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Peritraumatic C-reactive protein levels predict pain outcomes following traumatic stress exposure in a sex-dependent manner

Title: Peritraumatic C-reactive protein levels predict pain outcomes following traumatic stress exposure in a sex-dependent manner
Authors: McKibben, Lauren A.; Layne, Miranda N.; Albertorio-Sáez, Liz Marie; Zhao, Ying; Branham, Erica M.; House, Stacey L.; Beaudoin, Francesca L.; An, Xinming; Stevens, Jennifer S.; Neylan, Thomas C.; Clifford, Gari D.; Germine, Laura T.; Bollen, Kenneth A.; Rauch, Scott L.; Haran, John P.; Storrow, Alan B.; Lewandowski, Christopher; Musey, Paul I., Jr.; Hendry, Phyllis L.; Sheikh, Sophia; Jones, Christopher W.; Punches, Brittany E.; Swor, Robert A.; Hudak, Lauren A.; Pascual, Jose L.; Seamon, Mark J.; Datner, Elizabeth M.; Peak, David A.; Merchant, Roland C.; Domeier, Robert M.; Rathlev, Niels K.; O'Neil, Brian J.; Sanchez, Leon D.; Bruce, Steven E.; Sheridan, John F.; Harte, Steven E.; Kessler, Ronald C.; Koenen, Karestan C.; Ressler, Kerry J.; McLean, Samuel A.; Linnstaedt, Sarah D.
Contributors: Emergency Medicine, School of Medicine
Source: PMC
Publisher Information: medRxiv
Publication Year: 2024
Collection: Indiana University - Purdue University Indianapolis: IUPUI Scholar Works
Subject Terms: C-reactive protein (CRP); Adverse posttraumatic neuropsychiatric sequelae (APNS); Chronic pain; Posttraumatic stress symptoms (PTSS) and chronic musculoskeletal pain; Sex differences; Traumatic stress
Description: Background: Chronic pain following traumatic stress exposure (TSE) is common. Increasing evidence suggests inflammatory/immune mechanisms are induced by TSE, play a key role in the recovery process versus development of post-TSE chronic pain, and are sex specific. In this study, we tested the hypothesis that the inflammatory marker C-reactive protein (CRP) is associated with chronic pain after TSE in a sex-specific manner. Methods: We utilized blood-plasma samples and pain questionnaire data from men (n=99) and (n=223) women enrolled in AURORA, a multi-site emergency department (ED)-based longitudinal study of TSE survivors. We measured CRP using Ella/ELISA from plasma samples collected in the ED ('peritraumatic CRP', n=322) and six months following TSE (n=322). Repeated measures mixed-effects models were used to assess the relationship between peritraumatic CRP and post-TSE chronic pain. Results: Peritraumatic CRP levels significantly predicted post-TSE chronic pain, such that higher levels of CRP were associated with lower levels of pain over time following TSE, but only in men (men:β=-0.24, p=0.037; women:β=0.05, p=0.470). By six months, circulating CRP levels had decreased by more than half in men, but maintained similar levels in women (t(290)=1.926, p=0.055). More men with a decrease in CRP levels had decreasing pain over time versus women (men:83% women:65%; Z=2.21, p=0.027). Conclusions: In men but not women, we found circulating peritraumatic CRP levels predict chronic pain outcomes following TSE and resolution of CRP levels in men over time might be associated with increased pain recovery. Further studies are needed to validate these results.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://hdl.handle.net/1805/45359
Availability: https://hdl.handle.net/1805/45359
Rights: Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0
Accession Number: edsbas.4E074AC3
Database: BASE