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. 1995 Apr;54(4):251–255. doi: 10.1136/ard.54.4.251

Assessment of cutaneous sensory and autonomic axon reflexes in rheumatoid arthritis.

V A Jolliffe 1, P Anand 1, B L Kidd 1
PMCID: PMC1005569  PMID: 7763100

Abstract

OBJECTIVE--To assess sensory function in skin overlying the joints of patients with rheumatoid arthritis, in relation to the pain and tenderness which commonly arises in structures not directly involved in the inflammatory process. METHODS--An intradermal injection of capsaicin 0.05 microgram in 10 microliters was made over the wrists and forearms of 40 patients with rheumatoid arthritis and 46 control subjects. Axon reflex vasodilatation was measured using laser Doppler flowmetry. Cholinergic sympathetic function was assessed by measuring axon reflex sweating induced by a single intradermal injection of nicotine 0.5 microgram in 0.1 ml. RESULTS--Capsaicin induced axon reflex vasodilation over the wrists was found to decrease with age in normal subjects (r = -0.62, p < 0.001). In patients with rheumatoid arthritis, capsaicin induced axon reflex vasodilatation was significantly greater over the wrists, but not the forearms, when compared with age matched normal controls (p < 0.01). A minimal correlation between axon reflex vasodilatation and visual analogue pain score was apparent in the rheumatoid group (r = -0.37, p < 0.05). Nicotine induced sweating responses were similar in the rheumatoid and normal groups, and both showed a linear age related decline. CONCLUSIONS--The results show a selective increase of capsaicin induced vasodilatation in skin overlying joints in patients with rheumatoid arthritis. This suggests that the activity of a sub-population of periarticular small sensory fibres is altered, which may explain, at least in part, some of the clinical findings in this disorder.

