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A study, published today in PNAS, found a potential treatment for patients with complex regional pain syndrome (CRPS).
CRPS is a severe post-traumatic pain affecting one or more limbs and is badociated with regional pain and sensory, bone and skin changes. The causes of CRPS, however, still need to be fully understood.
About 15% of patients with CRPS still have symptoms, one year after onset, that severely affect their quality of life. The prognosis is often poor for these patients and the drug treatment for pain is rarely effective.
A team of international researchers, led by Dr. Andreas Goebel of the University of Liverpool's Institute for Pain Research, conducted a study to better understand the immunological causes of CRPS.
The researchers examined the antibodies present in the serum of these patients to determine the potential role of these proteins in the disease state; they were particularly interested in evaluating "neuroinflammation" – increasing levels of inflammatory mediators such as interleukin-1 (IL-1) -induced antibodies in peripheral tissues or the brain.
IL-1 is known to normally induce local and systemic body responses aimed at eliminating microorganisms and repairing tissue damage. However, an increasing number of clinical conditions have been identified in which the production of IL-1 is deemed inappropriate and IL-1 is part of the cause of the disease.
The researchers transferred the antibodies from the mice of patients with long-standing CRPS and found that these antibodies were consistently causing a condition similar to that of the CRPS. The activation of glial cells, a type of "neuroinflammation" in parts of the mouse brain related to pain, is an important part of the "transferred CRPS". The team then discovered that "blocking" IL-1 with a clinically available drug, anakinra, helped prevent and reverse all these changes in animals.
Researchers from the University of Pécs (Hungary), the University of Budapest (Hungary), the University of Manchester, the University of Sheffield and the Walton Trust Trust Foundation Fund in Liverpool also participated in the 'study.
Dr. Andreas Goebel said: "Our results support previous clinical observations that patients with persistent CRPS should respond to immune treatments by reducing at least some of the characteristics of their disease.
"This approach has an attractive therapeutic potential and could also have a real impact on the treatment of other unexplained chronic pain conditions.We will now request funds to test the effect of this drug and similar drugs on patients with CRPS. "
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The comprehensive study, entitled "The transfer of complex regional pain syndrome in mice via human autoantibodies is mediated by interleukin-1-mediated mechanisms," can be found here https: /
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