1. Changes in immune and glial markers in the CSF of patients with Complex Regional Pain Syndrome.
- Author
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Alexander GM, Perreault MJ, Reichenberger ER, and Schwartzman RJ
- Subjects
- Aged, Amyotrophic Lateral Sclerosis cerebrospinal fluid, Amyotrophic Lateral Sclerosis immunology, Amyotrophic Lateral Sclerosis metabolism, Biomarkers cerebrospinal fluid, Chemokines cerebrospinal fluid, Chemokines immunology, Complex Regional Pain Syndromes immunology, Complex Regional Pain Syndromes metabolism, Cytokines immunology, Female, Glucose cerebrospinal fluid, Humans, Hydrocephalus cerebrospinal fluid, Hydrocephalus immunology, Hydrocephalus metabolism, Male, Middle Aged, Neuroglia metabolism, Nitrates cerebrospinal fluid, Nitric Oxide metabolism, Nitrites cerebrospinal fluid, Peripheral Nervous System Diseases cerebrospinal fluid, Peripheral Nervous System Diseases immunology, Peripheral Nervous System Diseases metabolism, Radiculopathy immunology, Radiculopathy metabolism, Spondylolisthesis cerebrospinal fluid, Spondylolisthesis immunology, Spondylolisthesis metabolism, Calcium cerebrospinal fluid, Complex Regional Pain Syndromes cerebrospinal fluid, Cytokines cerebrospinal fluid, Glial Fibrillary Acidic Protein cerebrospinal fluid, Glutamic Acid cerebrospinal fluid, Radiculopathy cerebrospinal fluid
- Abstract
Complex Regional Pain Syndrome is a severe chronic pain condition characterized by sensory, autonomic, motor and dystrophic signs and symptoms. The pain in CRPS is continuous, it worsens over time, and it is usually disproportionate to the severity and duration of the inciting event. This study compares cerebrospinal fluid (CSF) levels of pro- and anti-inflammatory cytokines, chemokines and several biochemical factors (glial fibrillary acidic protein (GFAP), the nitric oxide metabolites (nitrate plus nitrite), the excitatory amino acid neurotransmitter glutamate, calcium, total protein and glucose) in patients afflicted with CRPS to levels found in patients suffering with other non-painful or painful conditions. The aim of the study is to determine the degree of involvement of glial cells and immune system mediators in the pathophysiology of CRPS. There was no elevation or reduction of a CSF marker that was specific for CRPS patients. However, there were several patterns of markers that could be helpful in both elucidating the mechanisms involved in the disease process and supporting the diagnosis of CRPS. The most common pattern was found in 50% (11 out of 22) of the CRPS patients and consisted of; elevated IL-6, low levels of IL-4 or IL-10, increased GFAP or MCP1 and increases in at least two of the following markers NO metabolites, calcium or glutamate. The results from this and other similar studies may aid in elucidating the mechanisms involved in the pathophysiology of CRPS. A better understanding of these mechanisms may lead to novel treatments for this very severe, life-altering illness.
- Published
- 2007
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