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Correlation Between Altered Central Pain Processing and Concentration of Peritoneal Fluid Inflammatory Cytokines in Endometriosis Patients With Chronic Pelvic Pain
  1. Alban Y. Neziri, MD*,,
  2. Nick A. Bersinger, MD,
  3. Ole K. Andersen, MD, PhD§,
  4. Lars Arendt-Nielsen, MD, PhD§,
  5. Michael D. Mueller, MD and
  6. Michele Curatolo, MD, PhD*,§
  1. *University Department of Anaesthesiology and Pain Therapy, University Hospital of Bern, Inselspital, Bern
  2. Department of Obstetrics and Gynaecology, Cantonal Hospital of St Gallen, St Gallen
  3. University Department of Obstetrics and Gynaecology, University Hospital of Berne, Inselspital, Berne, Switzerland
  4. §Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
  5. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA
  1. Address correspondence to: Michele Curatolo, MD, PhD, Department of Anesthesiology and Pain Medicine, University of Washington, 1959 Pacific St, Seattle, WA 98195-6540 (e-mail: curatolo{at}


Abstract Translational research has not yet elucidated whether alterations in central pain processes are related to peripheral inflammatory processes in chronic pain patients. We tested the hypothesis that the concentration of cytokines in the peritoneal fluid of endometriosis patients with chronic pain correlate with parameters of hyperexcitability of the nociceptive system. The concentrations of 15 peritoneal fluid cytokines were measured in 11 patients with chronic pelvic pain and a diagnosis of endometriosis. Six parameters assessing central pain processes were recorded. Positive correlations between concentration of some cytokines in the peritoneal fluid and amplification of central pain processing were found. The results suggest that inflammatory mechanisms may be important in the pathophysiology of altered central pain processes and that cytokines produced in the environment of endometriosis could act as mediators between the peripheral lesion and changes in central nociceptive processes.

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  • The authors declare no conflict of interest.

    Supported by the Swiss National Science Foundation (3247BO_122358/1), the Danish Research Council for Technology and Production, the Scientific Funds of the University Department of Anaesthesiology and Pain Therapy of the University of Bern, and the Foundation for Research in Anaesthesia and Intensive Care of the University Hospital of Bern.

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