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Selected References

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  1. Aloe L., Tuveri M. A., Carcassi U., Levi-Montalcini R. Nerve growth factor in the synovial fluid of patients with chronic arthritis. Arthritis Rheum. 1992 Mar;35(3):351–355. doi: 10.1002/art.1780350315. [DOI] [PubMed] [Google Scholar]
  2. Anand P., Rudge P., Mathias C. J., Springall D. R., Ghatei M. A., Naher-Noe M., Sharief M., Misra V. P., Polak J. M., Bloom S. R. New autonomic and sensory neuropathy with loss of adrenergic sympathetic function and sensory neuropeptides. Lancet. 1991 May 25;337(8752):1253–1254. doi: 10.1016/0140-6736(91)92921-n. [DOI] [PubMed] [Google Scholar]
  3. Arnett F. C., Edworthy S. M., Bloch D. A., McShane D. J., Fries J. F., Cooper N. S., Healey L. A., Kaplan S. R., Liang M. H., Luthra H. S. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988 Mar;31(3):315–324. doi: 10.1002/art.1780310302. [DOI] [PubMed] [Google Scholar]
  4. BENNETT P. H., SCOTT J. T. AUTONOMIC NEUROPATHY IN RHEUMATOID ARTHRITIS. Ann Rheum Dis. 1965 Mar;24:161–168. doi: 10.1136/ard.24.2.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. COLLINS K. J., WEINER J. S. Axon reflex sweating. Clin Sci. 1961 Dec;21:333–344. [PubMed] [Google Scholar]
  6. Cervero F., Gilbert R., Hammond R. G., Tanner J. Development of secondary hyperalgesia following non-painful thermal stimulation of the skin: a psychophysical study in man. Pain. 1993 Aug;54(2):181–189. doi: 10.1016/0304-3959(93)90207-6. [DOI] [PubMed] [Google Scholar]
  7. Coggeshall R. E., Hong K. A., Langford L. A., Schaible H. G., Schmidt R. F. Discharge characteristics of fine medial articular afferents at rest and during passive movements of inflamed knee joints. Brain Res. 1983 Aug 1;272(1):185–188. doi: 10.1016/0006-8993(83)90379-7. [DOI] [PubMed] [Google Scholar]
  8. Donnerer J., Schuligoi R., Stein C. Increased content and transport of substance P and calcitonin gene-related peptide in sensory nerves innervating inflamed tissue: evidence for a regulatory function of nerve growth factor in vivo. Neuroscience. 1992 Aug;49(3):693–698. doi: 10.1016/0306-4522(92)90237-v. [DOI] [PubMed] [Google Scholar]
  9. HART F. D., GOLDING J. R., MACKENZIE D. H. Neuropathy in rheumatoid disease. Ann Rheum Dis. 1957 Dec;16(4):471–480. doi: 10.1136/ard.16.4.471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Helme R. D., Littlejohn G. O., Weinstein C. Neurogenic flare responses in chronic rheumatic pain syndromes. Clin Exp Neurol. 1987;23:91–94. [PubMed] [Google Scholar]
  11. Helme R. D., McKernan S. Neurogenic flare responses following topical application of capsaicin in humans. Ann Neurol. 1985 Oct;18(4):505–509. doi: 10.1002/ana.410180414. [DOI] [PubMed] [Google Scholar]
  12. Holzer P. Capsaicin: cellular targets, mechanisms of action, and selectivity for thin sensory neurons. Pharmacol Rev. 1991 Jun;43(2):143–201. [PubMed] [Google Scholar]
  13. Holzer P. Local effector functions of capsaicin-sensitive sensory nerve endings: involvement of tachykinins, calcitonin gene-related peptide and other neuropeptides. Neuroscience. 1988 Mar;24(3):739–768. doi: 10.1016/0306-4522(88)90064-4. [DOI] [PubMed] [Google Scholar]
  14. Hornyak M. E., Naver H. K., Rydenhag B., Wallin B. G. Sympathetic activity influences the vascular axon reflex in the skin. Acta Physiol Scand. 1990 May;139(1):77–84. doi: 10.1111/j.1748-1716.1990.tb08899.x. [DOI] [PubMed] [Google Scholar]
  15. Jancsó G., Janka Z. A simple test for topographical diagnosis of sensory nervous system lesions. Eur Neurol. 1981;20(2):84–87. doi: 10.1159/000115212. [DOI] [PubMed] [Google Scholar]
  16. Jancsó N., Jancsó-Gábor A., Szolcsányi J. Direct evidence for neurogenic inflammation and its prevention by denervation and by pretreatment with capsaicin. Br J Pharmacol Chemother. 1967 Sep;31(1):138–151. doi: 10.1111/j.1476-5381.1967.tb01984.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. KALLIOMAKI J. L., SAARIMAA H. A., TOIVANEN P. Axon reflex sweating in rheumatoid arthritis. Ann Rheum Dis. 1963 Jan;22:46–49. doi: 10.1136/ard.22.1.46. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. LeVasseur S. A., Gibson S. J., Helme R. D. The measurement of capsaicin-sensitive sensory nerve fiber function in elderly patients with pain. Pain. 1990 Apr;41(1):19–25. doi: 10.1016/0304-3959(90)91104-Q. [DOI] [PubMed] [Google Scholar]
  19. Leden I., Eriksson A., Lilja B., Sturfelt G., Sundkvist G. Autonomic nerve function in rheumatoid arthritis of varying severity. Scand J Rheumatol. 1983;12(2):166–170. doi: 10.3109/03009748309102905. [DOI] [PubMed] [Google Scholar]
  20. Lindsay R. M., Harmar A. J. Nerve growth factor regulates expression of neuropeptide genes in adult sensory neurons. Nature. 1989 Jan 26;337(6205):362–364. doi: 10.1038/337362a0. [DOI] [PubMed] [Google Scholar]
  21. Low P. A., Caskey P. E., Tuck R. R., Fealey R. D., Dyck P. J. Quantitative sudomotor axon reflex test in normal and neuropathic subjects. Ann Neurol. 1983 Nov;14(5):573–580. doi: 10.1002/ana.410140513. [DOI] [PubMed] [Google Scholar]
  22. Lynn B. Capsaicin: actions on nociceptive C-fibres and therapeutic potential. Pain. 1990 Apr;41(1):61–69. doi: 10.1016/0304-3959(90)91110-5. [DOI] [PubMed] [Google Scholar]
  23. Mani R., Cooper C., Kidd B. L., Cole J. D., Cawley M. I. Use of laser Doppler flowmetry and transcutaneous oxygen tension electrodes to assess local autonomic dysfunction in patients with frozen shoulder. J R Soc Med. 1989 Sep;82(9):536–538. doi: 10.1177/014107688908200910. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Parkhouse N., Le Quesne P. M. Quantitative objective assessment of peripheral nociceptive C fibre function. J Neurol Neurosurg Psychiatry. 1988 Jan;51(1):28–34. doi: 10.1136/jnnp.51.1.28. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Schaible H. G., Grubb B. D. Afferent and spinal mechanisms of joint pain. Pain. 1993 Oct;55(1):5–54. doi: 10.1016/0304-3959(93)90183-P. [DOI] [PubMed] [Google Scholar]
  26. Schaible H. G., Schmidt R. F. Effects of an experimental arthritis on the sensory properties of fine articular afferent units. J Neurophysiol. 1985 Nov;54(5):1109–1122. doi: 10.1152/jn.1985.54.5.1109. [DOI] [PubMed] [Google Scholar]
  27. Schaible H. G., Schmidt R. F. Time course of mechanosensitivity changes in articular afferents during a developing experimental arthritis. J Neurophysiol. 1988 Dec;60(6):2180–2195. doi: 10.1152/jn.1988.60.6.2180. [DOI] [PubMed] [Google Scholar]
  28. Simone D. A., Baumann T. K., LaMotte R. H. Dose-dependent pain and mechanical hyperalgesia in humans after intradermal injection of capsaicin. Pain. 1989 Jul;38(1):99–107. doi: 10.1016/0304-3959(89)90079-1. [DOI] [PubMed] [Google Scholar]
  29. Wisden W., Morris B. J., Darlison M. G., Hunt S. P., Barnard E. A. Distinct GABAA receptor alpha subunit mRNAs show differential patterns of expression in bovine brain. Neuron. 1988 Dec;1(10):937–947. doi: 10.1016/0896-6273(88)90151-1. [DOI] [PubMed] [Google Scholar]

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