Abstract：
:Complex Regional Pain Syndrome (CRPS) has defied a clear unified pathological explanation to date. Not surprisingly, treatments for the condition are limited in number, efficacy and their ability to enact a cure. Whilst many observations have been made of physiological abnormalities, how these explain the condition and who does and doesn't develop CRPS remains unclear. We propose a new overarching hypothesis to explain the condition that invokes four dynamically changing and interacting components of tissue trauma, pathological pain processing, autonomic dysfunction (both peripheral and central) and immune dysfunction, primarily involving excessive and pathological activation of dendritic cells following trauma or atrophy. We outline pathophysiological changes that may initiate a cascade of events involving dendritic cells and the cholinergic anti-inflammatory pathway resulting in the condition, and the changes that maintain the condition into its chronic phase. This hypothesis should provide fertile ground for further investigations and development of new treatments that holistically address the nature of the disorder along its developmental continuum.
journal_name
Med Hypothesesjournal_title
Medical hypothesesauthors
Russo M,Georgius P,Santarelli DMdoi
10.1016/j.mehy.2018.07.026subject
Has Abstractpub_date
2018-10-01 00:00:00pages
41-53eissn
0306-9877issn
1532-2777pii
S0306-9877(18)30566-8journal_volume
119pub_type
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