| Background and Objective:PHN(postherpetic neuralgia) is one of the most common complications of HZ(herpes zoster) and often refractory to treatment. It was clear that the agent of PHN was VZV, but not clear how VZV to develop PHN. The rencent studies showed that PHN might be a neuropathic pain syndrome that was based on pathologic changes of the nerve system, and this made it possible to discuss the relationship between infection of virus and injury of never system, so deep study on this was not only advantaged to prevent and cure PHN, but also to provide theory evidence for study on the relationship between a latent infection of virus and its related diseases of nerve system in the future.PHN has the cardinal clinical features of all neuropathic pain syndromes including sensory abnormalities, ongoing pain, allodynia(touch-induced pain) and so on; using autopsies, skin biopsies,quantitative functional testing of primary afferent nerve, a few of scholars discovered that there were lots of pathologic changes in the central and/or peripheral parts of sensory nerve system. Although the above proofs suggested that it was more possible for PHN to be a neuropathic pain than others, the opinions about how these pathologic changes contribute to PHN didn't reach a coincidence among the scholars abroad. From the facts that not all PHN patients were sensitive to some normal remedies and that the clinic symptoms of these patients were different, we could guess that more than one mechanisms contributed to PHN. In this study, using thermal quantitative testing we identified whether or not there are sensory deficits in PHN patients, and obtained informatiion about the magnitude of thermal sensory deficits and its relationship with the painful intensity in PHN patients, and discussed whether there were multi- mechanisms in different PHN patients.From the facts that older people dominated PHN and that the reactivation and duplication of VZV was also common in older people, we supposed that PHN patients had persistent reactivation and duplication of VZV, so using PCR and Southern Blot methods, we would detecte VZV in PBMC of PHN patients and identify the relationship between PHN and VZV, and at last discuss the effect that persistent reactivation and duplication of VZV have on the injury of the nerve systemThe geriatrician would appear more easily immune disregulated states, such as cytokine disorder. The recent studies showed that over-expression IL-6 had caused so severe a neural damage that it could take part in developments of many kinds of acute or chronic neurological diseases, so we guessed that high level IL-6 had an important function on thedevelopment of PHN by causing the chronic damage of nerve system. In this study, we tried to discuss this assumption by identifying the serum level of IL-6 and its relationship with PHN. Method:Sixty-two subjects (including 38 HZ and 24 PHN) were collected from the out-patient clinic(OPC) of the department of dermatology in the first affiliated hospital of Chongqing medical university. There were 17 males and 21 females in HZ and the mean age was 52.35+17.47 years. These patients had been followed up for more than one mouth after healing of rash. There were 16 males and 8 females in PHN patients whose mean age was 65.56+9.55 years and who were composed of 16 allodynia and 8 spontaneous pain. In this study, Nested PCR and Southern blot methods were used to identify viral infection of peripheral blood mononuclear cells(PBMC); TSA-2001 was used to measure the thresholds of a series of thermal sensories in rash or mirror-image skin; enzyme-linked immunoadsordent assay(ELISA) was used to measure the amount of serum IL-6. Result:1 One of 38 patients of HZ had suffered from PHN which was characterized as allodynia, while the others hadn't.2 There were higher thresholds of CS and WS for rash or pain skin than for mirror-image area in patients of acute zoster and PHN, but there were no difference of the thermal thresholds between pain skin... |
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