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A clinical study exploring hip and knee osteoarthritis pain transmission using cerebrospinal fluid

Swift, Amelia (2012)
Ph.D. thesis, University of Birmingham.

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Background: Osteoarthritis affects approximately 40% of older adults but molecular mediation of OA pain in the dorsal horn is unexplored clinically. This study explored amino acids and cytokines related to pain signalling and sensitisation to determine whether significant differences existed in their concentration in comparison with pain-free controls after adjustment for age, gender and psychological distress.
Method: After ethical approval people having primary hip or knee arthroplasty (OA group) or urological surgery (pain-free controls) were recruited. Pain at rest, (PAR), pain on movement (POM) (0-10 numerical rating scale), and HADS data was collected before aspiration of 2ml sample of CSF. HPLC and multiplex bead array assay was conducted and data explored using ANCOVA and logistic regression.
Results: Data from 21 control (75% male) and 59 OA (46% male) participants revealed that HADS, serine, leucine, valine, and TNFα were significantly higher and IL-12 was significantly lower in the OA group. IFNγ was significantly lower in the PAR group.
Discussion: This study suggests central sensitisation is involved in OA. Psychological distress is an integral part of the OA experience. Amino acid and cytokine involvement in pain transmission is complex; further work exploring human CSF in painful conditions with clinical follow up is recommended.

Type of Work:Ph.D. thesis.
Supervisor(s):Metcalfe, Alison and Clifford, Collette
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:Department of Medical and Dental Sciences
Subjects:R Medicine (General)
RD Surgery
Institution:University of Birmingham
ID Code:3691
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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