CRPS diagnosis based on inflammation marker analysis

Objectives. The biological markers that can indicate specifically and sensitively the absence or presence of a certain condition or its state can be used for diagnostic support and disease monitoring. Thus, this research set out to study the changes in neuropeptides (substance P and calcitonin gene-related peptide) pro-inflammatory (TNFα, IL-1β and IL-6) and anti-inflammatory (IL-10) cytokine levels in the blood of patients with CRPS. Material and methods. Sixty patients were enlisted from the local Rheumatology Clinic of the Emergency County Hospital of Craiova and split into two groups (acute and chronic). CRPS related symptoms were estimated by means of the Neuropathic Pain Questionnaire. The quantification of cytokines and neuropeptides in blood was achieved using the high sensitivity colorimetric ELISA method. Outcomes. Cytokine analysis led to statistically insignificant results, while for the neuropeptides we obtained significantly increased values in the patient groups. ROC curves were used to assess the diagnostic accuracy of the neuropeptides both returning good AUC values. Conclusions. Our results indicate that the neuropeptide (substance P and calcitonin gene-related peptide) profile has a good diagnostic sensitivity. A limitation of the study is the low number of patients in the acute group, including more patients in this phase might offer more insights on the cytokines’ role, as they could be increased in comparison to chronic patients, due to their short half-life and low acting concentrations.