TY  - JOUR
A1  - Wippert, Pia-Maria
A1  - Fliesser, Michael
A1  - Krause, Matthias
T1  - Risk and protective factors in the clinical rehabilitation of chronic back pain
JF  - Journal of pain research
N2  - Objectives: Chronic back pain (CBP) can lead to disability and burden. In addition to its medical causes, its development is influenced by psychosocial risk factors, the so-called flag factors, which are categorized and integrated into many treatment guidelines. Currently, most studies investigate single flag factors, which limit the estimation of individual factor significance in the development of chronic pain. Furthermore, factors concerning patients’ lifestyle, biography and treatment history are often neglected. Therefore, the objectives of the present study are to identify commonly neglected factors of CBP and integrate them into an analysis model comparing their significance with established flag factors.

Methods: A total of 24 patients and therapists were cross-sectionally interviewed to identify commonly neglected factors of CBP. Subsequently, the impact of these factors was surveyed in a longitudinal study. In two rehabilitation clinics, CBP patients (n = 145) were examined before and 6 months after a 3-week inpatient rehabilitation. Outcome variables, chronification factor pain experience (CF-PE) and chronification factor disability (CF-D), were ascertained with confirmatory factor analysis (CFA) of standardized questionnaires. Predictors were evaluated using stepwise calculations of simple and multiple regression models.

Results: Through interviews, medical history, iatrogenic factors, poor compliance, critical life events (LEs), social support (SS) type and effort–reward were identified as commonly neglected factors. However, only the final three held significance in comparison to established factors such as depression and pain-related cognitions. Longitudinally, lifestyle factors found to influence future pain were initial pain, physically demanding work, nicotine consumption, gender and rehabilitation clinic. LEs were unexpectedly found to be a strong predictor of future pain, as were the protective factors, reward at work and perceived SS.

Discussion: These findings shed insight regarding often overlooked factors in the development of CBP, suggesting that more detailed operationalization and superordinate frameworks would be beneficial to further research.

Conclusion: In particular, LEs should be taken into account in future research. Protective factors should be integrated in therapeutic settings.
KW  - yellow flags
KW  - life events
KW  - clinical pain research
Y1  - 2017
U6  - https://doi.org/10.2147/JPR.S134976
SN  - 1178-7090
VL  - 10
SP  - 1569
EP  - 1579
PB  - Dove Medical Press
CY  - Albany, Auckland
ER  - 
TY  - JOUR
A1  - Keller, Johannes
A1  - Catala-Lehnen, Philip
A1  - Huebner, Antje K.
A1  - Jeschke, Anke
A1  - Heckt, Timo
A1  - Lueth, Anja
A1  - Krause, Matthias
A1  - Koehne, Till
A1  - Albers, Joachim
A1  - Schulze, Jochen
A1  - Schilling, Sarah
A1  - Haberland, Michael
A1  - Denninger, Hannah
A1  - Neven, Mona
A1  - Hermans-Borgmeyer, Irm
A1  - Streichert, Thomas
A1  - Breer, Stefan
A1  - Barvencik, Florian
A1  - Levkau, Bodo
A1  - Rathkolb, Birgit
A1  - Wolf, Eckhard
A1  - Calzada-Wack, Julia
A1  - Neff, Frauke
A1  - Gailus-Durner, Valerie
A1  - Fuchs, Helmut
A1  - de Angelis, Martin Hrabe
A1  - Klutmann, Susanne
A1  - Tsourdi, Elena
A1  - Hofbauer, Lorenz C.
A1  - Kleuser, Burkhard
A1  - Chun, Jerold
A1  - Schinke, Thorsten
A1  - Amling, Michael
T1  - Calcitonin controls bone formation by inhibiting the release of sphingosine 1-phosphate from osteoclasts
JF  - Nature Communications
N2  - The hormone calcitonin (CT) is primarily known for its pharmacologic action as an inhibitor of bone resorption, yet CT-deficient mice display increased bone formation. These findings raised the question about the underlying cellular and molecular mechanism of CT action. Here we show that either ubiquitous or osteoclast-specific inactivation of the murine CT receptor (CTR) causes increased bone formation. CT negatively regulates the osteoclast expression of Spns2 gene, which encodes a transporter for the signalling lipid sphingosine 1-phosphate (S1P). CTR-deficient mice show increased S1P levels, and their skeletal phenotype is normalized by deletion of the S1P receptor S1P(3). Finally, pharmacologic treatment with the nonselective S1P receptor agonist FTY720 causes increased bone formation in wild-type, but not in S1P(3)-deficient mice. This study redefines the role of CT in skeletal biology, confirms that S1P acts as an osteoanabolic molecule in vivo and provides evidence for a pharmacologically exploitable crosstalk between osteoclasts and osteoblasts.
Y1  - 2014
U6  - https://doi.org/10.1038/ncomms6215
SN  - 2041-1723
VL  - 5
PB  - Nature Publ. Group
CY  - London
ER  -