Acute pain induces an instant increase in natural killer cell cytotoxicity in humans and this response is abolished by local anaesthesia

Abstract

We have investigated the effect of pain without tissue injury on natural killer (NK) cell activity in peripheral blood in humans and the effect of local anaesthesia on the response. Ten subjects were investigated during two sessions. First, self-controlled painful electric stimulation was applied to abdominal skin for 30 min to an intensity of 8 on a visual analogue scale (0-10). Next, the electric intensity profile was reproduced during local anaesthesia (mepivacaine 10 mg ml-1 s.c. to a total dose of 2.5 mg kg-1). NK cell cytotoxicity was measured using a 4-h 51Cr-release assay against K562 target cells. NK cell activity increased from mean 22 (SEM 4)% (baseline) to 35 (6)% and 36 (5)% after 15 and 30 min of painful stimulation, respectively (P < 0.02). A simultaneous increase in the number of CD56+ cells in peripheral blood during pain was found. Stimulation after local anaesthesia did not change either NK cell activity or number. Parallel and significant increases in concentrations of plasma epinephrine and serum cortisol were observed. These changes were abolished by local anaesthesia. We conclude that acute severe pain without tissue injury markedly increased NK cell cytotoxicity. Local anaesthesia completely abolished this immunological and hormonal response.

Cognitive impairment in patients with chronic pain: The significance of stress

“…Specifically, pain relief is associated with reduced cortisol levels and HPA activity. For example, local anesthesia can reduce immunologic and hormonal responses (ie, increases in plasma epinephrine and serum cortisol) to acute painful stimulation [80], and septal stimulation-inducing analgesia can produce a decrease in plasma cortisol and in gastric ulceration [81]. Preoperative acupuncture can reduce postoperative pain and nausea and plasma cortisol and sympathoadrenal system activity in patients who have undergone surgery [82].…”

Increased apoptosis of peripheral blood mononuclear cells (PBMC) during general and epidural anaesthesia in dogs

“…However, the influence of epidural anaesthesia on apoptosis of lymphocytes is unclear. Several studies revealed that epidural anaesthesia with local anaesthetic agents may prevent completely or incompletely the endocrine response to surgery (Greisen et al 1999;Desborough 2000) and thus, may abolish stress-related apoptosis. Our results demonstrated that epidural anaesthesia using lidocaine induce apoptosis of PBMC without anaesthetic stress response evidenced by the unchanged cortisol levels.…”

Pain-Related Activation of Leukocyte Cellular Adhesion Molecules: Preliminary Findings

“…This pain model was chosen because electrical stimulation is known to provoke pain-related immune responses [6] , and its application to the small skin area of the earlobe allowed careful assessment to detect tissue damage. Stimulation time course and intensity were determined to allow for the development of autonomic responses, gene transcription, and to avoid undue subject risk and burden.…”

“…Eller [5] subjected controls and HIV-infected patients to cold pressor testing and observed a significant increase in natural killer cell (NKC) activity and numbers, and CD8+ lymphocyte numbers in all subjects. Greisen et al [6] used an electrical stimulation model to evoke pain in healthy male volunteers and observed significant increases in NE, cortisol, NKC activity, and circulating numbers of NKCs, lymphocytes, and neutrophils. Finally, Buemi et al [7] found that cold pressor pain testing produced an increase in serum concentrations of soluble cellular adhesion molecules (CAMs) in normo-and hypertensive subjects.…”