6533b871fe1ef96bd12d2545
RESEARCH PRODUCT
TNF-α in CRPS and 'normal' trauma--significant differences between tissue and serum.
Nurcan ÜçEylerT. EberleHeidrun H. KrämerFrank BirkleinThomas KlonschinskyIna WagnerLars Peter MüllerClaudia Sommersubject
AdultMaleBone pathologyEnzyme-Linked Immunosorbent AssayPilot ProjectsOsteoarthritisFractures BoneOsteoarthritismedicineHumansAgedSkinAged 80 and overmedicine.diagnostic_testbusiness.industryTumor Necrosis Factor-alphaBone fractureMiddle Agedmedicine.diseaseUp-RegulationAnesthesiology and Pain Medicinemedicine.anatomical_structureComplex regional pain syndromeNeurologyAnesthesiaSkin biopsyHyperalgesiaAcute DiseaseUpper limbWounds and InjuriesTumor necrosis factor alphaFemaleNeurology (clinical)medicine.symptombusinessComplex Regional Pain Syndromesdescription
Posttraumatic TNF-alpha signaling may be one of the factors responsible for pain and hyperalgesia in complex regional pain syndromes (CRPS). In order to further specify the role of TNF-alpha we investigated tissue (skin) and serum concentrations in three different patient groups: patients with osteoarthritis and planned surgery, with acute traumatic upper limb bone fracture waiting for surgery, and with CRPS I. Thirty patients (10 in each group) were recruited. Mean CRPS duration was 36.1 ± 8.1 weeks (range 8- 90 weeks). Skin punch biopsies were taken at the beginning of the surgery in osteoarthritis and fracture patients and from the affected side in CRPS patients. Blood samples were taken before the respective procedures. Skin and serum TNF-alpha levels were quantified by ELISA. Compared to patients with osteoarthritis, skin TNF-alpha was significantly elevated in CRPS (p<0.001) and fracture patients (p<0.04). Skin TNF-alpha in CRPS patients was higher than in patients with acute bone fracture (p<0.02). In contrast, serum TNF-alpha values were the same in osteoarthritis and CRPS, and lower in fracture patients (p<0.03). Our results indicate a local but not systemic increase of TNF-alpha in CRPS patients. This increase persists for months after limb trauma and may offer the opportunity for targeted treatment.
year | journal | country | edition | language |
---|---|---|---|---|
2011-02-01 | PainReferences |