Vaspin-Cytokine Interactions in Chronic Low Back Pain: Links Between Obesity, Inflammation, and Traction Therapy Response.

Interest in identifying biomarkers that reflect spine condition and support therapy monitoring has grown. Since low-grade inflammation and comorbidities can complicate treatment, they should be considered in research. Vaspin (SERPINA12) has been linked to low back pain (LBP) severity and disability, highlighting its potential as a biomarker connecting LBP and adipose tissue inflammation. The study aimed to assess the effect of traction therapy on serum vaspin levels and compare responses between women with obesity and normal BMI. A secondary aim was to explore associations between vaspin, LBP severity, disability scores, and selected inflammatory markers. It is a prospective clinical trial. Women aged 34-50 years with chronic LBP were divided into two groups: those with normal BMI and those with obesity. Both groups underwent 20 30-min sessions of lumbar traction therapy. At baseline and after therapy, LBP intensity, the Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RMDQ) were assessed, and blood samples were collected for analysis of vaspin, RANTES, interleukin (IL)-2, IL-17A, IL-4, and IL-10. After completing the traction therapy, there was a significant decrease in LBP, ODI, and RMDQ and an increase in the circulating levels of IL-10, regardless of BMI. However, vaspin concentration increased significantly only in women with normal BMI. Post-therapy, vaspin negatively correlated with ODI. IL-4 and IL-17A levels also correlated with vaspin, positively in women with normal BMI and negatively in those with obesity. Obesity-related inflammation may alter the biochemical response to traction therapy. Increases in vaspin concentration were found exclusively in women with normal BMI, indicating a possible BMI-dependent association between circulating vaspin concentrations and response to therapy.Registration: The study was registered at ClinicalTrials.gov with the ID number NCT04507074.