Complex regional pain syndrome (CRPS)
Complex regional pain syndrome (CRPS) is a painful condition with clinical features including sensory, sudomotor and vasomotor disturbances, trophic changes and impaired motor function. The course varies from mild and self-limiting to chronic disease with a high impact on daily functioning and quality of life. CRPS is often associated with a significant loss of quality of life. Despite increasing research efforts, the pathogenesis of CRPS has yet to be elucidated. Recent findings indicate that aberrant inflammation, vasomotor dysfunction and maladaptive neuroplasticity represent important biological pathways in triggering and maintaining the disease. The skin is densely innervated with different types of nerve endings, which discriminate between pain, temperature, and sense of touch. Sensory and sympathetic nerves and their neurotransmitters are the neuronal key effectors which also contribute to the regulation of healing processes after severe tissue damage. Various connective tissues cell types such as fibroblasts express receptors for sensory and sympathetic neurotransmitters and even synthesize neuropeptides in response.
We hypothesize that after an inciting event skin fibroblasts are chronically activated due to the sustained exposure to inflammatory cytokines affecting the intercellular communication with the neuro-immunological system. Our aim is to evaluate the regulatory role of stroma cells in the activation of the neuro-immunological system in CRPS.
Florian Brunner, Astrid Jüngel, Oliver Distler
The Balgrist Stiftung supports this study.