Immunological Alterations in Cluster Headache During Remission and Cluster Period. Comparison with Low Back Pain Patients

Bussone, Gennaro; Salmaggi, Andrea; Leone, Massimo; Valentini, Sergio; Dufour, A.; Nespolo, A.

doi:10.1046/j.1468-2982.1992.1204250.x

Cited by 16 publications

(24 citation statements)

References 17 publications

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“…We noticed significantly decreased numbers of cytotoxic CD8+ lymphocytes in both chronic pain patient groups as it has been described for chronic tension-type headache [31] and migraine sufferers [26,31] . However, our study did not confirm either changes in lymphocyte counts or percentages of CD3+ and CD4+ cells [23,25] in stressed pain patients.…”

Section: Decrease In the Cd8+ Lymphocyte Subpopulation In Chronic Paincontrasting

confidence: 96%

“…In contrast, in prolonged human stress responses such as posttraumatic stress disorder, lymphocyte subsets are not deranged [24] . With respect to chronic pain, information on alterations of lymphocyte subsets is inconsistent; cluster headache and low back pain lower the CD4+ subpopulation [25] , while migraine is characterized by decreased levels of CD8+ T lymphocytes [26] .…”

Section: Introductionmentioning

confidence: 99%

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Lymphocyte Subsets and the Role of Th1/Th2 Balance in Stressed Chronic Pain Patients

Kaufmann

Eisner

Richter

et al. 2007

Neuroimmunomodulation

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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.

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Section: Decrease In the Cd8+ Lymphocyte Subpopulation In Chronic Paincontrasting

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Lymphocyte Subsets and the Role of Th1/Th2 Balance in Stressed Chronic Pain Patients

Kaufmann

Eisner

Richter

et al. 2007

Neuroimmunomodulation

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“…Hingegen war die Mitogen-induzierte Immunglobulin-M-Produktion in mononukleären Zellen von Schmerzpatienten bereits vor Therapiebeginn deutlich geringer als im Kontrollkollektiv und sank unter Morphintherapie weiter ab. Die klinische Bedeutung dieses Morphineffektes bleibt jedoch unklar, nicht zuletzt weil durch Schmerz allein komplexe Immunantworten induziert werden können [14].…”

Section: Schmerztherapieunclassified

Opioide und Immunsuppression

Welters¹

2003

Der Anaesthesist

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First observations that opioids may have disadvantageous effects on the immune response have been made more than 100 years ago. Today the immunosuppressive effect of morphine is well established.Drug-induced immunomodulation is of growing importance in modern anesthetic concepts. The reduced stress response observed after morphine application contributes to this effect as well as direct impairment of immune effector cells such as bactericidal activity, intracellular killing,proliferative response or cytokine synthesis. Opioid-induced immunomodulation is mediated by opioid receptors found on immunocytes and in the central nervous system.A negative feedback mechanism via the hypothalamo-pituitary-adrenal axis may potentiate the direct inhibitory effect of morphine on the immune response.A final statement regarding the clinical relevance of opioid-induced immunosuppression cannot be made at this point, since the existing clinical data are preliminary and inconclusive.Therefore, further clinical studies are mandatory to elucidate the influence of opioid treatment on immune regulation in different clinical settings in anesthesia, critical care, pain therapy and emergency medicine. Further investigations may help to not only provide sufficient analgesia by application of opioids, but also to assess advantages and disadvantages on immune function.

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“…Im Gegensatz dazu beobachteten Giacovazzo et al [27] bei 21 Clusterpatienten häufiger zirkulierende Immunkomplexe und eine Erhöhung von NK-Zellen und Monozyten in der Episode, während T-Zellen, T-Helfer und T-Suppressorzellen nicht verändert waren. Bussone et al [7] stellten an 10 Patienten und 10 Kontrollen ebenfalls eine Erhöhung der Monozyten in der Episode und eine Erniedrigung in der Remissionsphase fest, während der Abfall in der Zahl der T-und T-Helferzellen als unspezifisch gewertet wurde, da diese auch in Patienten mit Lumbago nachweisbar waren. Weitere Erhebungen zur zellulären Immunität zeigten, dass Killerzellen von 20 Clusterpatienten stärker auf eine Stimulation mit Interleukin-2 reagierten als die von 10 Kontrollen [28].…”

Section: Immunologische Untersuchungen Bei Clusterkopfschmerzenunclassified

Immunsystem und primäre Kopfschmerzsyndrome

Empl

Straube²

2001

Der Anaesthesist

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The association between pain and inflammation and certain clinical signs led physicians to suspect a connection between immunological mechanisms and headache syndromes even years ago.This review intends to give an overview of the literature which deals with immunological mechanisms in headache syndromes -with divergent results.Thus, a food allergy as a cause of migraine only seems to be relevant in a few isolated cases.Immunoglobulins or infections do not seem to play a role.Whether the complement system, auto-antibodies, immune cells or cytokines are involved in migraine pathophysiology, still remains to be determined.With regards to cluster headache, a participation of the immune system seems more probable.Although a systemic vasculitis or auto-antibodies probably do not contribute to cluster headache pathophysiology, reports of an immune activation, especially of T-cells, predominate the literature. Nevertheless, the evidence for an immunogenically triggered cluster attack is still lacking.In summary, only a mutual modulation of the immune and the pain system can be assumed with certainty.

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Immunological Alterations in Cluster Headache During Remission and Cluster Period. Comparison with Low Back Pain Patients

Cited by 16 publications

References 17 publications

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

Opioide und Immunsuppression

Immunsystem und primäre Kopfschmerzsyndrome

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