Anti-TNF-alpha-Therapie bei anderen Indikationen

Zusammenfassung

Das Komplexe Regionale Schmerzsyndrom (CRPS) ist eine häufige Komplikation nach Traumen oder elektiven Eingriffen zumeist an der oberen Extremität mit einer Prävalenz von etwa 30 pro 100 000. Prospektive Studien von Patienten mit distaler Radiusfraktur ermittel-ten eine Inzidenz von mehr als 20 Prozent dieser Komplikation. Aktuell unterscheiden die Diagnose-Kriterien zwischen CRPS ohne (CRPS Typ 1) und CRPS mit Nervenläsion (CRPS Typ 2). Zytokine, wie z. B. Tumor-Nekrose-Faktor alpha (TNF-alpha) scheinen eine wichtige Rolle bei der Mediation von mechanischer Hyperalgesie und der Ödembildung in der akuten Phase des CRPS Typ 1 zu spielen. Die Erkenntnis dieser Zusammenhänge führte zu ersten erfolgreichen Einsätzen von Anti-TNF-alpha-Inhibitoren bei Patienten mit CRPS Typ 1.

Summary

Complex Regional Pain Syndrome (CRPS) is a frequent complication after trauma or operation with a prevalence of about 30 per 100,000. Prospective studies in patients with distal radial fracture revealed a more than 20 % incidence of this complication. Current diagnostic guidelines distinguish between CRPS without (CRPS type 1) or with obvious nerve lesion (CRPS type 2). Cytokines, particularly tumor necrosis factor (TNF)-alpha, seem to play an important role in the mediation of mechanical hyperalgesia in CRPS and other neuropathic pain syndromes. This understanding has led to successful treatment of early stage CRPS type 1 symptoms using systemic and local administration of TNF-alpha antibodies.

Schlüsselwörter

CRPS - TNF-alpha - mechanische Hyperalgesie

Keywords

CRPS - TNF-alpha - mechanical hyperalgesia

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