LA RESPUESTA INFLAMATORIA MEDIDA A TRAVÉS DE LA CUANTIFICACIÓN DE CITOCINAS PRO - INFLAMATORIAS (TNF-, IL-1, IL- 6) EN PACIENTES TRATADOS CON ELECTROACUPUNTURA POSTLUMBALGIA

Abstract

Low back pain is one of the most common causes of seeking medical care and work disability, in addition its treatment costs are one of the highest all around the world. In 95% of the cases the main cause is improper movements, causing tissue damage in some musculoskeletal components. All tissue injury triggers inflammation, as a response to repair the damage and restore homeostasis; infection and stress are inductors of inflammatory response. Inflammation is characterized by the release of proinflammatory cytokines such as TNF , IL- and IL-6, which are responsible for potentiating the inflammation, and increasing the nociception by facilitating the onset of pain. The release of proinflammatory cytokines is modulated by different pathways within the cholinergic anti-inflammatory pathway. Acupuncture has proven effectiveness in pain management, nevertheless, its anti-inflammatory mechanism has not yet been elucidated, this effect could be related to the stimulation of the cholinergic anti-inflammatory pathway. In this study we aimed to find any correlation between the analgesic effect of acupuncture and the concentration of circulating proinflammatory cytokines in patients with a diagnosis of acute and subacute low back pain. Fifteen individuals were recruited, five out of these ten were treated with electroacupuncture and the other five received non-steroidal analgesics (NSAIDs) treatment. Both groups were evaluated by visual scale of pain intensity, this assessment was carried out daily for 5 consecutive therapies. Additionally in these groups the circulating proinflammatory cytokines were quantified before and after the first session and the end of fifth session. The remaining 5 patients had a diagnosis of apparently healthy, and only underwent quantification of circulating proinflammatory cytokines. The results indicate that the analgesic effect of electroacupuncture was statistically significant compared to the group treated with NSAIDs. However, circulating proinflammatory cytokines levels were not affected in the group treated with electroacupuncture or the group treated with NSAIDs, because in many patients these levels were below detection limit.