The role of autoantibodies in complex regional pain syndrome
Kofi
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Autoantibodies in complex regional pain syndrome bind to a
differentiation-dependent neuronal surface autoantigen.
Kohr D, Tschernatsch M, Schmitz K, Singh P, Kaps M, Schafer KH, Diener
M, Mathies J, Matz O, Kummer W, Maihofner C, Fritz T, Birklein F, Blaes
F.
Dept. of Neurology, Justus-Liebig-University, Am Steg 14, 35392 Giessen,
Germany.
Complex regional pain syndrome, which is characterised by pain and
trophic disturbances, develops frequently after peripheral limb trauma.
There is an increasing evidence of an involvement of the immune system
in CRPS, and recently we showed that CRPS patients have autoantibodies
against nervous system structures. Therefore we tested the sera of CRPS
patients, neuropathy patients and healthy volunteers for surface-binding
autoantibodies to primary cultures of autonomic neurons and
differentiated neuroblastoma cell lines using flow cytometry. Thirteen
of 30 CRPS patients, but none of 30 healthy controls and only one of the
20 neuropathy sera had specific surface binding to autonomic neurons
(p<0.001). The majority of the sera reacted with both sympathetic and
myenteric plexus neurons. Interestingly, 6/30 CRPS sera showed binding
to undifferentiated SH-SY5Y neuroblastoma cells. However,
differentiation of SH-SY5Y into a cholinergic phenotype induced a
surface antigen, which is recognised by 60% of CRPS sera (18/30), but
not by controls (p<0.001). Our data show that about 30-40% of CRPS
patients have surface-binding autoantibodies against an inducible
autonomic nervous system autoantigen. These data support an autoimmune
hypothesis in CRPS patients. Further studies must elucidate origin and
function of these autoantibodies in CRPS.
Publication Types:
* Research Support, Non-U.S. Gov't
PMID: 19375222