Evidence for local inflammation in complex regional pain syndrome type 1
Evidence for local inflammation in complex regional pain syndrome type 1
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DOI：
10.1080/09629350210307
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发表时间：
2002-02-01
影响因子：
4.6
通讯作者：
Zijlstra, FJ
中科院分区：
文献类型：
--
作者：
Huygen, FJPM;de Bruijn, AGJ;Zijlstra, FJ
背景：复杂性局部疼痛综合征1型（CRPS 1）的病理生理学仍然是一个有争议的问题.外周传入，传出和中枢机制。根据临床体征和症状（如水肿，局部温度变化和慢性疼痛）局部炎症suspended.Aim：To determine the involvement of neuropeptides，cytokines and eicosanoids as local formed mediators of inflammation.Methods：在这项研究中，9例患者证实CRPS 1被列入。疾病活动和损害通过视觉疼痛量表、麦吉尔疼痛问卷、受累和未受累肢体之间的体积和温度差异以及受累肢体活动范围的减少来确定。分别于患肢和健肢取静脉血，制成水泡，测定细胞因子白细胞介素（IL）-6、IL-1 β和肿瘤坏死因子-α（TNF-α）、神经肽Y和CRGP以及前列腺素E-2。在血浆中，未观察到炎症介质的变化。然而，在水泡液中，IL-6和TNF-α的水平显着较高的参与四肢中观察到的比较与uninvolved limited.Conclusions：这是第一次参与CRPS 1的炎症介质已被如此清楚和直接证明。这一观察结果为CRPS 1中免疫抑制剂的成功使用和开发开辟了新途径。
BACKGROUND: The pathophysiology of complex regional pain syndrome type 1 (CRPS 1) is still a matter of debate. Peripheral afferent, efferent and central mechanisms are supposed. Based on clinical signs and symptoms (e.g. oedema, local temperature changes and chronic pain) local inflammation is suspected.Aim: To determine the involvement of neuropetides, cytokines and eicosanoids as locally formed mediators of inflammation.Methods: In this study, nine patients with proven CRPS 1 were included. Disease activity and impairment was determined by means of a Visual Analogue Scale, the McGill Pain Questionnaire, the difference in volume and temperature between involved and uninvolved extremities, and the reduction in active range of motion of the involved extremity. Venous blood was sampled from and suction blisters made on the involved and uninvolved extremities for measurement of cytokines interleukin (IL)-6, IL-1beta and tumour necrosis factor-alpha (TNF-alpha), the neuropetides NPY and CRGP, and prostaglandin E-2.Results: The patients included in this study did have a moderate to serious disease activity and impairment. In plasma, no changes of mediators of inflammation were observed. In blister fluid, however, significantly higher levels of IL-6 and TNF-alpha in the involved extremity were observed in comparison with the uninvolved extremity.Conclusions: This is the first time that involvement of mediators of inflammation in CRPS 1 has been so clearly and directly demonstrated. This observation opens new approaches for the succesful use and development of immunosuppressives in CRPS 1.