Brain-Derived Neurotrophic Factor and Immune Cells in Osteoarthritis, Chronic Low Back Pain, and Chronic Widespread Pain Patients: Association with Anxiety and Depression.

Background and Objectives: Musculoskeletal dysfunction can induce several types of chronic pain syndromes. It is of particular interest to elucidate the pathomechanism of different forms of chronic pain. It is possible that patients who have developed chronic widespread pain (CWP) may endure different pathomechanisms as compared to those who suffer from local pain (osteoarthritis, OA) and regional pain (chronic low back pain, cLBP), especially with regard to pain regulation and its related biomediators. The aim of this study was to determine the differences in pathomechanisms among these patients by measuring pain-related biomediators, particularly brain-derived neurotrophic factor (BDNF). Additionally, subpopulations of immune cells were determined in parallel. Materials and Methods: Patients and healthy subjects (HSs) were recruited (age and gender-matched). BDNF was measured from serum samples of patients and HSs and the data of body composition parameters were recorded. Additionally, both patients and HSs were asked to fill in questionnaires related to pain intensity, anxiety, and depression. Results: Our results highlight that the levels of both free and total BDNF are significantly lower in pain patients compared to HSs, with p values of 0.041 and 0.024, respectively. The number of CD3- CD56bright natural killer (NK) cells shows significant differences between the groups. Comparing all chronic pain patients with HSs reveals a significantly lower number of CD4+ CD8+ T cells (p = 0.031), CD3- CD56bright NK cells (p = 0.049) and CD20+ CD3- cells (p = 0.007). Conclusions: To conclude, it seems that a general conformity between the pathomechanisms of different chronic pain diseases exists, although there are unique findings only in specific chronic pain patients.

17-1 CO2- and H2S-balneotherapy: facts and future directions / 日本温泉気候物理医学会雑誌

  In the literature relevant knowledge is available about the properties and physiological effects of CO2 and H2S. Both gases penetrate the skin easily and increase microcirculation of the skin. Additionally, effects on thermal receptors (CO2) and pain perception (H2S) have been demonstrated in several trials. Other effects of H2S refer to a modulation of immune cells. From this knowledge indications and contraindications may be derived. However, there is a need for prospective controlled trials to prove the efficacy of such treatments. Future directions and perspectives of research using these balneological remedies will be discussed.

13-5 Balneotherapy and rehabilitation: differences, similarities and synergies / 日本温泉気候物理医学会雑誌

  Balneotherapy is defined as a group of treatment modalities using natural remedies. The term also is used to describe complex multimodal interventions for the prevention, treatment and rehabilitation of (chronic) health conditions. The use of the term rehabilitation also is dual: on one hand it is used for a health strategy to overcome disability and to improve functioning. On the other hand it is defined as a set of measures used in multidisciplinary teams. Thus, the definitions of balneotherapy and rehabilitation are different but have some overlap too. It needs to be discussed, how balneotherpy can be used for rehabilitation of chronic health conditions and what the evidence of the added value is. Secondly, the tradition of comprehensive treatments in health resorts should be analysed using the criteria of rehabilitation measures and also here the added value must be demonstrated.

13-5Balneotherapy and rehabilitation: differences, similarities and synergies / 日本温泉気候物理医学会雑誌

  Balneotherapy is defined as a group of treatment modalities using natural remedies. The term also is used to describe complex multimodal interventions for the prevention, treatment and rehabilitation of (chronic) health conditions. The use of the term rehabilitation also is dual: on one hand it is used for a health strategy to overcome disability and to improve functioning. On the other hand it is defined as a set of measures used in multidisciplinary teams. Thus, the definitions of balneotherapy and rehabilitation are different but have some overlap too. It needs to be discussed, how balneotherpy can be used for rehabilitation of chronic health conditions and what the evidence of the added value is. Secondly, the tradition of comprehensive treatments in health resorts should be analysed using the criteria of rehabilitation measures and also here the added value must be demonstrated.

17-1CO₂- and H₂S-balneotherapy: facts and future directions / 日本温泉気候物理医学会雑誌

  In the literature relevant knowledge is available about the properties and physiological effects of CO₂ and H₂S. Both gases penetrate the skin easily and increase microcirculation of the skin. Additionally, effects on thermal receptors (CO₂) and pain perception (H₂S) have been demonstrated in several trials. Other effects of H₂S refer to a modulation of immune cells. From this knowledge indications and contraindications may be derived. However, there is a need for prospective controlled trials to prove the efficacy of such treatments. Future directions and perspectives of research using these balneological remedies will be discussed.