Jae Y Lee, Ji Hoon Park, Joon Beom Park, Ji Hee Hong
{"title":"Reduction of Serum Substance P and Beta Endorphin in Herpes Zoster After Erector Spinae Plane Block.","authors":"Jae Y Lee, Ji Hoon Park, Joon Beom Park, Ji Hee Hong","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute herpes zoster (AHZ) is caused by the reactivation of varicella-zoster virus. This reactivation results in peripheral nerve fiber damage and triggers an immune reaction, which leads to the production of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha). In the skin of patients affected with postherpetic neuralgia (PHN), high levels of calcitonin gene-related peptide (CGRP) have been found.</p><p><strong>Objectives: </strong>The primary goal of this study was to compare changes in serum inflammatory cytokines (IL-6, IL-8) and pain neurotransmitters (substance P, CGRP) with those of a control group, and before and after fascial plane blocks.</p><p><strong>Study design: </strong>A prospective, nonrandomized, and case-control study.</p><p><strong>Methods: </strong>The diagnosis of AHZ (< 2 months) and PHN (> 6 months) were determined based on the duration of each patient's pain since the onset of skin eruption. Healthy age- and gender-matched volunteers were included as the control group. For the sake of the enzyme-linked immunosorbent assay (ELISA), blood sampling was performed 2 or 3 times before and after the block. An ultrasound-guided erector spinae plane block (ESPB) was performed 2 or 3 times at an affected dermatome.</p><p><strong>Results: </strong>The levels of IL-6 and pain neurotransmitters (substance P, CGRP) in HZ patients did not show any significant differences from those in the control group. However, the serum substance P (median, 24.0; IQR, 7.2-49.5) and beta-endorphin levels following the ESPBs (median, 237.8; IQR, 177.4-414.5) were significantly lower than they were prior to the ESPBs (median, 30.6; IQR, 13.3-71.6; P = 0.009).</p><p><strong>Limitations: </strong>The AHZ patients in this study did not experience a very acute phase. Since the matter of whether or not the levels of serum inflammatory cytokines in AHZ patients can demonstrate a significant reduction or increase is uncertain, further study is required.</p><p><strong>Conclusions: </strong>Between the HZ patients and the control group, the levels of inflammatory cytokines (IL-6) and pain neurotransmitters (substance P, CGRP) did not show any significant differences. However, a significant reduction of substance P and beta-endorphin following the ESPBs was observed.</p>","PeriodicalId":19841,"journal":{"name":"Pain physician","volume":"29 6","pages":"E725-E732"},"PeriodicalIF":3.2000,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain physician","FirstCategoryId":"3","ListUrlMain":"","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Acute herpes zoster (AHZ) is caused by the reactivation of varicella-zoster virus. This reactivation results in peripheral nerve fiber damage and triggers an immune reaction, which leads to the production of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha). In the skin of patients affected with postherpetic neuralgia (PHN), high levels of calcitonin gene-related peptide (CGRP) have been found.
Objectives: The primary goal of this study was to compare changes in serum inflammatory cytokines (IL-6, IL-8) and pain neurotransmitters (substance P, CGRP) with those of a control group, and before and after fascial plane blocks.
Study design: A prospective, nonrandomized, and case-control study.
Methods: The diagnosis of AHZ (< 2 months) and PHN (> 6 months) were determined based on the duration of each patient's pain since the onset of skin eruption. Healthy age- and gender-matched volunteers were included as the control group. For the sake of the enzyme-linked immunosorbent assay (ELISA), blood sampling was performed 2 or 3 times before and after the block. An ultrasound-guided erector spinae plane block (ESPB) was performed 2 or 3 times at an affected dermatome.
Results: The levels of IL-6 and pain neurotransmitters (substance P, CGRP) in HZ patients did not show any significant differences from those in the control group. However, the serum substance P (median, 24.0; IQR, 7.2-49.5) and beta-endorphin levels following the ESPBs (median, 237.8; IQR, 177.4-414.5) were significantly lower than they were prior to the ESPBs (median, 30.6; IQR, 13.3-71.6; P = 0.009).
Limitations: The AHZ patients in this study did not experience a very acute phase. Since the matter of whether or not the levels of serum inflammatory cytokines in AHZ patients can demonstrate a significant reduction or increase is uncertain, further study is required.
Conclusions: Between the HZ patients and the control group, the levels of inflammatory cytokines (IL-6) and pain neurotransmitters (substance P, CGRP) did not show any significant differences. However, a significant reduction of substance P and beta-endorphin following the ESPBs was observed.
期刊介绍：
Pain Physician Journal is the official publication of the American Society of Interventional Pain Physicians (ASIPP). The open access journal is published 6 times a year.
Pain Physician Journal is a peer-reviewed, multi-disciplinary, open access journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine.
Pain Physician Journal presents the latest studies, research, and information vital to those in the emerging specialty of interventional pain management – and critical to the people they serve.
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