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Nutrient deficiencies as a risk factor in Taiwanese patients with postherpetic neuralgia

  • Jen-Yin Chen (a1) (a2) (a3), Chin-Chen Chu (a1), Yung-Song Lin (a4), Edmund Cheng So (a1), Ja-Ping Shieh (a1) and Miao-Lin Hu (a2) (a5)...

Abstract

Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). The aim of the present study was to compare the nutritional status of PHN patients with that of healthy controls, and then to identify risk factors for PHN using multivariate multiple logistic regressions. In the present cross-sectional study, we prospectively enrolled fifty PHN patients for at least 3 months and fifty healthy controls. We selected nine circulating nutrients including ionised Ca, Zn, retinol, folic acid, vitamin B12, vitamin C, α-tocopherol, γ-tocopherol and lycopene associated with both immunity and the modulation of neuropathic pain, and measured their concentrations in plasma/serum. Concentrations of ionised Ca, Zn, vitamin C and vitamin B12 were significantly lower in PHN patients than in controls after excluding those patients receiving supplements since the outbreak of HZ. The prevalence of either mild/marginal or severe deficiencies for any of the nine selected circulating nutrients in PHN patients (92 %) was much higher than that in controls (46 %) (P < 0·001). Lower concentrations of vitamin C ( ≤ 45·0 μmol/l), ionised Ca ( ≤ 1·05 mmol/l) and Zn ( ≤ 0·91 g/l) were found to increase independently the risk of PHN using binary variable (dichotomy) analyses with both PHN patients and controls in a multivariate logistic regression analysis. No significant correlations existed between the risks of PHN and the concentrations of retinol, folic acid, vitamin B12, lycopene or α:γ-tocopherol ratios. Thus, lower concentrations of circulating nutrients, namely vitamin C, ionised Ca or Zn, are probably a risk factor in Taiwanese patients with PHN.

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Corresponding author

*Corresponding author: Distinguished Professor M.-L. Hu, email mlhuhu@dragon.nchu.edu.tw

