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Up-Regulation of cutaneous α1-Adrenoceptors in complex regional pain syndrome Type I

Finch, P.M.ORCID: 0000-0002-2717-054X, Drummond, E.S., Dawson, L.F., Phillips, J.K. and Drummond, P.D. (2014) Up-Regulation of cutaneous α1-Adrenoceptors in complex regional pain syndrome Type I. Pain Medicine, 15 (11). pp. 1945-1956.

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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.

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.

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.

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.

Item Type: Journal Article
Murdoch Affiliation: School of Psychology and Exercise Science
Journal or Publication Title: Pain Medicine
Page Range: pp. 1945-1956
Publisher: Wiley
Copyright: 2014 Wiley Periodicals, Inc
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