title: Elevated serum inflammatory markers in post-poliomyelitis syndrome.
abstract: 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.
authors.affiliation: Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Fordyce
authors.forename: Donald
authors.initials: D
authors.lastname: Gagne
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Jalili
authors.forename: Sudabeh
authors.initials: S
authors.lastname: Alatab
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Arnold
authors.forename: Deborah
authors.initials: D
authors.lastname: Da Costa
authors.forename: Stefan
authors.initials: S
authors.lastname: Sawoszczuk
authors.forename: Caroline
authors.initials: C
authors.lastname: Bodner
authors.forename: Stan
authors.initials: S
authors.lastname: Shapiro
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Collet
authors.forename: Ann
authors.initials: A
authors.lastname: Robinson
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Le Cruguel
authors.forename: Yves
authors.initials: Y
authors.lastname: Lapierre
authors.forename: Amit
authors.initials: A
authors.lastname: Bar-Or
authors.forename: Daria A
authors.initials: DA
authors.lastname: Trojan
mesh_terms: 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
chemical_list: D016207:Cytokines; D020738:Leptin