The serum protease network—one key to understand complex regional pain syndrome pathophysiology

6533b7d3fe1ef96bd1261577

RESEARCH PRODUCT

The serum protease network—one key to understand complex regional pain syndrome pathophysiology

Frank Birklein Josef Bednarik Violeta Dimova Myriam Herrnberger Malte Bayer Heike L. Rittner Fabiola Escolano-lozano Eva Vlčková Tanja Schlereth Simone König

subject

Adult Male medicine.medical_treatment Pain Inflammation Peptidyl-Dipeptidase A Bradykinin Proinflammatory cytokine 03 medical and health sciences 0302 clinical medicine Diabetic Neuropathies 030202 anesthesiology Healthy control Humans Medicine Pain Measurement Inflammation Protease business.industry Middle Aged medicine.disease Pathophysiology 3. Good health Reflex Sympathetic Dystrophy Anesthesiology and Pain Medicine Complex regional pain syndrome Neurology Painful diabetic neuropathy Immunology Cytokines Female Neurology (clinical)medicine.symptom Epidemiologic data business Complex Regional Pain Syndromes 030217 neurology & neurosurgery Peptide Hydrolases

description

Complex regional pain syndrome (CRPS) develops after fracture. The acute CRPS phenotype resembles exaggerated inflammation, which is explained by local and systemic activation of a proinflammatory network including peptides and cytokines. Epidemiologic data suggest that inactivation of the peptidase angiotensin-converting enzyme in patients treated for hypertension increases the odds to develop CRPS. This hint leads us to investigate the serum protease network activity in patients with CRPS vs respective controls. For this purpose, we developed a dabsyl-bradykinin (DBK)-based assay and used it to investigate patients with CRPS, as well as healthy and pain (painful diabetic neuropathy [dPNP]) controls. The major result is that the degradation of DBK to fragments 1-8 and 1-5 in healthy control and dPNP is shifted to higher values for DBK1-8 and lower values for DBK1-5 at 1 hour of incubation in patients with CRPS. Using this novel reporter peptide assay, we have been able to show that the resolving protease network for mediators such as BK might be different in patients with CRPS; having a look at the clinical signs, which resemble inflammation, this resolving protease network is probably less effective in CRPS.

year	journal	country	edition	language
2019-01-28	Pain

https://doi.org/10.1097/j.pain.0000000000001503