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|Title:||Association between lymphocyte expression of the apoptotic receptor Fas and pain in critically ill patients||Authors:||Papathanassoglou, Elizabeth
Giannakopoulou, Margarita D.
Tsiaousis, George Z.
Karabinis, Andreas P.
|Keywords:||Adrenocorticotropic hormone;Cortisol;Critical illness;Lymphocyte apoptosis;Pain;Substance P||Category:||Health Sciences||Field:||Medical and Health Sciences||Issue Date:||13-Jan-2017||Publisher:||Dove Medical Press Ltd.||Source:||Journal of Pain Research, 2017, Volume 10, Pages 175-181||DOI:||10.2147/JPR.S118105||Abstract:||Objective: Lymphocyte apoptosis in critical illness is associated with immunosuppression. We explored for the first time the associations between pain ratings and expression of the apoptotic receptor Fas on B and T cells in critically ill patients and the potential mediating effects of adrenocorticotropic hormone (ACTH), cortisol, and substance P (SP). Design: This is an exploratory correlational study with repeated measurements (14 days followup) and cross-sectional comparisons. Setting: This study was conducted in a state hospital in the metropolitan area of Athens, Greece. Participants: The participants were 36 consecutive critically ill patients and 36 matched controls. Outcome measures: Pain measured by the self-reported numeric rating scale [NRS], the behavioral pain scale, and the pain assessment scale was the primary outcome measure. Flow cytometry (Fas), electrochemiluminescence (ACTH and cortisol) and enzyme-linked immunosorbent assay (SP) were used. Mixed linear models for repeated measurements and bivariable associations at discrete time points were employed. Results: Significant pain at rest was noted. Pain ratings associated with Fas expression on cytotoxic T cells (P=0.041) and B cells (P=0.005), even after adjustment for a number of clinical treatment factors (P=0.006 and P=0.052, respectively). On the day that more patients were able to communicate, Fas on B cells (r=0.897, P=0.029) and cytotoxic T cells (r=0.832; P=0.037) associated with NRS ratings. Associations between pain ratings and ACTH serum levels were noted (P<0.05). When stress neuropeptide levels were added to the model, the statistical significance of the associations between pain ratings and Fas expression was attenuated (P=0.052–0.063), suggesting that stress neuropeptides may partially mediate the association. Conclusion: Preliminary evidence for the association between pain and lymphocyte apoptotic susceptibility is provided. The role of pain management in maintaining immunocompetence in critical illness is worth exploring.||URI:||http://ktisis.cut.ac.cy/handle/10488/10068||ISSN:||11787090||Rights:||© 2017 Papathanassoglou et al.||Type:||Article|
|Appears in Collections:||Άρθρα/Articles|
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