Cerebrospinal fluid interleukin 8 concentrations and the subsequent development of postherpetic neuralgia

• Published in: The American journal of medicine Vol. 116; no. 5; pp. 318 - 324
• Main Authors: Kotani, Naoki, Kudo, Ryoko, Sakurai, Yutaka, Sawamura, Daisuke, Sessler, Daniel I, Okada, Hiroshi, Nakayama, Hiroto, Yamagata, Toshifumi, Yasujima, Minoru, Matsuki, Akitomo
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2004; Elsevier; Elsevier Sequoia S.A
• Subjects: Aged; Biological and medical sciences; Biomarkers - cerebrospinal fluid; Body fluids; Cranial nerves. Spinal roots. Peripheral nerves. Autonomic nervous system. Gustation. Olfaction; Cytokines; Diagnostic tests; Female; General aspects; Herpes viruses; Herpes Zoster - cerebrospinal fluid; Herpes Zoster - complications; Herpes Zoster - drug therapy; Humans; Interleukin-8 - cerebrospinal fluid; Logistic Models; Male; Medical research; Medical sciences; Nervous system; Nervous system (semeiology, syndromes); Neuralgia - cerebrospinal fluid; Neuralgia - diagnosis; Neuralgia - virology; Neurology; Pain; Pain Measurement; Risk Factors; ROC Curve; Medicine; Nervous system diseases; Pain; Angiogenic factor; Cytokine; Development; Concentration; Cerebrospinal fluid; Neuralgia; Neurological disorder; Interleukin 8
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2003.10.027

Other than age, the risk factors for postherpetic neuralgia are not well established. We studied whether the concentration of interleukin 8 in the cerebrospinal fluid is associated with the risk of postherpetic neuralgia. We enrolled 170 patients more than 50 years old who had a typical painful and nontrigeminal herpetic rash. Patients were treated with acyclovir; no corticosteroids were given. Cerebrospinal fluid was taken for analysis of interleukin 8 during and at full crusting of the herpetic rash. Age, sex, comorbid conditions, prodromal pain, localization and severity of herpetic rash, number of skin lesions, and degree of pain were recorded. We used multivariate logistic regression modeling to identify significant predictive factors. Receiver operating characteristic (ROC) curves were evaluated to determine the contribution of each factor. Six months after healing, 31 patients (18%) had postherpetic neuralgia; 27 patients still had it after 1 year. Only three variables—age (odds ratio [OR] = 2.7 per 10-year increase; 95% confidence interval [CI]: 1.2 to 6.2), acute pain (OR = 1.8 per unit increase in visual analog scale; 95% CI: 1.2 to 2.8), and interleukin 8 concentration in the cerebrospinal fluid at full crusting of the herpetic rash (OR = 1.6 per 20-μg/L increase; 95% CI: 1.3 to 2.0)—were significant predictors of postherpetic neuralgia at 1 year. Interleukin 8 concentration also had the highest area under the ROC curve at these evaluation points ( P <0.001). Our results suggest that interleukin 8 concentration in the cerebrospinal fluid at full crusting of herpetic rash may be useful for identifying patients who are likely to develop intractable postherpetic neuralgia.