Aims: To investigate if the plasma N-glycome would provide a biomarker of acute-to-chronic low back pain (LBP) transition. Patients & Methods: A prospective longitudinal sample of n = 1,114 individuals enrolled at the first ever episode of LBP and followed-up for three months. Total plasma N-glycome was measured and compared at the baseline and follow-up. Results: Initial pro-inflammatory patterns of plasma N-glycome change to normal levels between baseline and follow-up in those who resolved from LBP, but not in those who remained at pain after three months. Baseline levels of N-glycans were not predictive of the risk of chronic LBP at follow-up. Conclusion: Total plasma N-glycan levels may reflect ongoing inflammation that is aberrant and promotes ongoing pain and chronicity of symptoms.

YSA and LCK are the founders and owners of PolyOmica and PolyKnomics, private organizations providing services, research, and development in the field of computational and statistical genomics. GL is the founder and owner of Genos Ltd., a private research organization that specializes in high-throughput glycomic analysis and has several patents in this field. IU, ITA, MV, AS, and TP are employees of Genos Ltd. Other authors declare no competing interests.

This research was supported by the European Commission FP7 PainOmics project (contract No. 602736). YAT and EEE were supported by the Russian Science Foundation grant # 22-15-20037 and the Government of the Novosibirsk region. YSA was partially supported by the budget project of the Institute of Cytology and Genetics # FWNR-2022-0020.

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Ethical approval has been obtained at each respective institution who carried out recruitment and sample collection: National Research Ethics Service Committee London - Westminster (London, UK); Comite Medische Ethiek van Ziekenhuis Oost-Limburg (Genk, Belgium); Comitato Etico per Parma (Parma, Italy); IRCCS Fondazione Policlinico San Matteo (Pavia, Italy); Eticki odbor Specijalna bolnica Sv. Katarina (Zagreb, Croatia). Copies of approvals were provided to the European Commission before starting the study. All participants gave informed consent to take part in the study.

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