Serum and salivary oxidative analysis in Complex Regional Pain Syndrome.
Although both inflammatory and neural mechanisms have been suggested as potential contributors to Complex Regional Pain Syndrome type I (CRPS-I), the pathogenesis of the syndrome is still unclear. Clinical trials have shown that free radical scavengers can reduce signs and symptoms of CRPS-I, indirectly suggesting that free radicals and increased oxidative stress are involved in the pathogenesis of CRPS-I. This study investigated this premise by determining the levels of antioxidants in the serum and saliva of 31 patients with CRPS-I and in a control group of 21 healthy volunteers. Serum lipid peroxidation products (MDA) and all antioxidative parameters analyzed were significantly elevated in CRPS-I patients: median salivary peroxidase and superoxide dismutase (SOD) activity values, uric acid (UA) concentration and total antioxidant status (TAS) values were higher in CRPS-I patients by 150% (p=0.01), 280% (p=0.04), 60% (p=0.0001), and 200% (p=0.0003), respectively, as compared with controls. Similar although not as extensive pattern of oxidative changes were found in the serum: mean serum UA and MDA concentrations and TAS value in the CRPS-I patients were higher by 16% (p=0.04), 25% (p=0.02), and 22% (p=0.05), respectively, than in the controls. Additionally, median salivary albumin concentration and median salivary LDH activities in the patients were 2.5 times (p=0.001) and 3.1 (p=0.004) times higher than in the controls. The accumulated data show that free radicals are involved in the pathophysiology of CRPS-I, which is reflected both in serum and salivary analyses. These data could be used for both diagnostic and therapeutic purposes in CRPS-I patients.
Pain Relief Unit, Rambam Medical Center, Haifa, Israel Department of Hand Surgery, Rambam Medical Center, Haifa, Israel Department of Anatomy and Cell Biology, Rambam Medical Center, Haifa, Israel Oral and Maxillofacial Surgery Department and Oral Biochemistry Laboratory, Rambam Medical Center, Bat Galim, 31096 Haifa, Israel Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Elon
E
Eisenberg
Shalom
S
Shtahl
Rimma
R
Geller
Abraham Z
AZ
Reznick
Ordi
O
Sharf
Meirav
M
Ravbinovich
Adam
A
Erenreich
Rafael M
RM
Nagler
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001774:Blood Chemical Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017382:Reactive Oxygen Species / Q000032:analysis*; D012019:Reflex Sympathetic Dystrophy / Q000175:diagnosis* / Q000378:metabolism*; D012463:Saliva / Q000737:chemistry*
D015415:Biomarkers; D017382:Reactive Oxygen Species