title: Enhanced anandamide plasma levels in patients with complex regional pain syndrome following traumatic injury: a preliminary report.
abstract: The complex regional pain syndrome (CRPS) is a disabling neuropathic pain condition that may develop following injuries of the extremities. The pathogenesis of this syndrome is not clear; however, it includes complex interactions between the nervous and the immune system resulting in chronic inflammation, pain and trophic changes. This interaction may be mediated by chronic stress which is thought to activate the endogenous cannabinoid (endocannabinoid) system (ECS). We conducted an open, prospective, comparative clinical study to determine plasma level of the endocannabinoid anandamide by high-performance liquid chromatography and a tandem mass spectrometry system in 10 patients with CRPS type I versus 10 age- and sex-matched healthy controls. As compared to healthy controls, CRPS patients showed significantly higher plasma concentrations of anandamide. These results indicate that the peripheral ECS is activated in CRPS. Further studies are warranted to evaluate the role of the ECS in the limitation of inflammation and pain.
authors.affiliation: Department of Anesthesiology, Ludwig Maximilians University, Munich, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Kaufmann
authors.forename: D
authors.initials: D
authors.lastname: Hauer
authors.forename: V
authors.initials: V
authors.lastname: Huge
authors.forename: M
authors.initials: M
authors.lastname: Vogeser
authors.forename: P
authors.initials: P
authors.lastname: Campolongo
authors.forename: A
authors.initials: A
authors.lastname: Chouker
authors.forename: M
authors.initials: M
authors.lastname: Thiel
authors.forename: G
authors.initials: G
authors.lastname: Schelling
mesh_terms: D000328:Adult; D001095:Arachidonic Acids / Q000097:blood*; D001774:Blood Chemical Analysis; D063385:Cannabinoid Receptor Modulators / Q000097:blood*; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid; D063388:Endocannabinoids; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053284:Polyunsaturated Alkamides / Q000097:blood*; D011446:Prospective Studies; D012019:Reflex Sympathetic Dystrophy / Q000097:blood* / Q000209:etiology; D053719:Tandem Mass Spectrometry; D014947:Wounds and Injuries / Q000150:complications; D055815:Young Adult
chemical_list: D001095:Arachidonic Acids; D063385:Cannabinoid Receptor Modulators; D063388:Endocannabinoids; D053284:Polyunsaturated Alkamides; C078814:anandamide