Article

Lymphocyte Subsets and the Role of Th1/Th2 Balance in Stressed Chronic Pain Patients

Department of Anesthesiology, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Germany.
NeuroImmunoModulation (Impact Factor: 1.78). 02/2007; 14(5):272-80. DOI: 10.1159/000115041
Source: PubMed

ABSTRACT The complex regional pain syndrome (CRPS) and fibromyalgia (FM) are chronic pain syndromes occurring in highly stressed individuals. Despite the known connection between the nervous system and immune cells, information on distribution of lymphocyte subsets under stress and pain conditions is limited.
We performed a comparative study in 15 patients with CRPS type I, 22 patients with FM and 37 age- and sex-matched healthy controls and investigated the influence of pain and stress on lymphocyte number, subpopulations and the Th1/Th2 cytokine ratio in T lymphocytes.
Lymphocyte numbers did not differ between groups. Quantitative analyses of lymphocyte subpopulations showed a significant reduction of cytotoxic CD8+ lymphocytes in both CRPS (p < 0.01) and FM (p < 0.05) patients as compared with healthy controls. Additionally, CRPS patients were characterized by a lower percentage of IL-2-producing T cell subpopulations reflecting a diminished Th1 response in contrast to no changes in the Th2 cytokine profile.
Future studies are warranted to answer whether such immunological changes play a pathogenetic role in CRPS and FM or merely reflect the consequences of a pain-induced neurohumoral stress response, and whether they contribute to immunosuppression in stressed chronic pain patients.

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    • "Although results are mixed, two published meta-analyses indicate that depression is accompanied by a lymphopenia and reduced natural killer cell (NK) counts (Herbert and Cohen, 1993a; Miller, 2010; Zorrilla et al., 2001). For somatization syndromes and associated conditions such as insomnia or pain disorders, there is some evidence for reduced counts of lymphocytes including whole T cell counts, suppressor T cells and T helper cells (Kaufmann et al., 2007; Rief et al., 2001a, 2001b; Savard et al., 2003). Previous research indicates that exercise and physical activity have beneficial effects across several physical and mental-health outcomes (Penedo and Dahn, 2005). "
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