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Colman M, Syx D, De Wandele I, Rombaut L, Wille D, Malfait Z, Meeus M, Malfait AM, Van Oosterwijck J, Malfait F. Sensory Profiling in Classical Ehlers-Danlos Syndrome: A Case-Control Study Revealing Pain Characteristics, Somatosensory Changes, and Impaired Pain Modulation. J Pain 2023; 24:2063-2078. [PMID: 37380025 DOI: 10.1016/j.jpain.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
Pain is one of the most important yet poorly understood complaints in heritable connective tissue disorders (HCTDs) caused by monogenic defects in extracellular matrix molecules. This is particularly the case for the Ehlers-Danlos syndrome (EDS), paradigm collagen-related disorders. This study aimed to identify the pain signature and somatosensory characteristics in the rare classical type of EDS (cEDS) caused by defects in type V or rarely type I collagen. We used static and dynamic quantitative sensory testing and validated questionnaires in 19 individuals with cEDS and 19 matched controls. Individuals with cEDS reported clinically relevant pain/discomfort (Visual Analogue Scale ≥5/10 in 32% for average pain intensity the past month) and worse health-related quality of life. An altered somatosensory profile was found in the cEDS group with higher (P = .04) detection thresholds for vibration stimuli at the lower limb, indicating hypoesthesia, reduced thermal sensitivity with more (P < .001) paradoxical thermal sensations (PTSs), and hyperalgesia with lower pain thresholds to mechanical (P < .001) stimuli at both the upper and lower limbs and cold (P = .005) stimulation at the lower limb. Using a parallel conditioned pain modulation paradigm, the cEDS group showed significantly smaller antinociceptive responses (P-value .005-.046) suggestive of impaired endogenous pain modulation. In conclusion, individuals with cEDS report chronic pain and worse health-related quality of life and present altered somatosensory perception. This study is the first to systematically investigate pain and somatosensory characteristics in a genetically defined HCTD and provides interesting insights into the possible role of the ECM in the development and persistence of pain. PERSPECTIVE: Chronic pain compromises the quality of life in individuals with cEDS. Moreover, an altered somatosensory perception was found in the cEDS group with hypoesthesia for vibration stimuli, more PTSs, hyperalgesia for pressure stimuli, and impaired pain modulation.
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Affiliation(s)
- Marlies Colman
- Center for Medical Genetics, Ghent University Hospital, Ghent, East Flanders, Belgium; Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, East Flanders, Belgium; Pain in Motion International Research Consortium, Belgium
| | - Delfien Syx
- Center for Medical Genetics, Ghent University Hospital, Ghent, East Flanders, Belgium; Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, East Flanders, Belgium
| | - Inge De Wandele
- Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, East Flanders, Belgium
| | - Lies Rombaut
- Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, East Flanders, Belgium
| | - Deborah Wille
- Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, East Flanders, Belgium
| | - Zoë Malfait
- Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, East Flanders, Belgium
| | - Mira Meeus
- Pain in Motion International Research Consortium, Belgium; Spine, Head and Pain Research Unit Ghent, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, East Flanders, Belgium
| | - Anne-Marie Malfait
- Department of Internal Medicine, Division of Rheumatology, Rush University Medical Center, Chicago, Illinois
| | - Jessica Van Oosterwijck
- Pain in Motion International Research Consortium, Belgium; Spine, Head and Pain Research Unit Ghent, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, East Flanders, Belgium
| | - Fransiska Malfait
- Center for Medical Genetics, Ghent University Hospital, Ghent, East Flanders, Belgium; Department of Biomolecular Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, East Flanders, Belgium
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Wille D, Bredehorn-Mayr T, Nitschke FP, Duncker GIW. Die Auswirkungen des Inkrafttretens des neuen Gewebegesetzes auf die Hornhautspende am Beispiel der Mitteldeutschen Corneabank Halle (MCH) – Update 2010. Klin Monbl Augenheilkd 2010. [DOI: 10.1055/s-0030-1267557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Bredehorn T, Wille D, Duncker GIW. Die Auswirkungen des Inkrafttretens des neuen Gewebegesetzes auf die Hornhautspende am Beispiel der Mitteldeutschen Corneabank Halle. Klin Monbl Augenheilkd 2008. [DOI: 10.1055/s-0028-1096418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pötzsch B, Grulich-Henn J, Rössing R, Wille D, Müller-Berghaus G. Identification of endothelial and mesothelial cells in human omental tissue and in omentum-derived cultured cells by specific cell markers. J Transl Med 1990; 63:841-52. [PMID: 1701509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Human omental tissue has been used as a source for the isolation and cultivation of microvascular endothelial cells, but also for mesothelial cells. Since both cell types have several morphologic and functional features in common, concerns were raised whether endothelial cells can be separated from mesothelial cells by the methods described for the isolation of microvascular endothelial cells. In the present study, endothelial cells were identified in the capillaries of native human omentum by several endothelial-cell specific markers. von Willebrand factor was demonstrated by polyclonal and monoclonal antibodies, a lectin-specific ligand by Ulex europaeus I, and an endothelial-cell specific surface epitope by the monoclonal antibody, PAL-E. These markers were not found positive with mesothelial cells of native omentum. Mesothelial cells were identified by monoclonal antibodies against the intermediate filaments, cytokeratin and vimentin. After having demonstrated the specificity of the methods for the distinction between endothelial and mesothelial cells within native omentum, these methods were applied to omentum-derived cells previously claimed to be microvascular endothelial cells. These cultured cells proved to be negative for von Willebrand factor, Ulex europaeus I ligand and PAL-E epitope. In contrast to this, the cultivated cells stained positive to cytokeratin and vimentin. Furthermore, it was shown by immunoprecipitation studies that omentum-derived cells did not synthesize and secrete vWF, indicating the nonendothelial nature of these cells. Finally, electron microscopy demonstrated microvilli on the surface of cultivated omentum-derived cells indicative for the mesothelial origin of these cells. The data presented demonstrate that the cells obtained using the previously published methods for the isolation and cultivation of "microvascular endothelial cells" from omental tissue are of mesothelial and not of endothelial origin. Thus, a great number of data obtained with this type of omentum-derived cells thought to be microvascular endothelial cells need re-evaluation.
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Affiliation(s)
- B Pötzsch
- Clinical Research Unit for Blood Coagulation and Thrombosis, Max-Planck-Gesellschaft, Giessen, West Germany
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