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. 2025 Aug 22;20(8):e0329552.
doi: 10.1371/journal.pone.0329552. eCollection 2025.

A reduction in serum IFN-γ, IL-1β, IL-6, and GM-CSF serves as potential markers for a positive outcome to lumbar epidural steroid injections

Pornpan Chalermkitpanit  1 , Weerasak Singhatanadgige  2   3 , Wicharn Yingsakmongkol  2   3 , Teerachat Tanasansomboon  4 , Manassanan Jitjumnong  5 , Sittisak Honsawek  5
Affiliations

A reduction in serum IFN-γ, IL-1β, IL-6, and GM-CSF serves as potential markers for a positive outcome to lumbar epidural steroid injections

Pornpan Chalermkitpanit et al. PLoS One. .

Abstract

Introduction: This study evaluated serum inflammatory cytokine levels before and after transforaminal epidural steroid injections (TFESI) to assess their potential as biomarkers for predicting favorable outcomes in patients with lumbosacral radiculopathy.

Methods: All 120 eligible patients diagnosed with lumbosacral radiculopathy underwent blood collection 1) before TFESI and 2) two weeks after the procedure. A 5.0 mg dexamethasone mixture with local anesthetics was injected at each epidural level. This study defined a favorable response as a pain reduction of more than 50% at the 2-week follow-up. Serum inflammatory cytokines between good and poor responders were analyzed. Data collection included pain characteristics, clinical presentations, and radiographic findings.

Results: Positive responses were observed in 73 out of 120 patients (60.8%). Patients with favorable responses demonstrated a significant reduction in serum IFN-γ, IL-1β, IL-6, and GM-CSF concentration at 2 weeks after TFESI compared to their baseline levels. However, mean differences in serum inflammatory cytokines post-TFESI showed no significant variation between two groups. The duration of pain symptoms was associated with increased levels of IFN-γ and decreased levels of MMP7. The increased serum IL-6, GDF-15, and GM-CSF exhibited a significant correlation with clinical presentations. The higher level of serum IFN-γ significantly correlated with the severity of HNP (r = 0.436, P = 0.039) while the elevated serum concentration of MMP7 exhibited a significant correlation with the presence of foraminal stenosis (r = 0.436, P = 0.045).

Conclusion: The decrease in serum IFN-γ, IL-1β, IL-6, and GM-CSF levels post-TFESI was a promising biomarker for a favorable response in patients with lumbosacral radiculopathy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The correlation between the duration of pain symptoms and baseline serum inflammatory cytokine levels before TFESI.
(A) IFN- γ, and (B) MMP-7. The lines of best fit are indicated on the graphs.
Fig 2
Fig 2. The correlation between clinical presentations and baseline serum inflammatory cytokines before TFESI.
(A, B) GDF-15, (C) GM-CSF, and (D) IL-6.
See this image and copyright information in PMC

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