Up-Regulation of cutaneous α1-adrenoceptors in complex regional pain syndrome type I

Philip M. Finch, Eleanor S. Drummond, Linda F. Dawson, Jacqueline K. Phillips, Peter D. Drummond

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: In a small radioligand-binding study of cutaneous α1-adrenoceptors in complex regional pain syndrome (CRPS), signal intensity was greater in the CRPS-affected limb than in controls. However, it was not possible to localize heightened expression of α1-adrenoceptors to nerves, sweat glands, blood vessels, or keratinocytes using this technique. Methods: To explore this in the present study, skin biopsies were obtained from 31 patients with CRPS type I and 23 healthy controls of similar age and sex distribution. Expression of α1-adrenoceptors on keratinocytes and on dermal blood vessels, sweat glands, and nerves was assessed using immunohistochemistry. Results: α1-Adrenoceptors were expressed more strongly in dermal nerve bundles and the epidermis both on the affected and contralateral unaffected side in patients than in controls (P<0.05). However, expression of α1-adrenoceptors in sweat glands and blood vessels was similar in patients and controls. α1-Adrenoceptor staining intensity in the CRPS-affected epidermis was associated with pain intensity (P<0.05), but a similar trend for nerve bundles did not achieve statistical significance. Discussion: Epidermal cells influence nociception by releasing ligands that act on sensory nerve fibers. Moreover, an increased expression of α1-adrenoceptors on nociceptive afferents has been shown to aggravate neuropathic pain. Thus, the heightened expression of α1-adrenoceptors in dermal nerves and epidermal cells might augment pain and neuroinflammatory disturbances after tissue injury in patients with CRPS type I.

Original languageEnglish
Pages (from-to)1945-1956
Number of pages12
JournalPain Medicine (United States)
Volume15
Issue number11
DOIs
Publication statusPublished - 1 Nov 2014

Bibliographical note

Erratum can be found at Pain Medicine volume 16(4), 830-832, https://doi.org/10.1111/pme.12708

Keywords

  • Complex regional pain syndrome
  • α1-adrenoceptors
  • immunohistochemistry
  • epidermis
  • dermal Nerves

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