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Pathogen-specific exposure is associated with multisite chronic pain: A prospective cohort study.

Jialiu Fang1, Zemene Demelash Kifle2, Jing Tian2

  • 1Department of Orthopedics, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.

Brain, Behavior, and Immunity
|June 5, 2025
PubMed
Summary

Infections like Epstein-Barr Virus (EBV) and Chlamydia Trachomatis are linked to widespread chronic musculoskeletal pain. This study suggests infectious agents may contribute to the development of chronic pain conditions.

Keywords:
Chronic painInfectionMultisite painPathogen

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Area of Science:

  • Immunology
  • Epidemiology
  • Pain Research

Background:

  • Pathogens are increasingly recognized for their potential to influence pain perception and regulation.
  • However, the specific link between serological evidence of infection and multisite chronic musculoskeletal pain remains unexplored.

Purpose of the Study:

  • To investigate the association between serological evidence of infection and multisite chronic musculoskeletal pain.
  • To explore the role of specific infectious agents in the pathogenesis of widespread chronic pain.

Main Methods:

  • Utilized UK Biobank data from 6,814 participants, assessing chronic pain across multiple sites (knee, neck/shoulder, hip, back, 'all over').
  • Employed a multiplex serology panel to detect immunoglobulin G antibodies against 20 infectious agents.
  • Applied multinomial logistic regression and mixed-effect models for cross-sectional and longitudinal analyses.

Main Results:

  • Serological evidence of Epstein-Barr Virus (EBV), Human T-Cell Lymphotropic Virus Type-1 (HTLV-1), and Chlamydia Trachomatis showed cross-sectional association with pain in ≥3 sites.
  • Longitudinal analyses confirmed associations for EBV and Chlamydia Trachomatis with multisite chronic pain.
  • Both single and multiple infections were associated with pain in ≥3 sites, but not in 1-2 sites.

Conclusions:

  • Serological evidence of infection, particularly with EBV and Chlamydia Trachomatis, is associated with multisite chronic musculoskeletal pain.
  • These findings highlight a potential role for infectious agents in the development of widespread chronic pain.
  • Suggests a need for further research into the mechanisms linking infection and chronic pain.