TY  - JOUR
A1  - Hartmannsberger, Beate
A1  - Scriba, Sabrina
A1  - Guidolin, Carolina
A1  - Becker, Juliane
A1  - Mehling, Katharina
A1  - Doppler, Kathrin
A1  - Sommer, Claudia
A1  - Rittner, Heike L.
T1  - Transient immune activation without loss of intraepidermal innervation and associated Schwann cells in patients with complex regional pain syndrome
JF  - Journal of Neuroinflammation
N2  - Background
Complex regional pain syndrome (CRPS) develops after injury and is characterized by disproportionate pain, oedema, and functional loss. CRPS has clinical signs of neuropathy as well as neurogenic inflammation. Here, we asked whether skin biopsies could be used to differentiate the contribution of these two systems to ultimately guide therapy. To this end, the cutaneous sensory system including nerve fibres and the recently described nociceptive Schwann cells as well as the cutaneous immune system were analysed.

Methods
We systematically deep-phenotyped CRPS patients and immunolabelled glabrous skin biopsies from the affected ipsilateral and non-affected contralateral finger of 19 acute (< 12 months) and 6 chronic (> 12 months after trauma) CRPS patients as well as 25 sex- and age-matched healthy controls (HC). Murine foot pads harvested one week after sham or chronic constriction injury were immunolabelled to assess intraepidermal Schwann cells.

Results
Intraepidermal Schwann cells were detected in human skin of the finger—but their density was much lower compared to mice. Acute and chronic CRPS patients suffered from moderate to severe CRPS symptoms and corresponding pain. Most patients had CRPS type I in the warm category. Their cutaneous neuroglial complex was completely unaffected despite sensory plus signs, e.g. allodynia and hyperalgesia. Cutaneous innate sentinel immune cells, e.g. mast cells and Langerhans cells, infiltrated or proliferated ipsilaterally independently of each other—but only in acute CRPS. No additional adaptive immune cells, e.g. T cells and plasma cells, infiltrated the skin.

Conclusions
Diagnostic skin punch biopsies could be used to diagnose individual pathophysiology in a very heterogenous disease like acute CRPS to guide tailored treatment in the future. Since numbers of inflammatory cells and pain did not necessarily correlate, more in-depth analysis of individual patients is necessary.
KW  - complex regional pain syndrome
KW  - IENFD
KW  - nociceptive Schwann cells
KW  - mast cells
KW  - Langerhans cells
KW  - tissue resident T cells
KW  - dermal B cells
KW  - skin punch biopsy
KW  - chronic constriction nerve injury
Y1  - 2024
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357164
VL  - 21
ER  - 
TY  - JOUR
A1  - Reinhold, Ann Kristin
A1  - Krug, Susanne M.
A1  - Salvador, Ellaine
A1  - Sauer, Reine S.
A1  - Karl-Schöller, Franziska
A1  - Malcangio, Marzia
A1  - Sommer, Claudia
A1  - Rittner, Heike L.
T1  - MicroRNA-21-5p functions via RECK/MMP9 as a proalgesic regulator of the blood nerve barrier in nerve injury
JF  - Annals of the New York Academy of Sciences
N2  - Both nerve injury and complex regional pain syndrome (CRPS) can result in chronic pain. In traumatic neuropathy, the blood nerve barrier (BNB) shielding the nerve is impaired—partly due to dysregulated microRNAs (miRNAs). Upregulation of microRNA-21-5p (miR-21) has previously been documented in neuropathic pain, predominantly due to its proinflammatory features. However, little is known about other functions. Here, we characterized miR-21 in neuropathic pain and its impact on the BNB in a human-murine back translational approach. MiR-21 expression was elevated in plasma of patients with CRPS as well as in nerves of mice after transient and persistent nerve injury. Mice presented with BNB leakage, as well as loss of claudin-1 in both injured and spared nerves. Moreover, the putative miR-21 target RECK was decreased and downstream Mmp9 upregulated, as was Tgfb. In vitro experiments in human epithelial cells confirmed a downregulation of CLDN1 by miR-21 mimics via inhibition of the RECK/MMP9 pathway but not TGFB. Perineurial miR-21 mimic application in mice elicited mechanical hypersensitivity, while local inhibition of miR-21 after nerve injury reversed it. In summary, the data support a novel role for miR-21, independent of prior inflammation, in elicitation of pain and impairment of the BNB via RECK/MMP9.
KW  - claudin-1
KW  - RECK
KW  - MMP9
KW  - CRPS
KW  - microRNA
KW  - neuropathic pain
KW  - blood nerve barrier
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-318226
VL  - 1515
IS  - 1
SP  - 184
EP  - 195
ER  -