Медицинская иммунология (Aug 2020)
Immunological indexes in evaluation of chronic pain syndrome”, Medical Immunology (Russia)
Abstract
Chronic pain in humans remains a challenge for diagnosis. It manifests itself as multicomponent symptoms and leads to dysregulation of many biochemical systems. The approaches based on measuring the neurohumoral factors regulating transmission of a pain signal, are promising for the pain evaluation. These include immunological parameters, such as natural antibodies (e-At), which can specifically interact with endogenous bioregulators of pain impulse (EB), especially, with serotonin, dopamine, and modulate the process of pain development. Antibody metabolism is characterized by longer circulation in the bloodstream as compared to EB. Therefore, the content of e-At to EB reflects long-term changes in the body upon development of chronic pain. Detection of relationships between their level and the course of treatment will allow us to establish the prognostic role of immunological parameters in objective assessment of pain status of patients.The study included 136 patients (70 women and 66 men) with chronic pain syndrome. The patients were subjected to assays of e-At to dopamine, serotonin, and a survey using a visual analogue scale, in order to assess the intensity of pain. The indexes were measured in the course of treatment (1st, 10th , and 21st days).As a result, a significant decrease in pain intensity was found in 63% of women and in 71% of males. E-At levels in patients admitted for treatment were initially mostly elevated and high. The dynamics of e-At change was multidirectional. On the day 21, an increase in the occurrence of normal levels of e-At to serotonin was detected in 52% of women and in 59% of men. The content of e-At to dopamine in this period was recorded at a normal level in 56% of women, however, being increased in men (50% of cases), with high levels in 17% of males.Thus, examination of patients with CHD showed that, against the background of ongoing therapy, pain intensity decreases, and antibodies to pain mediators may continue to circulate at elevated concentrations. It is likely that the body maintains pathologically elevated levels of e-At to EB, reflecting the content of EB itself, contributes to prolongation of CHD. Monitoring individual profile of the immunological parameters of e-Ab to EB in patients may have prognostic value for choosing an effective, personalized treatment program.
