Lymphocyte subsets and the role of Th1/Th2 balance in stressed chronic pain patients
Lymphocyte subsets and the role of Th1/Th2 balance in stressed chronic pain patients
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DOI：
10.1159/000115041
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发表时间：
2007-01-01
影响因子：
2.4
通讯作者：
Thiel, Manfred
中科院分区：
文献类型：
--
作者：
Kaufmann, Ines;Eisner, Christoph;Thiel, Manfred
背景：复杂区域疼痛综合征（CRPS）和纤维肌痛（FM）是发生于高度应激个体的慢性疼痛综合征。尽管已知神经系统和免疫细胞之间的联系，在压力和疼痛条件下的淋巴细胞亚群的分布信息是有限的。研究方法：我们在15例CRPS I型患者、22例FM患者和37例年龄和性别匹配的健康对照者中进行了比较研究，并研究了疼痛和应激对T淋巴细胞中淋巴细胞数量、亚群和Th 1/Th 2细胞因子比例的影响。结果：两组间淋巴细胞数量无差异。淋巴细胞亚群的定量分析显示，与健康对照组相比，CRPS（p < 0.01）和FM（p < 0.05）患者的细胞毒性CD 8+淋巴细胞显著减少。此外，CRPS患者的特征是产生IL-2的T细胞亚群的百分比较低，反映了Th 1应答的减少，而Th 2细胞因子谱没有变化。结论：未来的研究有必要回答这种免疫学变化是否在CRPS和FM中发挥致病作用，或者仅仅反映疼痛诱导的神经体液应激反应的后果，以及它们是否有助于应激慢性疼痛患者的免疫抑制。版权所有（c）2008 S. Karger AG，巴塞尔。
Background: The complex regional pain syndrome (CRPS) and fibromyalgia (FM) are chronic pain syndromes occurring in highly stressed individuals. Despite the known connection between the nervous system and immune cells, information on distribution of lymphocyte subsets under stress and pain conditions is limited. Methods: We performed a comparative study in 15 patients with CRPS type I, 22 patients with FM and 37 age- and sex-matched healthy controls and investigated the influence of pain and stress on lymphocyte number, subpopulations and the Th1/Th2 cytokine ratio in T lymphocytes. Results: Lymphocyte numbers did not differ between groups. Quantitative analyses of lymphocyte subpopulations showed a significant reduction of cytotoxic CD8+ lymphocytes in both CRPS (p < 0.01) and FM (p < 0.05) patients as compared with healthy controls. Additionally, CRPS patients were characterized by a lower percentage of IL-2-producing T cell subpopulations reflecting a diminished Th1 response in contrast to no changes in the Th2 cytokine profile. Conclusions: Future studies are warranted to answer whether such immunological changes play a pathogenetic role in CRPS and FM or merely reflect the consequences of a pain-induced neurohumoral stress response, and whether they contribute to immunosuppression in stressed chronic pain patients. Copyright (c) 2008 S. Karger AG, Basel.