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The dynamics of possible markers of pain syndrome: pain pressure thresholds of intolerance (PTI) and natural antibodies to mediators of pain processing (nAbs) in blood serum at dorsalgia was studied. We have shown that most men and women had reduced PTIs. Night PTIs were lower than daytime PTIs regardless of the gender. The study of the content of nAbs to opioids and biogenic amines by ELISA have shown a prolonged maintenance of their elevated and high levels that could evoke long-term effect in pain chronization. Thus, the pressure algometry and ELISA of nAbs to pain processing mediators make it possible to assess the individual pain status objectively and, on this bases, to propose personal schemes of treatment.

Objective: Our aim was to study the possible markers of pain syndrome--indicators of pain sensitivity--pain pressure tolerance thresholds (PPTT), and immuno-indicators--natural antibodies against pain processing mediators (eAb) for evaluation the possibility of its using for a objective pain assessment at chronic low back pain., Methods: Pain sensitivity was assessed daily and nightly, by measuring the PPTT The natural antibody levels (eAb), were determined in serum by ELISA. Measurement of all parameters were performed at 1st, 10th and 21 days., Results: 173 patients (93 women and 80 men) with chronic low back pain were included in the study. At 1st day most patients had lowered PPTT: 55% of men and 74% during the day, 72% of men and 89% of women at night. Dynamic study has shown a tendency of PPTT normalization in men. The study of diurnal PPTT variations have shown that night PPTT lower than day PPTT on 15-17%. We found gender PPTT differences: PPTT values in women 17-26% lower than in men. Analysis of individual eAb profiles has showed that elevated and high levels of eAb to β-endorphin, orphanin and histamine have 84%, 78%, 84% women and 82%, 85 and 95% men, respectively. These indicators higher than those for serotonin, dopamine and angiotensin (55%, 65%, 70% in women and 65%, 66%, 66% in men, respectively; p < 0.05). Dynamic study of eAb levels have shown a significant anti-histamine eAbs decrease (23%; p = 0.015) only., Conclusion: The pathological changes in pain sensitivity and levels of eAbs to pain-processing mediatos are evidenced. Further investigations are necessary to clarify to role of these variations in pain processing and for use these indicators for objective pain assessment.

Objective. To run complex investigations of patients with chronic reflex syndrome (CRS). Materials and methods. A total of 136 patients (70 women and 66 men) with chronic reflex syndrome were investigated. Pain was assessed on a visual analog scale (VAS) and levels of natural antibodies (n-Ab) to opioid peptides (β-endorphin and orphanin) and biogenic amines (dopamine and serotonin) were determined; surface electromyograms (sEMG) of the erector spinae muscle were recorded at the L3–L4 level on both sides. Parameters were measured at the beginning (day 1), in the middle (day 10), and end (day 21) of treatment. Results. Significant reductions in pain intensity (by 63% in women and 71% in men) were accompanied by 10–25% decreases in muscle tension in terms of group sEMG amplitude and by 34–38% in terms of individual dynamics of sEMG amplitude. Levels of n-Ab to all endogenous pain regulators were initially mostly elevated or high. Changes in n-Ab levels were in different directions. By the end of treatment (day 21), there were increases in the frequency of high levels of n-Ab to opioid peptides (39–41% of women and 33–39% of men) and normal levels of n-Ab to serotonin (in 52% of women and 59% of men). Levels of n-Ab to dopamine in women on day 21 were mainly normal (56% of subjects), while in men they were mostly elevated (in 50%) or high (in 17%). Conclusions. Changes in immunological measures did not correlate with pain intensity and evidently reflected pathological changes in neurohumoral interactions in chronic pain. Thus, monitoring of individual endogenous pain regulator n-Ab profiles in patients may have predictive value in assessing the further process of chronicization of pain status. [ABSTRACT FROM AUTHOR]