{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:23:24Z","timestamp":1787732604237,"version":"build-2784847793"},"reference-count":49,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mol Pain"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>\n                    Chronic pain is accompanied by widespread physiological dysregulation, yet the mucosal immune system has received little attention. Salivary secretory-immunoglobulin-A (S-IgA) is a non-invasive biomarker of mucosal immunity modulated by sustained stress and autonomic activity. This cross-sectional secondary analysis examined whether pain intensity in chronic back pain is associated with salivary S-IgA in 57 adults enrolled in a parent interventional study (NCT05994118). Pain was assessed on a computerized visual analogue scale (CoVAS, 0\u2013100) at the laboratory visit (current pain and 24-hour average) and via a twice-daily electronic CoVAS diary (1-week, 2-week, and 14-day averages). Two saliva samples collected \u223c90 minutes apart were assayed by ELISA, and baseline heart rate variability (HRV) was recorded. Spearman correlations were computed with and without partial adjustment for age, sex, and BMI; Benjamini\u2013Hochberg correction was applied to the ten primary pain \u00d7 S-IgA tests. Average 24-hour pain was negatively correlated with both S-IgA samples (\u03c1 \u2248 \u2212.45 for both, p &lt; .001); the 1-week (\u03c1 \u2248 \u2212.34 to \u2212.35, p \u2264 .009) and 14-day averages (\u03c1 \u2248 \u2212.38 for both, p = .004) showed similar associations. All average-pain associations survived FDR correction and partial adjustment. Current pain was not significantly associated with S-IgA. Baseline high-frequency HRV power was positively associated with S-IgA\n                    <jats:sub>1<\/jats:sub>\n                    (\u03c1 = .29, p = .033) but not S-IgA\n                    <jats:sub>2<\/jats:sub>\n                    . Sustained pain experience, rather than current pain, appears to track salivary mucosal immune function in chronic back pain. However, these hypothesis-generating findings may reflect unmeasured stress- or mood-related confounding, not a pain-specific effect.\n                  <\/jats:p>","DOI":"10.1177\/17448069261483479","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:32:03Z","timestamp":1787563923000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Average pain over time, but not current pain, is associated with salivary secretory immunoglobulin a in chronic back pain: A cross-sectional study"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3524-3128","authenticated-orcid":false,"given":"Adi","family":"Shani","sequence":"first","affiliation":[{"name":"University of Haifa"},{"name":"Galilee Medical Center"},{"name":"Galilee Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Granot","sequence":"additional","affiliation":[{"name":"University of Haifa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eilam","family":"Palzur","sequence":"additional","affiliation":[{"name":"Galilee Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Agostinho","sequence":"additional","affiliation":[{"name":"University of Haifa"},{"name":"CIIS"},{"name":"Universidade Cat\u00f3lica Portuguesa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roi","family":"Treister","sequence":"additional","affiliation":[{"name":"University of Haifa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-0010","authenticated-orcid":false,"given":"Nimrod","family":"Rahamimov","sequence":"additional","affiliation":[{"name":"Galilee Medical Center"},{"name":"Bar Ilan Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_3_9_2_2","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.133.4.581"},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3516"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00145-1"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.2541-04.2004"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-016-0879-8"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.1650-20.2020"},{"key":"e_1_3_9_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/nri3621"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002590"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204428"},{"issue":"392","key":"e_1_3_9_11_2","first-page":"1789","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study","volume":"2018","author":"James SL","year":"2017","unstructured":"James SL, Abate D, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study. Lancet 2017; 2018(392): 1789\u20131858. https:\/\/doi.org\/10.1016\/S0140-6736(18)32279-7","journal-title":"Lancet"},{"key":"e_1_3_9_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-018-5673-2"},{"key":"e_1_3_9_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/2470547017704763"},{"key":"e_1_3_9_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2005.06.009"},{"key":"e_1_3_9_15_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v66n0707"},{"key":"e_1_3_9_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbih.2021.100349"},{"key":"e_1_3_9_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm.2234"},{"key":"e_1_3_9_18_2","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00011.2002"},{"key":"e_1_3_9_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab146"},{"key":"e_1_3_9_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-12-245"},{"key":"e_1_3_9_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2010.08.013"},{"key":"e_1_3_9_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/PR9.0000000000000905"},{"key":"e_1_3_9_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.1877"},{"key":"e_1_3_9_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yhbeh.2018.04.011"},{"key":"e_1_3_9_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2006.10.006"},{"key":"e_1_3_9_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2015.08.017"},{"key":"e_1_3_9_27_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnint.2013.00086"},{"key":"e_1_3_9_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2005.06.006"},{"key":"e_1_3_9_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2007.11.007"},{"key":"e_1_3_9_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/2515690X18823691"},{"key":"e_1_3_9_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yfrne.2023.101083"},{"key":"e_1_3_9_32_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1366.014"},{"key":"e_1_3_9_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"e_1_3_9_34_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2013.00026"},{"key":"e_1_3_9_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60610-7"},{"key":"e_1_3_9_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30480-X"},{"key":"e_1_3_9_37_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200005010-00017"},{"key":"e_1_3_9_38_2","first-page":"324","article-title":"Epidemiology of back disorders: prevalence, risk factors, and prognosis","volume":"4","author":"Manek NJ","year":"2005","unstructured":"Manek NJ, MacGregor AJ. Epidemiology of back disorders: prevalence, risk factors, and prognosis. Curr Opin Rheumatol 2005; 4: 324\u2013330. https:\/\/doi.org\/10.1097\/01.bor.0000154215.08986.06","journal-title":"Curr Opin Rheumatol"},{"key":"e_1_3_9_39_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0296764"},{"key":"e_1_3_9_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-017-1763-z"},{"key":"e_1_3_9_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/jop.12350"},{"key":"e_1_3_9_42_2","first-page":"115","article-title":"Effects of stretch-based progressive relaxation training on the secretion of salivary immunoglobulin A in orofacial pain patients","volume":"11","author":"Sherman JJ","year":"1997","unstructured":"Sherman JJ, Carlson CR, McCubbin JA, et al. Effects of stretch-based progressive relaxation training on the secretion of salivary immunoglobulin A in orofacial pain patients. J Orofac Pain 1997; 11: 115\u2013124.","journal-title":"J Orofac Pain"},{"key":"e_1_3_9_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2024.104761"},{"key":"e_1_3_9_44_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14207348"},{"key":"e_1_3_9_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2026.112645"},{"key":"e_1_3_9_46_2","volume-title":"Practical nonparametric statistics","author":"Conover WJ","year":"1999","unstructured":"Conover WJ. Section on partial rank-order correlation. Practical nonparametric statistics. 3rd ed. John Wiley & Sons, 1999.","edition":"3"},{"key":"e_1_3_9_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8760(99)00112-9"},{"key":"e_1_3_9_48_2","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep16010003"},{"key":"e_1_3_9_49_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19106226"},{"key":"e_1_3_9_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jshs.2018.09.009"}],"container-title":["Molecular Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17448069261483479","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17448069261483479","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17448069261483479","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T08:16:36Z","timestamp":1787732196000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17448069261483479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":49,"alternative-id":["10.1177\/17448069261483479"],"URL":"https:\/\/doi.org\/10.1177\/17448069261483479","relation":{},"ISSN":["1744-8069","1744-8069"],"issn-type":[{"value":"1744-8069","type":"print"},{"value":"1744-8069","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"article-number":"17448069261483479"}}