OBJECTIVES: We conducted a systematic review of the literature with meta-analysis to determine whether complex regional pain syndrome (CRPS) is associated with a specific inflammatory profile and whether this is dependent on the duration of the condition. METHODS: Comprehensive searches of the literature using MEDLINE, Embase, Scopus, Web of Science, and reference lists from published reviews identified articles that measured inflammatory factors in CRPS. Two independent investigators screened titles and abstracts, and performed data extraction and risk of bias assessments. Studies were subgrouped by medium (blood, blister fluid, and CSF) and duration (acute and chronic CRPS). Where possible, meta-analyses of inflammatory factor concentrations were performed and pooled effect sizes were calculated using random-effects models. RESULTS: Twenty-two studies were included in the systematic review and 15 in the meta-analysis. In acute CRPS, the concentrations of interleukin (IL)-8 and soluble tumor necrosis factor receptors I (sTNF-RI) and II (sTNF-RII) were significantly increased in blood. In chronic CRPS, significant increases were found in 1) TNFα, bradykinin, sIL-1RI, IL-1Ra, IL-2, sIL-2Ra, IL-4, IL-7, interferon-γ, monocyte chemoattractant protein-1 (MCP-1), and sRAGE (soluble receptor for advanced glycation end products) in blood; 2) IL-1Ra, MCP-1, MIP-1β, and IL-6 in blister fluid; and 3) IL-1β and IL-6 in CSF. Chronic CRPS was also associated with significantly decreased 1) substance P, sE-selectin, sL-selectin, sP-selectin, and sGP130 in blood; and 2) soluble intercellular adhesion molecule-1 (sICAM-1) in CSF. Most studies failed to meet 3 or more of our quality criteria. CONCLUSION: CRPS is associated with the presence of a proinflammatory state in the blood, blister fluid, and CSF. Different inflammatory profiles were found for acute and chronic cases.
OBJECTIVES: We conducted a systematic review of the literature with meta-analysis to determine whether complex regional pain syndrome (CRPS) is associated with a specific inflammatory profile and whether this is dependent on the duration of the condition. METHODS: Comprehensive searches of the literature using MEDLINE, Embase, Scopus, Web of Science, and reference lists from published reviews identified articles that measured inflammatory factors in CRPS. Two independent investigators screened titles and abstracts, and performed data extraction and risk of bias assessments. Studies were subgrouped by medium (blood, blister fluid, and CSF) and duration (acute and chronic CRPS). Where possible, meta-analyses of inflammatory factor concentrations were performed and pooled effect sizes were calculated using random-effects models. RESULTS: Twenty-two studies were included in the systematic review and 15 in the meta-analysis. In acute CRPS, the concentrations of interleukin (IL)-8 and soluble tumor necrosis factor receptors I (sTNF-RI) and II (sTNF-RII) were significantly increased in blood. In chronic CRPS, significant increases were found in 1) TNFα, bradykinin, sIL-1RI, IL-1Ra, IL-2, sIL-2Ra, IL-4, IL-7, interferon-γ, monocyte chemoattractant protein-1 (MCP-1), and sRAGE (soluble receptor for advanced glycation end products) in blood; 2) IL-1Ra, MCP-1, MIP-1β, and IL-6 in blister fluid; and 3) IL-1β and IL-6 in CSF. Chronic CRPS was also associated with significantly decreased 1) substance P, sE-selectin, sL-selectin, sP-selectin, and sGP130 in blood; and 2) soluble intercellular adhesion molecule-1 (sICAM-1) in CSF. Most studies failed to meet 3 or more of our quality criteria. CONCLUSION: CRPS is associated with the presence of a proinflammatory state in the blood, blister fluid, and CSF. Different inflammatory profiles were found for acute and chronic cases.
Authors: Stephen Bruehl; R Norman Harden; Bradley S Galer; Samuel Saltz; Miroslav Backonja; Michael Stanton-Hicks Journal: Pain Date: 2002-01 Impact factor: 6.961
Authors: Guillermo M Alexander; B Lee Peterlin; Marielle J Perreault; John R Grothusen; Robert J Schwartzman Journal: J Pain Date: 2011-12-14 Impact factor: 5.820
Authors: Frank J P M Huygen; Navin Ramdhani; Albert van Toorenenbergen; Jan Klein; Freek J Zijlstra Journal: Immunol Lett Date: 2004-02-15 Impact factor: 3.685
Authors: Frank J P M Huygen; Anke G J De Bruijn; Martha T De Bruin; J George Groeneweg; Jan Klein; Freek J Zijlstra Journal: Mediators Inflamm Date: 2002-02 Impact factor: 4.711
Authors: Shan Yu; Constance Chen; Yue Pan; Michael C Kurz; Elizabeth Datner; Phyllis L Hendry; Marc-Anthony Velilla; Christopher Lewandowski; Claire Pearson; Robert Domeier; Samuel A McLean; Sarah D Linnstaedt Journal: Am J Med Genet B Neuropsychiatr Genet Date: 2018-12-11 Impact factor: 3.568
Authors: Benjamin Luchting; Ludwig Christian Giuseppe Hinske; Banafscheh Rachinger-Adam; Leo Anthony Celi; Simone Kreth; Shahnaz Christina Azad Journal: Biomark Med Date: 2017-02-16 Impact factor: 2.851
Authors: Frank Birklein; Seena K Ajit; Andreas Goebel; Roberto S G M Perez; Claudia Sommer Journal: Nat Rev Neurol Date: 2018-03-16 Impact factor: 42.937