Immunological indexes in evaluation of chronic pain syndrome”, Medical Immunology (Russia)

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.

1. Barinov A.N. Modern approach to the diagnosis and treatment of back pain. Russkiy meditsinskiy zhurnal = Russian Medical Journal, 2013, Special Iss., pp. 8-15. (In Russ.)

2. Barulin A.E., Kurushina O.V., Kalinchenko B.M., Chernovolenko E.P. Chronic pain and depression. Lekarstvennyy vestnik = Medicinal Bulletin, 2016, Vol. 10, no. 61, pp. 3-10. (In Russ.)

3. Borisova E.G., Nikitenko V.V. The study of catecholamines in chronic pain syndromes of the oral cavity. Rossiyskiy zhurnal boli = Russian Journal of Pain, 2016, no. 2, pp. 8-9. (In Russ.)

4. Davydova T.V., Kolobov V.V., Gorbatov V.Yu., Zakharova I.A., Vetrile L.A., Fomina V.G., Fedenko A.M. Antibodies to glutamate, neurodegenerative brain damage. Immunotherapy prospects. Patogenez = Pathogenesis, 2012, Vol. 10, no. 3, pp. 26-31. (In Russ.)

5. Zakharova I.A., Vetrile S.T., Shvets V.V., Chronic pain syndrome in spinal osteochondrosis: autoantibodies to neurotransmitters. Rossiyskiy zhurnal boli = Russian Journal of Pain, 2015, Vol. 1, no. 46, pp. 65-66. (In Russ.)

6. Igonkina S.I., Kukushkin M.L., Vetrile L.A., Reshetnyak V.K. Antitel to the neurotransmitters of the antinociceptive system strengthen and prolong neuropathic pain. Rossiyskiy zhurnal boli = Russian Journal of Pain, 2014, Vol. 1, no. 42, pp. 15-16. (In Russ.)

7. Igonkina S.I., Vetrile L.A., Davydova T.V., Fomina V.G. Pronociceptive and antinociceptive effects of antibodies to serotonin. Rossiyskiy zhurnal boli = Russian Journal of Pain, 2014, Vol. 1, no. 42, pp. 14-15. (In Russ.)

8. Igonkina S.I., Vetrile L.A., Kukushkin M.L. The effect of antibodies to norepinephrine on the development of neuropathic pain. Byulleten eksperimentalnoy biologii i meditsiny = Bulletin of Experimental Biology and Medicine, 2016. Vol. 162, no. 12, pp. 678-681. (In Russ.)

9. Karakulova Yu.V. Serotonergic mechanisms of chronification of tension headache. Rossiyskiy zhurnal boli = Russian Journal of Pain, 2017, Vol. 1, no. 52, pp. 9-10. (In Russ.)

10. Kuchaeva A.V. Biopsychosocial analysis of pharmacotherapy of chronic pain syndrome in depression. Biotekhnologii i meditsina = Biotechnology and Medicine, 2013, no. 8, pp. 7-9. (In Russ.)

11. Levashov A.I., Morozova V.S., Polyvianaya O.Yu., Petrochenko S.N., Myagkova M.A., Moseykin I.A. Comparative analysis of the intensity of pain syndrome and immunochemical parameters – the levels of natural antibodies in patients with chronic dorsalgia. Biologicheskie membrany = Biological Membranes, 2014, Vol. 31, no. 3, pp. 218-225. (In Russ.)

12. Manzhulo I.V. Duisen I.V. Neurochemical changes in the rostral ventromedial nucleus of the medulla of the rat with the development of neuropathic pain syndrome. Neyrokhimiya = Neurochemistry, 2015, no. 3, pp. 259-367. (In Russ.)

13. Myagkova M.A., Morozova V.S. Natural antibodies and their physiological functions. Immunopatologiya. Allergologiya. Infektologiya = Immunopathology. Allergology. Infectology, 2014, no. 3, pp. 75-81. (In Russ.)

14. Myagkova M.A., Petrochenko S.N., Morozova V.S.. Detection of antibodies to endogenous bioregulators for the diagnosis of the functional state of the body. Izvestiya AN. Seriya khimicheskaya = Proceedings of the Academy of Sciences. Chemical Series, 2018, no. 4, pp. 762-767. (In Russ.)

15. Paltsev M.A., Poletaev A.B., Suchkov S.V. Autoimmunity and autoimmune syndrome: the limits of the norm and pathology. Vestnik RAMN = Bulletin of Russian Academy Medical Sciences, 2010, no. 8, pp. 1-9. (In Russ.)

16. Podchufarova E.V. Topical issues of acute and chronic pain in the lumbosacral region. Nevrologiya. Neyropsikhiatriya, psikhosomatika = Neurology. Neuropsychiatry, Psychosomatics, 2012, no. 1, pp. 27-35. (In Russ.)

17. Podchufarova E.V., Razumov D.V. Myogenic back pain: clinical features, formation mechanisms, treatment. Rossiyskiy zhurnal boli = Russian Journal of Pain, 2011, Vol. 3-4, no. 32-33, pp. 46-54. (In Russ.)

18. Reshetnyak V.K. Gender differences in corticalsubcortical brain structures involved in pain perception. Rossiyskiy zhurnal boli = Russian Journal of Pain, 2014, Vol. 1, no. 42, pp. 20-21. (In Russ.)

19. Reshetnyak V.K., Kukushkin M.L. Central and peripheral mechanisms of physiological and pathological pain. Klinicheskaya patofiziologiya = Clinical Pathophysiology, 2015, no. 1, pp. 1-17. (In Russ.)

20. Tretyakova E.A., Karakulova Yu.V. Clinical and biochemical study of the mechanisms of formation of chronic pain in the lumbosacral region. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova = S. Korsakov Journal of Neurology and Psychiatry, 2011, Vol. 9, no. 1, pp. 58-65. (In Russ.)

21. Attal N., Bouhassira D., Baron R. Diagnosis and assessment of neuropathic pain through questionnaires. Lancet Neurol., 2018, Vol. 17, no. 5, pp. 456-466.

22. Johannes C.B., Le T.K., Zhou X., Johnston J.A., Dworkin R.H. The prevalence of chronic pain in United States adults: results of an Internet-based survey. J. Pain, 2010, Vol. 11, no. 11, pp. 1230-1239.

23. Hegadoren K.M., O’Donnell T., Lanius R., Coupland N.J., Lacaze-Masmonteil N. The role of beta-endorphin in the pathophysiology of major depression. Neuropeptides, 2009, Vol. 43, no. 5, pp. 341-353.

24. Neblett R. Surface electromyographic (SEMG) biofeedback for chronic low back pain. Healthcare, 2016, Vol. 4, 27. doi: 10.3390/healthcare4020027.

25. Toll L., Bruchas M.R., Calo’ G., Cox B.M., Zaveri N.T. Nociceptin/orphanin FQ receptor structure, signaling, ligands, functions, and interactions with opioid systems. Pharmacol. Rev., 2016, Vol. 68, no. 2, pp. 419-436.