Lopes Revelino, Santos André, Gomes Teresa, Ribeiro Júlia, Rodrigues Ivone, Paiva Bruno, Nzwalo Isa, Catamo Deise, Baco Jamal, Buque Helena, Botelho Marta, Pais Sandra, Nzwalo Hipólito
Faculty of Medicine and Biomedical Sciences, University of Algarve, 8005-139 Faro, Portugal.
Faro Unit Hospital, Local Health Unit of Algarve, 8000-386 Faro, Portugal.
J Clin Med. 2025 May 27;14(11):3751. doi: 10.3390/jcm14113751.
Complex regional pain syndrome (CRPS) is a rare, chronic, painful, neurological, debilitating disorder. Despite the substantial impact on quality of life, diagnosis remains challenging due to its complex pathophysiology and subjective clinical criteria. This integrative review aims to synthesize current research on potential diagnostic biomarkers for CRPS. A systematic search was conducted using the PubMed and Scopus databases to identify relevant studies published until January 2025. Inclusion criteria focused on adult CRPS patients, with studies examining diagnostic or predictive biomarkers. Key findings highlight the role of inflammatory and immune-related biomarkers, such as elevated levels of cytokines (IL-6, TNF-α), immune cell infiltration, and specific autoantibodies. Neuropeptides, including substance P and calcitonin gene-related peptide, were associated with pain sensitization in acute phases, though their levels normalized in chronic stages. Additionally, genetic and epigenetic markers, brain imaging, and neurophysiological alterations provided insights into CRPS pathogenesis, emphasizing the dynamic nature of these biomarkers across disease stages. This review underscores the need for further research to integrate these biomarkers into diagnostic frameworks, which could enhance early diagnosis and treatment strategies for CRPS.
复杂性区域疼痛综合征（CRPS）是一种罕见的、慢性的、疼痛性的、神经性的、使人衰弱的疾病。尽管对生活质量有重大影响，但由于其复杂的病理生理学和主观的临床标准，诊断仍然具有挑战性。本综述旨在综合当前关于CRPS潜在诊断生物标志物的研究。使用PubMed和Scopus数据库进行了系统检索，以识别截至2025年1月发表的相关研究。纳入标准侧重于成年CRPS患者，研究检查诊断或预测性生物标志物。主要发现突出了炎症和免疫相关生物标志物的作用，如细胞因子（IL-6、TNF-α）水平升高、免疫细胞浸润和特定自身抗体。神经肽，包括P物质和降钙素基因相关肽，在急性期与疼痛敏化有关，尽管它们的水平在慢性期恢复正常。此外，基因和表观遗传标记、脑成像和神经生理改变为CRPS发病机制提供了见解，强调了这些生物标志物在疾病各阶段的动态性质。本综述强调需要进一步研究将这些生物标志物整合到诊断框架中，这可能会加强CRPS的早期诊断和治疗策略。
