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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

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Volume 19, Issue 3


Possible inflammatory pain biomarkers in postamputation pain

Nina Stockfleth Buch
  • Corresponding author
  • Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, building C319, Aarhus N, Denmark
  • Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark, Phone: +45 78464317
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Lone Nikolajsen
  • Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus N, Denmark
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Páll Karlsson
  • Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
  • Core Center for Molecular Morphology, Section for Stereology and Microscopy Aarhus University Hospital, Aarhus, Denmark
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2019-04-29 | DOI: https://doi.org/10.1515/sjpain-2019-0042


Although chronic pain after amputation is frequent, the underlying mechanisms are still not well understood. It is widely accepted that the pathogenesis of postamputation pain is multifactorial, with both peripheral and central mechanisms playing an essential role. However, recent studies suggest that the immune system plays an important role in different neuropathic pain conditions, including postamputation pain. Eleven amputees were included in this clinical study. Information on the type and intensity of spontaneous postamputation pain was obtained and evoked pain responses for brush, cold, and warm allodynia and pinprick hyperalgesia were determined. In addition, skin biopsies were taken from the amputated site and a contralateral control site and analysed for possible markers of pain: IbA1 (macrophages), calcitonin gene-related peptide (CGRP), and substance P (SP). Irrespectively of the type and intensity of postamputation pain, no differences were found in IbA1, CGRP, and SP levels between the amputated site and the control site. Although no differences between the sites were seen in this study, this new method seems promising for our understanding of skin changes in amputees. In future studies, staining for other cytokines and inflammatory mediators in skin biopsies could provide new insight into the mechanisms of postamputation pain.

Keywords: postamputation pain; inflammation; skin biopsies; substans P; calcitonin gene-related peptide; macrophages


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About the article

Received: 2019-03-11

Revised: 2019-03-20

Accepted: 2019-03-28

Published Online: 2019-04-29

Published in Print: 2019-07-26

Authors’ statements

Research funding: The study was funded by the Independent Research Fund Denmark (ID: DFF-4183-00311) and supported by the Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark. P. Karlsson is funded by the International Diabetic Neuropathy Consortium (IDNC), which is supported by a Novo Nordisk Foundation Challenge Programme grant (NNF14OC0011633) and a research grant by the Novo Nordisk Foundation (NNF18OC0052301).

Conflict of interest: L. Nikolajsen has previously received honoraria for serving on Grünenthal advisory boards and speakers’ panels. P. Karlsson receives honoraria for consultancy for Grünenthal, unrelated to this work. N. Buch has no conflict of interest to declare.

Informed consent: Informed consent has been obtained from all individuals included in this study.

Ethical approval: The study got ethical approval from the Regional Research Ethics Committee of Central Denmark and the Danish Data Protection Agency.

Author’s contributions: All authors contributed to planning of the study, interpretation of results, and writing of the manuscript. Nina Buch examined the patients and took the skin biopsies, and Páll Karlsson stained and analysed the skin biopsies.

Citation Information: Scandinavian Journal of Pain, Volume 19, Issue 3, Pages 623–627, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1515/sjpain-2019-0042.

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©2019 Scandinavian Association for the Study of Pain. Published by Walter de Gruyter GmbH, Berlin/Boston. All rights reserved..Get Permission

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