Perioperatives Patientenmanagement

Gauter-Fleckenstein, Benjamin; Kaviani, Reza; Weiss, Carmen; Burges, Alexander; Korell, M.; Anthuber, C.; Hermann, H.-D.; Weninger, E.; Kreimeier, U.

doi:10.1007/s00101-007-1176-y

Cited by 6 publications

(2 citation statements)

References 36 publications

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“…The KAB was designed to repeatedly quantify the individual’s level of acute or chronic stress. It is highly sensitive to short-term or situational changes during a stressful experience [ 18 ]. The rating on a scale ranging from 1 to 6 is based on normalized adjectives.…”

Section: Methodsmentioning

confidence: 99%

Differential expression of P2X7 receptor and IL-1β in nociceptive and neuropathic pain

Luchting¹,

Heyn²,

Woehrle³

et al. 2016

J Neuroinflammation

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BackgroundDespite substantial progress, pathogenesis and therapy of chronic pain are still the focus of many investigations. The ATP-gated P2X7 receptor (P2X7R) has previously been shown to play a central role in animal models of nociceptive inflammatory and neuropathic pain. Recently, we found that the adaptive immune system is involved in the pathophysiology of chronic nociceptive and neuropathic pain in humans. So far, data regarding P2X7R expression patterns on cells of the adaptive immune system of pain patients are scarce. We therefore analyzed the P2X7R expression on peripheral blood lymphocytes and monocytes, as well as serum levels of IL-1β in patients suffering from chronic nociceptive and neuropathic pain in comparison to healthy volunteers in order to identify individuals who might benefit from a P2X7R modulating therapy.MethodsP2X7R messenger RNA (mRNA) and protein expression were determined in patients with either chronic nociceptive low back pain (CLBP) or neuropathic pain (NeP), and in healthy volunteers by quantitative real-time PCR (qPCR) and by fluorescence-assisted cell-sorting (FACS), respectively. IL-1β serum levels were measured with a multiplex cytokine assay.ResultsCompared to healthy volunteers, P2X7R mRNA (1.6-fold, p = 0.038) and protein levels were significantly increased on monocytes (NeP: 24.6 ± 6.2, healthy volunteers: 17.0 ± 5.4; p = 0.002) and lymphocytes (NeP: 21.8 ± 6.5, healthy volunteers: 15.6 ± 5.2; p = 0.009) of patients with NeP, but not in patients with CLBP. Similarly, IL-1β serum concentrations were significantly elevated only in NeP patients (1.4-fold, p = 0.04).ConclusionsA significant upregulation of P2X7R and increased IL-1β release seems to be a particular phenomenon in patients with NeP. P2X7R inhibitors may therefore represent a potential option for the treatment of this frequently intractable type of pain.German Clinical Trial Register (DRKS): Registration Trial DRKS00005954.

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Section: Methodsmentioning

confidence: 99%

Differential expression of P2X7 receptor and IL-1β in nociceptive and neuropathic pain

Luchting¹,

Heyn²,

Woehrle³

et al. 2016

J Neuroinflammation

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“…The rating is based on a six-point scale ranging from one to six based on normalized adjectives. Higher KAB values indicate increased perceived levels of stress [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

Anti-inflammatory T-cell shift in neuropathic pain

Luchting

Rachinger-Adam

Heyn

et al. 2015

J Neuroinflammation

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BackgroundThe classification of pain into nociceptive and neuropathic pain is based on characteristic symptoms and different pathophysiological mechanisms. In a recent investigation, we found a disrupted TH17/Treg balance in patients suffering from chronic unspecific low back pain (CLBP). These patients did not show any signs of neuropathy. There is evidence for a considerable impact of the immune system also in neuropathic pain. However, the role of the adaptive immune system is still unclear. In the present study, we investigated systemic T-cell subset responses and T-cell related cytokine profiles in patients with chronic neuropathic pain.MethodsWe analyzed T-cell subsets, mRNA expression and T-cell-related cytokine profiles in 26 patients suffering from neuropathic pain in comparison to 26 healthy controls. Using multicolor flow cytometry (FACS), we quantified the number of T helper cells 1 (TH1), TH2, TH17 and regulatory T-cells (Tregs). Forkhead-Box-Protein 3 (FoxP3), Transforming growth factor-β (TGF-β) and RAR-related orphan receptor-γT (ROR-γT) mRNA expression was determined by quantitative real-time PCR (qPCR) and levels of pain-related cytokines were measured by Human Cytokine Multiplex Immunoassay (Macrophage inflammatory protein-1α (MIP-1α), Tumor necrosis factor-α (TNF-α), Interferon-γ (IFN-γ), Interleukin (IL) -4, IL-6, IL-10, IL-17, and IL-23).ResultsWe found a TH17/Treg imbalance with significantly increased anti-inflammatory Tregs and decreased pro-inflammatory TH17 cells in patients with neuropathic pain as compared to healthy controls. These results were confirmed on mRNA level: Treg-related FoxP3 and TGF-β mRNA expression was elevated, whereas expression of TH17-related RORγT was reduced. Cytokine analyses revealed only marginal changes.ConclusionsOur investigation revealed a clear shift of T-cell subsets towards anti-inflammation in patients with neuropathic pain. Interestingly, this is quite similar to our previous findings in CLBP patients, but even more pronounced. Therefore, it remains to be elucidated in future investigations whether the immune changes represent an underlying pathophysiological mechanism or an epiphenomenon induced by ongoing pain and stress.German Clinical Trial Register (DRKS)Trial registration number: DRKS00005954Electronic supplementary materialThe online version of this article (doi:10.1186/s12974-014-0225-0) contains supplementary material, which is available to authorized users.

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Prämedikationsregime

Gauter-Fleckenstein¹

2007

Anaesthesist

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Perioperatives Patientenmanagement

Abstract: In future studies assessing the perioperative management of patients and quality of care, standardized testing questionnaires should be preferred, instead of vegetative parameters alone, to reliably evaluate perioperative demands and stress in surgical patients.

Cited by 6 publications

References 36 publications

Differential expression of P2X7 receptor and IL-1β in nociceptive and neuropathic pain

Differential expression of P2X7 receptor and IL-1β in nociceptive and neuropathic pain

Anti-inflammatory T-cell shift in neuropathic pain

Prämedikationsregime

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