A CRPS-IgG-transfer-trauma model reproducing inflammatory and positive sensory signs associated with complex regional pain syndrome

• Published in: Pain (Amsterdam) Vol. 155; no. 2; pp. 299 - 308
• Main Authors: Tékus, Valéria, Hajna, Zsófia, Borbély, Éva, Markovics, Adrienn, Bagoly, Teréz, Szolcsányi, János, Thompson, Victoria, Kemény, Ágnes, Helyes, Zsuzsanna, Goebel, Andreas
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier B.V 01-02-2014; International Association for the Study of Pain; Elsevier
• Subjects: Adult; Animals; Autoantibodies - biosynthesis; Autoantibodies - blood; Autoantibody; Autoimmunity; Biological and medical sciences; Complex regional pain syndrome; Complex Regional Pain Syndromes - blood; Complex Regional Pain Syndromes - chemically induced; Complex Regional Pain Syndromes - pathology; CRPS; Disease Models, Animal; Female; Fundamental and applied biological sciences. Psychology; Humans; Hyperalgesia - blood; Hyperalgesia - chemically induced; Hyperalgesia - pathology; Immunoglobulin G - biosynthesis; Immunoglobulin G - blood; Immunoglobulin G - toxicity; Inflammation - blood; Inflammation - chemically induced; Inflammation - pathology; Male; Mice; Mice, Inbred C57BL; Middle Aged; Pain; Pain Measurement - methods; Pilot Projects; Somesthesis and somesthetic pathways (proprioception, exteroception, nociception); interoception; electrolocation. Sensory receptors; Vertebrates: nervous system and sense organs; Autoimmunity; Autoantibody; Pain; CRPS; Complex regional pain syndrome; IgG; Transfer; Inflammation; Models; Trauma
• ISSN: 0304-3959; 1872-6623
• DOI: 10.1016/j.pain.2013.10.011

The transfer of serum IgG from patients with long-standing complex regional pain syndrome (CRPS) to mice, followed by mild hind paw trauma, causes typical signs of CRPS.
The aetiology of complex regional pain syndrome (CRPS), a highly painful, usually post-traumatic condition affecting the limbs, is unknown, but recent results have suggested an autoimmune contribution. To confirm a role for pathogenic autoantibodies, we established a passive-transfer trauma model. Prior to undergoing incision of hind limb plantar skin and muscle, mice were injected either with serum IgG obtained from chronic CRPS patients or matched healthy volunteers, or with saline. Unilateral hind limb plantar skin and muscle incision was performed to induce typical, mild tissue injury. Mechanical hyperalgesia, paw swelling, heat and cold sensitivity, weight-bearing ability, locomotor activity, motor coordination, paw temperature, and body weight were investigated for 8days. After sacrifice, proinflammatory sensory neuropeptides and cytokines were measured in paw tissues. CRPS patient IgG treatment significantly increased hind limb mechanical hyperalgesia and oedema in the incised paw compared with IgG from healthy subjects or saline. Plantar incision induced a remarkable elevation of substance P immunoreactivity on day 8, which was significantly increased by CRPS-IgG. In this IgG-transfer-trauma model for CRPS, serum IgG from chronic CRPS patients induced clinical and laboratory features resembling the human disease. These results support the hypothesis that autoantibodies may contribute to the pathophysiology of CRPS, and that autoantibody-removing therapies may be effective treatments for long-standing CRPS.