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Plasma endothelin‐1 levels in patients with complex regional pain syndrome
Author(s) -
Eisenberg Elon,
Erlich Tomer,
Zinder Oren,
Lichinsky Sophie,
Diamond Eric,
Pud Dorit,
Davar Gudarz
Publication year - 2004
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1016/j.ejpain.2003.12.003
Subject(s) - complex regional pain syndrome , medicine , allodynia , pathogenesis , fibromyalgia , pathophysiology , weakness , hyperalgesia , endothelin receptor , neuropathic pain , nociception , edema , anesthesia , receptor , surgery
The clinical characteristics of complex regional pain syndrome (CRPS) – spontaneous and stimulus‐evoked pain, autonomic abnormalities, motor dysfunction, and trophic changes in the affected limb—are well known. However, its pathogenesis is unclear, and the diagnosis is often delayed, in part due to lack of objective laboratory tests. Endothelin‐1 (ET‐1) is a potent vasoconstrictor that has recently been shown to produce pain, allodynia, edema, and muscle weakness, as well as to exert a direct excitatory effect on nociceptive afferents. Furthermore, new evidence indicates that ET‐1 is involved in various cancer‐ and non‐cancer‐related painful conditions. The aim of the present explorative study was to determine the ET‐1 plasma levels in patients with CRPS in an attempt to identify a ‘laboratory marker’ for CRPS and to search for evidence suggesting that ET‐1 may be involved in the pathogenesis of CRPS. ET‐1 plasma levels were determined in 20 severely affected CRPS patients, in eight patients with non‐CRPS chronic painful conditions, and in 10 healthy volunteers. The results showed that there were no significant differences in ET‐1 plasma levels between the three groups. We conclude that the plasma level of ET‐1 cannot be regarded as a ‘marker’ for CRPS. Yet, the possibility that ET‐1 is involved in the pathophysiology of CRPS has not been excluded and deserves further investigation.