References

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1Arvin, AM (1996) Varicella-zoster virus. Clin Microbiol Rev 9, 361381.
2Dworkin, RH, Gnann, JW Jr, Oaklander, AL, et al. (2008) Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia. J Pain 9, S37S44.
3Jung, BF, Johnson, RW, Griffin, DR, et al. (2004) Risk factors for postherpetic neuralgia in patients with herpes zoster. Neurology 62, 15451551.
4Mueller, NH, Gilden, DH, Cohrs, RJ, et al. (2008) Varicella zoster virus infection: clinical features, molecular pathogenesis of disease, and latency. Neurol Clin 26, 675697, vii.
5Chandra, RK (2002) Nutrition and the immune system from birth to old age. Eur J Clin Nutr 56, Suppl. 3, S73S76.
6Maggini, S, Wintergerst, ES, Beveridge, S, et al. (2007) Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses. Br J Nutr 98, Suppl. 1, S29S35.
7Thomas, SL, Wheeler, JG & Hall, AJ (2006) Micronutrient intake and the risk of herpes zoster: a case–control study. Int J Epidemiol 35, 307314.
8Chen, JY, Chang, CY, Feng, PH, et al. (2009) Plasma vitamin C is lower in postherpetic neuralgia patients and administration of vitamin C reduces spontaneous pain but not brush-evoked pain. Clin J Pain 25, 562569.
9Patrick, L (2000) Nutrients and HIV: part two – vitamins A and E, zinc, B-vitamins, and magnesium. Altern Med Rev 5, 3951.
10Jariwalla, RJ & Harakeh, S (1996) Antiviral and immunomodulatory activities of ascorbic acid. Subcell Biochem 25, 213231.
11Furuya, A, Uozaki, M, Yamasaki, H, et al. (2008) Antiviral effects of ascorbic and dehydroascorbic acids in vitro. Int J Mol Med 22, 541545.
12Chew, BP & Park, JS (2004) Carotenoid action on the immune response. J Nutr 134, 257S261S.
13Kimura, K, Reinhardt, TA & Goff, JP (2006) Parturition and hypocalcemia blunts calcium signals in immune cells of dairy cattle. J Dairy Sci 89, 25882595.
14Zollinger, PE, Tuinebreijer, WE, Kreis, RW, et al. (1999) Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial. Lancet 354, 20252028.
15Zollinger, PE, Tuinebreijer, WE, Breederveld, RS, et al. (2007) Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose–response study. J Bone Joint Surg Am 89, 14241431.
16Perez, RS, Zollinger, PE, Dijkstra, PU, et al. (2010) Evidence based guidelines for complex regional pain syndrome type 1. BMC Neurol 10, 20.
17Wang, T, Wang, J, Cottrell, JE, et al. (2004) Small physiologic changes in calcium and magnesium alter excitability and burst firing of CA1 pyramidal cells in rat hippocampal slices. J Neurosurg Anesthesiol 16, 201209.
18Martinez Figueroa, A, Johnson, RH, Lambie, DG, et al. (1980) The role of folate deficiency in the development of peripheral neuropathy caused by anticonvulsants. J Neurol Sci 48, 315323.
19Arrieta, O, Garcia-Navarrete, R, Zuniga, S, et al. (2005) Retinoic acid increases tissue and plasma contents of nerve growth factor and prevents neuropathy in diabetic mice. Eur J Clin Invest 35, 201207.
20Wang, ZB, Gan, Q, Rupert, RL, et al. (2005) Thiamine, pyridoxine, cyanocobalamin and their combination inhibit thermal, but not mechanical hyperalgesia in rats with primary sensory neuron injury. Pain 114, 266277.
21Kim, HK, Kim, JH, Gao, X, et al. (2006) Analgesic effect of vitamin E is mediated by reducing central sensitization in neuropathic pain. Pain 122, 5362.
22Kuhad, A, Sharma, S & Chopra, K (2008) Lycopene attenuates thermal hyperalgesia in a diabetic mouse model of neuropathic pain. Eur J Pain 12, 624632.
23Liu, T, Walker, JS & Tracey, DJ (1999) Zinc alleviates thermal hyperalgesia due to partial nerve injury. Neuroreport 10, 645649.
24Nelson, MT, Joksovic, PM, Su, P, et al. (2007) Molecular mechanisms of subtype-specific inhibition of neuronal T-type calcium channels by ascorbate. J Neurosci 27, 1257712583.
25Traboulsie, A, Chemin, J, Chevalier, M, et al. (2007) Subunit-specific modulation of T-type calcium channels by zinc. J Physiol 578, 159171.
26Chang, CY, Chen, JY, Ke, D, et al. (2005) Plasma levels of lipophilic antioxidant vitamins in acute ischemic stroke patients: correlation to inflammation markers and neurological deficits. Nutrition 21, 987993.
27Lee, W, Roberts, SM & Labbe, RF (1997) Ascorbic acid determination with an automated enzymatic procedure. Clin Chem 43, 154157.
28Drop, LJ, Tochka, LN & Misiano, DR (1982) Comparative evaluation of two calcium ion-selective electrode systems, and their utility for monitoring steady-state changes in [Ca2+]. Clin Chem 28, 129133.
