• Mediators of inflammation · Jan 2008

    Case Reports

    Expression of endothelial nitric oxide synthase and endothelin-1 in skin tissue from amputated limbs of patients with complex regional pain syndrome.

    • J George Groeneweg, Claudia Heijmans Antonissen, Frank J P M Huygen, and Freek J Zijlstra.
    • Pain Treatment Center, Department of Anesthesiology, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. j.groeneweg@erasmusmc.nl
    • Mediators Inflamm. 2008 Jan 1; 2008: 680981.

    Background And ObjectivesImpaired microcirculation during the chronic stage of complex regional pain syndrome (CRPS) is related to increased vasoconstriction, tissue hypoxia, and metabolic tissue acidosis in the affected limb. Endothelial dysfunction is suggested to be the main cause of diminished blood flow. The aim of this study was to examine the distribution of endothelial nitric oxide synthase (eNOS) and endothelin-1(ET-1) relative to vascular density represented by the endothelial marker CD31-immunoreactivity in the skin tissue of patients with chronic CRPS.MethodsWe performed immunohistochemical staining on sections of skin specimens obtained from the amputated limbs (one arm and one leg) of two patients with CRPS.ResultsIn comparison to proximal specimens we found an increased number of migrated endothelial cells as well as an increase of eNOS activity in distal dermis specimens.ConclusionsWe found indications that endothelial dysfunction plays a role in chronic CRPS.

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