Regulatory effects of continuous epidural block on the balance of regulatory T lymphocytes/helper T lymphocytes 17 and cytokines in patients with herpes zoster-related pain

Objective To investigate the changes and significance of regulatory T lymphocytes (Treg), helper T lymphocytes 17 (Th17), interleukin (IL)-6, IL-10 and IL-17 in the treatment of herpes zoster-associated pain (ZAP) with continuous epidural block (CEB).

Methods A total of 60 patients with ZAP were selected as the study subjects and randomly divided into observation group (n=30) and control group (n=30) using a digital randomization table. The control group received conventional drug therapy, while the observation group received CEB treatment in addition to the conventional drug therapy administered to the control group. The pain Visual Analogue Scale (VAS) scores, peripheral blood Treg cell counts, Treg/Th17, and inflammatory cytokine levels were observed and compared between the two groups.

Results The VAS scores in both groups were significantly lower after treatment than treatment before (P < 0.01). After 4 and 8 days of treatment, the VAS scores in the observation group were significantly lower than those in the control group (P < 0.01). After 4 and 8 days of treatment, the proportion of peripheral blood CD4⁺Foxp3⁺Treg cells among CD4⁺T cells, the Treg/Th17, and the expression level of IL-10 in the observation group were significantly higher than those before treatment, while the proportion of CD4⁺IL-17⁺Th17 cells among CD4⁺T cells and the expression levels of IL-6 and IL-17 were significantly lower than those before treatment (P < 0.01 or P < 0.05). After 8 days of treatment, the proportion of peripheral blood CD4⁺Foxp3⁺Treg cells among CD4⁺T cells, the Treg/Th17, and the expression level of IL-10 in the control group were significantly higher than those before treatment, while the proportion of CD4⁺IL-17⁺Th17 cells among CD4⁺T cells and the expression levels of IL-6 and IL-17 were significantly lower than those before treatment (P < 0.01 or P < 0.05). After 4 and 8 days of treatment, the proportion of peripheral blood CD4⁺Foxp3⁺Treg cells among CD4⁺T cells, the Treg/Th17, and the expression level of IL-10 in the observation group were significantly higher than those in the control group, while the proportion of CD4⁺IL-17⁺Th17 cells among CD4⁺T cells and the expression levels of IL-6 and IL-17 were significantly lower than those in the control group (P < 0.01 or P < 0.05).

Conclusion CEB can effectively alleviate pain in patients with ZAP, upregulate the Treg/Th17, and reduce the expression levels of IL-6 and IL-17.