29Belbraouet, S, Biaudet, H, Tebi, A, et al. (2007) Serum zinc and copper status in hospitalized vs. healthy elderly subjects. J Am Coll Nutr 26, 650654.
30Song, YM & Chen, MD (2005) Relative reduced plasma zinc concentration in middle-aged but not elderly adults in Taiwan. Biol Trace Elem Res 103, 97102.
31Chen, KJ, Pan, WH, Yang, FL, et al. (2005) Association of B vitamins status and homocysteine levels in elderly Taiwanese. Asia Pac J Clin Nutr 14, 250255.
32Mayne, ST, Cartmel, B, Silva, F, et al. (1999) Plasma lycopene concentrations in humans are determined by lycopene intake, plasma cholesterol concentrations and selected demographic factors. J Nutr 129, 849854.
33Tzeng, MS, Yang, FL, Wang, GS, et al. (2004) Determination of major carotenoids in human serum by liquid chromatography. J Food Drug Anal 12, 7983.
34Handelman, GJ, Machlin, LJ, Fitch, K, et al. (1985) Oral alpha-tocopherol supplements decrease plasma gamma-tocopherol levels in humans. J Nutr 115, 807813.
35Zaloga, GP (1992) Hypocalcemia in critically ill patients. Crit Care Med 20, 251262.
36Bentrem, DJ, Rademaker, A & Angelos, P (2001) Evaluation of serum calcium levels in predicting hypoparathyroidism after total/near-total thyroidectomy or parathyroidectomy. Am Surg 67, 249251, discussion 51–52.
37Cheng, WY, Fu, ML, Wen, LJ, et al. (2005) Plasma retinol and α-tocopherol status of the Taiwanese elderly population. Asia Pac J Clin Nutr 14, 256262.
38High, KP, Legault, C, Sinclair, JA, et al. (2002) Low plasma concentrations of retinol and alpha-tocopherol in hematopoietic stem cell transplant recipients: the effect of mucositis and the risk of infection. Am J Clin Nutr 76, 13581366.
39Jacob, RA, Otradovec, CL, Russell, RM, et al. (1988) Vitamin C status and nutrient interactions in a healthy elderly population. Am J Clin Nutr 48, 14361442.
40Allen, LH (2009) How common is vitamin B-12 deficiency? Am J Clin Nutr 89, 693S696S.
41Chen, KJ, Pan, WH, Shaw, NS, et al. (2005) Association between dietary folate-rich food intake and folate status of elderly Taiwanese. Asia Pac J Clin Nutr 14, 244249.
42Behrens, WA & Madere, R (1986) Alpha- and gamma tocopherol concentrations in human serum. J Am Coll Nutr 5, 9196.
43Stambullian, M, Feliu, S & Slobodianik, NH (2007) Nutritional status in patients with HIV infection and AIDS. Br J Nutr 98, Suppl. 1, S140S143.
44Wu, SJ, Chang, YH, Wei, IL, et al. (2005) Intake levels and major food sources of energy and nutrients in the Taiwanese elderly. Asia Pac J Clin Nutr 14, 211220.
45VanderJagt, DJ, Garry, PJ & Bhagavan, HN (1987) Ascorbic acid intake and plasma levels in healthy elderly people. Am J Clin Nutr 46, 290294.
46Jacob, RA & Sotoudeh, G (2002) Vitamin C function and status in chronic disease. Nutr Clin Care 5, 6674.
47Marin Caro, MM, Laviano, A & Pichard, C (2007) Nutritional intervention and quality of life in adult oncology patients. Clin Nutr 26, 289301.
48Joksovic, PM, Nelson, MT, Jevtovic-Todorovic, V, et al. (2006) CaV3.2 is the major molecular substrate for redox regulation of T-type Ca2+ channels in the rat and mouse thalamus. J Physiol 574, 415430.
49Todorovic, SM, Meyenburg, A & Jevtovic-Todorovic, V (2004) Redox modulation of peripheral T-type Ca2+ channels in vivo: alteration of nerve injury-induced thermal hyperalgesia. Pain 109, 328339.
50Shishkov, S, Varadinova, T, Bontchev, P, et al. (1996) Complexes of zinc with picolinic and aspartic acids inactivate free varicella-zoster virions. Met Based Drugs 3, 1114.
51Grinstein, S & Klip, A (1989) Calcium homeostasis and the activation of calcium channels in cells of the immune system. Bull N Y Acad Med 65, 6979.
52Mo, C, Schneeberger, EE & Arvin, AM (2000) Glycoprotein E of varicella-zoster virus enhances cell–cell contact in polarized epithelial cells. J Virol 74, 1137711387.
53Sweitzer, SM, Hickey, WF, Rutkowski, MD, et al. (2002) Focal peripheral nerve injury induces leukocyte trafficking into the central nervous system: potential relationship to neuropathic pain. Pain 100, 163170.

Keywords

Nutrient deficiencies as a risk factor in Taiwanese patients with postherpetic neuralgia

  • Jen-Yin Chen (a1) (a2) (a3), Chin-Chen Chu (a1), Yung-Song Lin (a4), Edmund Cheng So (a1), Ja-Ping Shieh (a1) and Miao-Lin Hu (a2) (a5)...

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