Evidence map›Paper›PMID 42214575›Full record

ArticleThe journal of pain2026

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

Lauren A McKibben, Miranda N Layne, Liz M Albertorio-Sáez, Ying Zhao, Erica M Branham, Stacey L House, Francesca L Beaudoin, Xinming An, Jennifer S Stevens, Thomas C Neylan and 31 more

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Article in The journal of pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

41 authors.

Lauren A McKibbenInstitute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA; Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA.
Miranda N LayneInstitute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA; Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA.
Liz M Albertorio-SáezInstitute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA; Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA.
Ying ZhaoInstitute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA; Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA.
Erica M BranhamInstitute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA; Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA.
Stacey L HouseDepartment of Emergency Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA.
Francesca L BeaudoinDepartment of Epidemiology, Brown University, Providence, RI 02930, USA; Department of Emergency Medicine, Brown University, Providence, RI 02930, USA.
Xinming AnInstitute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA; Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA.
Jennifer S StevensDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA.
Thomas C NeylanDepartments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA 94143, USA.
Gari D CliffordDepartment of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA 30332, USA; Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA.
Laura T GermineInstitute for Technology in Psychiatry, McLean Hospital, Belmont, MA 02478, USA; The Many Brains Project, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
Kenneth A BollenDepartment of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA.
Scott L RauchInstitute for Technology in Psychiatry, McLean Hospital, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA.
John P HaranDepartment of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.
Alan B StorrowDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Christopher LewandowskiDepartment of Emergency Medicine, Henry Ford Health System, Detroit, MI 48202, USA.
Paul I MuseyDepartment of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Phyllis L HendryDepartment of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA.
Sophia SheikhDepartment of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA.
Christopher W JonesDepartment of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ 08103, USA.
Brittany E PunchesDepartment of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH 43210, USA; Ohio State University College of Nursing, Columbus, OH 43210, USA.
Robert A SworDepartment of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA.
Lauren A HudakDepartment of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30329, USA.
Jose L PascualDepartment of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Mark J SeamonPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA.
Elizabeth M DatnerDepartment of Emergency Medicine, Jefferson Einstein hospital, Jefferson Health, Philadelphia, PA 19141, USA; Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
David A PeakDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA; Department of Emergency Medicine, Harvard Medical School, Boston, MA 02115, USA.
Roland C MerchantDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Robert M DomeierDepartment of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, MI 48197, USA.
Niels K RathlevDepartment of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA 01107, USA.
Brian J O'NeilDepartment of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI 48202, USA.
Leon D SanchezDepartment of Emergency Medicine, Harvard Medical School, Boston, MA 02115, USA; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Steven E BruceDepartment of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO 63121, USA.
John F SheridanDivision of Biosciences, Ohio State University College of Dentistry, Columbus, OH 43210, USA; Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH 43211, USA.
Steven E HarteDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI 48109, USA.
Ronald C KesslerDepartment of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
Karestan C KoenenDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
Kerry J ResslerDepartment of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA 02478, USA.
Samuel A McLeanInstitute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA; Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA.
Sarah D LinnstaedtInstitute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA; Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27559, USA. Electronic address: sarah_linnstaedt@med.unc.edu.

Funding

Longitudinal Assessment of Post-traumatic SyndromesU01MH110925 · NIMH · UNIV OF NORTH CAROLINA CHAPEL HILL · PI KESSLER, RONALD C, KOENEN, KARESTAN C · 2016 to 2020
$25.8M
Mobile Measures of Threat Sensitivity for Cross-sectional and Longitudinal AssessmentR01MH121617 · NIMH · MCLEAN HOSPITAL · PI GERMINE, LAURA THI · 2020 to 2025
$3.9M
TRAUMA RESEARCH FELLOWSHIPT32GM008450 · NIGMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Bruce A Cairns, Anthony G Charles · 1992 to 2026
$3.8M
FKBP51 antagonism to prevent chronic pain: optimizing efficacy & evaluating safety and mechanismsR01NS118563 · NINDS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI LINNSTAEDT, SARAH, MCLEAN, SAMUEL A. · 2020 to 2024
$3.4M
Sex-dependent microRNA-mediated pathways to chronic musculoskeletal pain following traumaR01AR081454 · NIAMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI LINNSTAEDT, SARAH · 2024 to 2025
$950k
Key Molecular Mechanisms of Chronic Pain Vulnerability in Women Experiencing MVCK01AR071504 · NIAMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI LINNSTAEDT, SARAH · 2018 to 2021
$502k
NIAMS NIH HHS K01 AR071504NIAMS NIH HHS R01 AR081454NIGMS NIH HHS T32 GM008450NIMH NIH HHS R01 MH121617NIMH NIH HHS U01 MH110925NINDS NIH HHS R01 NS118563
6 · The paper itself

Abstract

Chronic pain following traumatic stress exposure (TSE) is common. Increasing evidence suggests inflammatory and immune mechanisms are activated following TSE, play a role in the transition from acute to chronic pain, and may differ by sex. In this study, we tested the hypothesis that elevated levels of the inflammatory marker C-reactive protein (CRP) would be associated with acute and chronic pain in a sex-specific manner. We utilized blood-plasma samples and pain questionnaire data from men (n=116) and women (n=269) enrolled in AURORA, a multi-site emergency department (ED)-based longitudinal study of TSE survivors. CRP levels were measured by ELISA using plasma samples collected in the ED ('peritraumatic CRP') and six-months following TSE. Multivariate models were used to assess the relationship between CRP and pain. Men and women reported similar acute pain levels in the ED; however, pain resolved more rapidly in men over time. Peritraumatic CRP was not associated with acute pain severity in either men or women. However, six-month CRP levels were positively associated with six-month pain severity in both men (r=0.19, p=0.089, non-significant) and women (r=0.21, p=0.0015). In men only, higher peritraumatic CRP predicted lower chronic pain severity (β=-0.36, p=0.024) whereas no association was observed in women (β=0.04, p=0.628). Among men with elevated peritraumatic CRP, decreases in CRP over time were associated with decreases in pain over time (r=-0.38, p=0.0197). These findings suggest sex-specific relationships between CRP and chronic pain following TSE and highlight inflammation as a potential mechanism contributing to differential pain recovery trajectories in men and women. PERSPECTIVE: Longitudinal CRP levels following traumatic stress exposure showed sex-dependent associations with chronic pain outcomes. Unexpectedly, higher early CRP predicted lower chronic pain severity in men, suggesting inflammatory responses may differentially influence pain recovery trajectories in men and women.

Indexed as

Acute PainChronic PainC-Reactive ProteinSex CharacteristicsAdultBiomarkersFemaleHumansLongitudinal StudiesMaleMiddle AgedPain MeasurementBiomarkersC-Reactive ProteinChronic musculoskeletal painC-reactive protein (CRP)ImmuneSex differencesTraumatic stress

Identifiers

PMID42214575
PMCPMC13318087

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.