The Correlation Among The Expression Levels Of Serum Ninjurin 2,Degree Of Neurologic Damage And Postherpetic Neuralgia Occurrence In Patients With Herpes Zoster

BackgroundHerpes zoster is a painful and disabling disease.It is caused by the reactivation of latent varicella-zoster virus in sensory ganglia.Its typical features are pain,blistering rash.8%to 27%of patients,acute herpes zoster rash will occur after 6 months to reach more than 10 levels of pain,which is defined as postherpetic neuralgia.Herpes zoster neuralgia is the most common complication of herpes zoster,which can cause severe pain.Neuropathic pain often profoundly affects the quality of life of patients and may lead to physical disability,emotional distress and social isolation.Now there is no effective improvement in disease therapy.The treatment goal is symptomatic control,but usually not enough to relieve pain.This review summarizes the definition,epidemiology,pathology,clinical features and treatment of postherpetic neuralgia.As an effective prevention strategy,it is important to understand the predictors of postherpetic neuralgia for the ability of physicians to identify and conduct early prevention of postherpetic neuralgia risk.ObjectivesPostherpetic neuralgia(PHN)is the most common complication of herpeszoster(HZ)infection.The study aimed to explore whether serum Ninjurin 2(nerve injury-induced protein 2,NINJ 2),a novel neurologic damage related protein,which is associated with nerve injury and the occurrence of PHN.MethodsEighty individuals with acute herpetic neuralgia(AHN)and 60 controls were recruited.The following nerve injury testing was performed on all of the patients including:the numerical rating scale(NRS)test,quantitative sensory testing(QST),and the investigation of serum NINJ 2 level on the 7th day of AHN.In addition,all of the patients repeated all of the items at 6 months after herpes.ResultsSeventy-four of the eighty patients completed the study.On the 7th day of AHN,the patients had significantly higher values of NINJ 2,cold-sense dispersion(?CS),warm-sense dispersion(?WS),cold-pain dispersion(?CP),heat-pain dispersion(?HP)and NRS score compared with controls.Six months after herpes,thirty four patients developed PHN.The values of serum NINJ 2,?CS,?WS,?ACP and AHP in PHN patients remained higher than that in the controls and the non-PHN patients.The PHN patients had significantly lower values of serum NINJ 2 than non-PHN patients in the period of AHN.With partial correlations and multivariable logistic regressions,serum NINJ2 level was strongly predictive of PHN.ConclusionsThe serum NINJ2 levels are associated with nerve injury,particularly nerve recovery,and may be predictors of PHN occurrence.