Usefulness of Inflammatory Markers for the Prediction of Postherpetic Neuralgia in Patients with Acute Herpes Zoster
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초록
Background: Increasing evidence suggests a pivotal role for neuronal inflammation in response to replicating varicella zoster virus in the development of postherpetic neuralgia (PHN). Objective: In this study, we investigated the value of serum levels of various inflammatory markers in acute herpes zoster (HZ) as predictors for the development of PHN. Methods: A total of 116 patients with acute HZ were enrolled in this study. We measured scores on the pain visual analogue scale (VAS) at baseline and at 1, 3, and 6 months after diagnosis of HZ. We defined PHN as pain greater than 1 on the VAS lasting for more than 6 months. Serum samples for laboratory assay, including complete blood count were obtained at the initial visit. Correlations between the levels of each inflammatory marker and the development of PHN were evaluated. Results: Levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte count, and albumin showed significant correlations with development of PHN in univariate analysis. Levels of ESR, CRP, and lymphocyte count also showed significant correlations in multivariate analysis. ESR level showed stronger correlations with development of PHN than levels of CRP and lymphocyte count. Conclusion: In this study, we confirmed that elevated ESR was an independent and significant predictor of PHN in patients with acute HZ. To validate these results, further well-designed, randomized clinical trials are needed.
Abstract
Background: Increasing evidence suggests a pivotal role for neuronal inflammation in response to replicating varicella zoster virus in the development of postherpetic neuralgia (PHN). Objective: In this study, we investigated the value of serum levels of various inflammatory markers in acute herpes zoster (HZ) as predictors for the development of PHN. Methods: A total of 116 patients with acute HZ were enrolled in this study. We measured scores on the pain visual analogue scale (VAS) at baseline and at 1, 3, and 6 months after diagnosis of HZ. We defined PHN as pain greater than 1 on the VAS lasting for more than 6 months. Serum samples for laboratory assay, including complete blood count were obtained at the initial visit. Correlations between the levels of each inflammatory marker and the development of PHN were evaluated. Results: Levels of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lymphocyte count, and albumin showed significant correlations with development of PHN in univariate analysis. Levels of ESR, CRP, and lymphocyte count also showed significant correlations in multivariate analysis. ESR level showed stronger correlations with development of PHN than levels of CRP and lymphocyte count. Conclusion: In this study, we confirmed that elevated ESR was an independent and significant predictor of PHN in patients with acute HZ. To validate these results, further well-designed, randomized clinical trials are needed.
참고문헌 (17)
- Kost RG, "Postherpetic neuralgia--pathogenesis, treatment, and prevention", N Engl J Med, 335, pp.32~42 (1996)[DOI]
- Wall PD, "Neuropathic pain and injured nerve: central mechanisms", Br Med Bull, 47, pp.631~643 (1991)[DOI]
- 장용현, "Do Interventional Pain Management Procedures during the Acute Phase of Herpes Zoster Prevent Postherpetic Neuralgia in the Elderly?: A Meta-Analysis of Randomized Controlled Trials", Annals of Dermatology, 27(6), pp.771~774 (2015), 대한피부과학회
- Jung BF, "Risk factors for postherpetic neuralgia in patients with herpes zoster", Neurology, 62, pp.1545~1551 (2004)[DOI]
- Ko EJ, "The clinical significance of infrared thermography for the prediction of postherpetic neuralgia in acute herpes zoster patients", Skin Res Technol, 22, pp.108~114 (2016)[DOI]
- Imoto K, "VZV skin-test reaction, but not antibody, is an important predictive factor for postherpetic neuralgia", J Dermatol Sci, 79, pp.235~240 (2015)[DOI]
- Kim YN, "Efficacy of continuous epidural block in acute herpes zoster: Incidence and predictive factors of postherpetic neuralgia, a retrospective single-center study", Medicine (Baltimore), 95, pp.e4577~ (2016)[DOI]
- Baron R, "Peripheral neuropathic pain: from mechanisms to symptoms", Clin J Pain, 16(2 Suppl), pp.S12~S20 (2000)[DOI]
- Austin PJ, "The neuro-immune balance in neuropathic pain: involvement of inflammatory immune cells, immune-like glial cells and cytokines", J Neuroimmunol, 229, pp.26~50 (2010)[DOI]
- Kraychete DC, "Proinflammatory cytokines in patients with neuropathic pain treated with tramadol", Rev Bras Anestesiol, 59, pp.297~303 (2009)[DOI]
- Wuertz K, "Inflammatory mediators in intervertebral disk degeneration and discogenic pain", Global Spine J, 3, pp.175~184 (2013)[DOI]
- Zak-Prelich M, "Local immune responses and systemic cytokine responses in zoster: relationship to the development of postherpetic neuralgia", Clin Exp Immunol, 131, pp.318~323 (2003)[DOI]
- Backryd E, "Plasma pro-inflammatory markers in chronic neuropathic pain: A multivariate, comparative, cross-sectional pilot study", Scand J Pain, 10, pp.1~5 (2016)
- Zhu SM, "Influence of systemic immune and cytokine responses during the acute phase of zoster on the development of postherpetic neuralgia", J Zhejiang Univ Sci B, 10, pp.625~630 (2009)[DOI]
- Gabay C, "Interleukin-6 and chronic inflammation", Arthritis Res Ther, 8(Suppl 2), pp.S3~ (2006)
- Karadag Oncel E, "Determination and clinical correlation of markers of inflammation in unvaccinated patients with varicellazoster infection", Eur Rev Med Pharmacol Sci, 17, pp.2032~2039 (2013)
- Desmond RA, "Clinical applications for change-point analysis of herpes zoster pain", J Pain Symptom Manage, 23, pp.510~516 (2002)[DOI]