Pioneering research at a number of universities, including the University of Liverpool in the UK, has led to a potential breakthrough in the treatment of severe, longstanding and seemingly therapy-resistant CRPS.
Investigating whether an autoimmune mechanism was responsible for causing CRPS, researchers found a high incidence of auto-antibodies in people suffering CRPS. These auto-antibodies alter sensory nerve function in the peripheral nervous system, strongly suggesting that auto-antibodies are contributing to CRPS.
Plasma Exchange Therapy
Noting these results, researchers treated CRPS patients with Plasma Exchange Therapy. During Plasma Exchange, blood is extracted through a vein in the patient’s arm. The blood is separated by a machine into its constituent parts and the abnormal blood plasma removed, a process known as apheresis. The plasma is then replaced by a substitute before the blood is returned to the patient’s body through a vein in the other arm. In this way, auto-antibody serum levels can be significantly reduced.
Whilst not a cure, many, although not all, participants achieved a significant reduction in pain. The average (median) reduction in pain was 64% and a number of those participants have continued to receive maintenance therapy which has maintained their levels of pain relief. The levels of pain in those original participants not receiving maintenance therapy has returned to pre-treatment levels.
A word of caution
So far the number of participants in the trials has been limited and the trials themselves have not been blind or randomised. However, lead researcher and world renowned expert in CRPS, Dr Andreas Goebel, said:
“This is a fantastic example of how translational research can achieve benefit for patients; our work has highlighted, that peculiar autoimmune processes can cause severe chronic pain, without causing tissue destruction.
“A lot of work is still required. We need additional trials. We would also like to find ways to treat patients effectively with a simple oral drug, or an injection. It is rewarding to see, that as a result of this work patients around the world with unrelenting, severe pain can benefit.”
As a result of this groundbreaking work, the American Society for Apheresis (ASFA) has included CRPS on the list of conditions that may benefit from Plasma Exchange.
Further Reading: https://www.ncbi.nlm.nih.gov/pubmed/26218942
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