Cerebrospinal fluid interleukin 8 concentrations and the subsequent development of postherpetic neuralgia - 25/08/11
, Ryoko Kudo c, Yutaka Sakurai, MD, PhD d, Daisuke Sawamura, MD, PhD e, Daniel I Sessler, MD a, f, Hiroshi Okada, MD, PhD g, Hiroto Nakayama, MD, PhD g, Toshifumi Yamagata h, Minoru Yasujima, MD, PhD c, Akitomo Matsuki, MD, PhD cAbstract |
Purpose |
Other than age, the risk factors for postherpetic neuralgia are not well established. We studied whether the concentration of interleukin 8 in the cerebrospinal fluid is associated with the risk of postherpetic neuralgia.
Methods |
We enrolled 170 patients more than 50 years old who had a typical painful and nontrigeminal herpetic rash. Patients were treated with acyclovir; no corticosteroids were given. Cerebrospinal fluid was taken for analysis of interleukin 8 during and at full crusting of the herpetic rash. Age, sex, comorbid conditions, prodromal pain, localization and severity of herpetic rash, number of skin lesions, and degree of pain were recorded. We used multivariate logistic regression modeling to identify significant predictive factors. Receiver operating characteristic (ROC) curves were evaluated to determine the contribution of each factor.
Results |
Six months after healing, 31 patients (18%) had postherpetic neuralgia; 27 patients still had it after 1 year. Only three variables—age (odds ratio [OR] = 2.7 per 10-year increase; 95% confidence interval [CI]: 1.2 to 6.2), acute pain (OR = 1.8 per unit increase in visual analog scale; 95% CI: 1.2 to 2.8), and interleukin 8 concentration in the cerebrospinal fluid at full crusting of the herpetic rash (OR = 1.6 per 20-μg/L increase; 95% CI: 1.3 to 2.0)—were significant predictors of postherpetic neuralgia at 1 year. Interleukin 8 concentration also had the highest area under the ROC curve at these evaluation points (P <0.001).
Conclusion |
Our results suggest that interleukin 8 concentration in the cerebrospinal fluid at full crusting of herpetic rash may be useful for identifying patients who are likely to develop intractable postherpetic neuralgia.
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 | This work was supported by Grants-in-aid for Scientific Research B2-30205415 and C2-14571415 from the Ministry of Education and Science, Tokyo, Japan; Grant-in-aid for Cancer Research No. 11-1 from the Ministry of Health, Labor, and Welfare, Tokyo, Japan; grants GM58273 and GM061655 from the National Institutes of Health, Bethesda, Maryland; the Joseph Drown Foundation, Los Angeles, California; and the Commonwealth of Kentucky Research Challenge Trust Fund, Louisville, Kentucky. |
Vol 116 - N° 5
P. 318-324 - mars 2004 Regresar al número
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