normal controls. Clinical parameters assessed included disease duration, muscle strength (Medical Research Council sumscore), fatigue (Fatigue Severity Scale and Multidimensional Fatigue Inventory), and pain (visual analog scale scores).


RESULTS
In PPS, TNFalpha levels, as well as IL-6 and leptin were significantly increased compared to controls (Wilcoxon rank-sum test, p=0.03 for TNFalpha, p=0.03 for IL-6, p=0.01 for leptin). The elevated TNFalpha levels in PPS were associated with increased pain due to illness (Spearman correlation coefficient r=0.36, 95% C.I. 0.09 to 0.57) and specifically, with muscle pain (r=0.38, 95% C.I. 0.11 to 0.59). There were no correlations between inflammatory markers in PPS and joint pain, muscle strength, fatigue, or disease duration.


CONCLUSIONS
Serum TNFalpha, IL-6 and leptin levels are abnormally increased in PPS patients. Elevated TNFalpha levels appear to be specifically associated with increased muscle pain.
Fordyce
Christopher B
CB
Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada.
Gagne
Donald
D
Jalili
Farzaneh
F
Alatab
Sudabeh
S
Arnold
Douglas L
DL
Da Costa
Deborah
D
Sawoszczuk
Stefan
S
Bodner
Caroline
C
Shapiro
Stan
S
Collet
Jean-Paul
JP
Robinson
Ann
A
Le Cruguel
Jean-Pierre
JP
Lapierre
Yves
Y
Bar-Or
Amit
A
Trojan
Daria A
DA
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D016262:Postpoliomyelitis Syndrome / Q000097:blood* / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D016207:Cytokines; D020738:Leptin