Evidence for local inflammation in complex regional pain syndrome type 1.

BACKGROUND: The pathophysiology of complex regional pain syndrome type 1 (CRPS 1) is still a matter of debate. Peripheral afferent, efferent and central mechanisms are supposed. Based on clinical signs and symptoms (e.g. oedema, local temperature changes and chronic pain) local inflammation is suspected. AIM: To determine the involvement of neuropetides, cytokines and eicosanoids as locally formed mediators of inflammation. METHODS: In this study, nine patients with proven CRPS 1 were included. Disease activity and impairment was determined by means of a Visual Analogue Scale, the McGill Pain Questionnaire, the difference in volume and temperature between involved and uninvolved extremities, and the reduction in active range of motion of the involved extremity. Venous blood was sampled from and suction blisters made on the involved and uninvolved extremities for measurement of cytokines interleukin (IL)-6, II-1beta and tumour necrosis factor-alpha (TNF-alpha), the neuropetides NPY and CRGP, and prostaglandin E2RESULTS: The patients included in this study did have a moderate to serious disease activity and impairment. In plasma, no changes of mediators of inflammation were observed. In blister fluid, however, significantly higher levels of IL-6 and TNF-alpha in the involved extremity were observed in comparison with the uninvolved extremity. CONCLUSIONS: This is the first time that involvement of mediators of inflammation in CRPS 1 has been so clearly and directly demonstrated. This observation opens new approaches for the succesful use and development of immunosuppressives in CRPS 1

Planck early results. I. The Planck mission

The European Space Agency’s Planck satellite was launched on 14 May 2009, and has been surveying the sky stably and continuously since 13 August 2009. Its performance is well in line with expectations, and it will continue to gather scientific data until the end of its cryogenic lifetime. We give an overview of the history of Planck in its first year of operations, and describe some of the key performance aspects of the satellite. This paper is part of a package submitted in conjunction with Planck’s Early Release Compact Source Catalogue, the first data product based on Planck to be released publicly. The package describes the scientific performance of the Planck payload, and presents results on a variety of astrophysical topics related to the sources included in the Catalogue, as well as selected topics on diffuse emission