Effects Of Different Drugs On Chemokine Expression In Cerebrospinal Fluid Of Patients With Postherpetic Neuralgia

ObjectiveCompared with the healthy control group,the levels of chemokines in the cerebrospinal fluid of patients with neuropathic pain caused by trauma or surgery were significantly increased,indicating the presence of neuroinflammation in patients with neuropathic pain.Post-herpetic neuralgia(PHN)is a refractory neuropathic pain,therefore,neuroinflammation meditated by chemokines may also take an important role in the induction and maintenance of PHN,but there are few reports on the levels of chemokines in the cerebrospinal fluid of patients with PHN.Consequently,this experiment is to explored the treatment of PHN drugs gabapentin,pregabalin,oxcarbazepine,lidochloride on the expression of chemokines in cerebrospinal fluid of patients with PHN,and explored the relationship between the levels of chemokines and the severity of symptoms by detecting the levels of chemokines in the cerebrospinal fluid of patients with PHN.Subjects and MethodsDivide these 72 cases of patients with PHN who were diagnosed and treated in Department of Pain at the First Affiliated Hospital of Zhengzhou University from December 2018 to August 2019 into 4 groups using random number table method:pregabalin group(group 1),gabapentin group(group 2),oxcarbazepine group(group 3),oxcarbazepine+lidocaine intravenous drip group(group 4),18 cases were involved in per group.On day 1(T1),day 3(T3),day 6(T6),and day 9(T9)of admission,the pressure pain thresholds of the pain area was measured by DS2-200N digital push-pull force gauge,and VAS scores of patient was recorded;and on day 1 and day 9 of hospitalization,2ml of cerebrospinal fluid of patients were collected through lumbar puncture.The concentrations of chemokines CCL2,CXCL10,CX3CL1,CXCL1 in cerebrospinal fluid of each group before and after treatment were detected by enzyme-linked immunosorbent assay(ELISA).ResultsThere were no statistical differences in age,gender,VAS scores,pressure pain thresholds and the levels of CCL2,CXCL1,CX3CL1,CXCL10 in the cerebrospinal fluid of the four groups of patients before treatment(P>0.05).Nine days after treatment,the levels of chemokines in the cerebrospinal fluid and VAS scores of the four groups of patients were significantly lower than before treatment,and pressure pain thresholds were markedly higher than before treatment,the differences were all statistically significant(P<0.05).There were no statistical differences in the levels of CCL2,CXCL1,CX3CL1,CXCL10 in the cerebrospinal fluid among the four groups after treatment(P>0.05).Before treatment,in group 1 patients,the levels of CCL2 and CX3CL1 in cerebrospinal fluid and pressure pain thresholds T1 were strongly correlated(r were both-0.93,P<0.01),CXCL1 and CXCL10 were moderately related to pressure pain thresholds T1(r was-0.76,-0.75,respectively,P<0.01).In group 2 pat-ients,the levels of CCL2 and CX3 CL 1 were strongly correlated with pressure pain thresholds T1(r was-0.92,0.91,respectively,P<0.01),while CXCL1,CXCL10 were moderately correlated with pressure pain thresholds T1(r was-0.81,-0.83,respectively,P<0.01).In group 3 patients,the levels of CCL2 and CX3CL1 were strongly correlated with pressure pain thresholds T1(r was-0.96,-0.94,respectively,P<0.01),while CXCL1 and CXCL10 were moderately correlated with pressure pain thresholds T1(r was-0.80,-0.83,respectively,P<0.01).In group 4 patients,the level of CCL2 in cerebrospinal fluid was strongly correlated with pressure pain thresholds T1(r=-0.95,P<0.01),while CXCL1,CXCL10,and CX3CL1 were moderately correlated with pressure pain thresholds T1(r was-0.83,-0.84,-0.89,respectively,P<0.01).ConclusionCalcium channel antagonists(gabapentin and pregabalin)and sodium channel blockers(oxcarbazepine)both can reduce the levels of CCL2,CXCL1,CX3CL1,and CXCL10 in cerebrospinal fluid of PHN,and relieve the pain of patients.However,the higher the level of chemokines in cerebrospinal fluid of patients before treatment,the more severe the patient’s pain,which indicating that chemokines may be associated with the induction and maintenance of PHN.