Peritraumatic 17β-estradiol levels influence chronic posttraumatic pain outcomes

Area of Science:

• Trauma research
• Pain medicine
• Endocrinology

Background:

• Biologic factors influencing chronic posttraumatic pain (CPTP) remain unclear.
• Understanding mediators of CPTP is crucial for effective intervention.

Purpose of the Study:

• To investigate the role of peritraumatic 17β-estradiol (E2) levels in predicting CPTP trajectories.
• To examine potential sex differences and body mass index (BMI) interactions in the E2-CPTP relationship.

Main Methods:

• Longitudinal study of 254 trauma survivors across three cohorts.
• Measurement of plasma E2 levels immediately post-trauma.
• Assessment of CPTP severity at 6 weeks, 6 months, and 1 year post-trauma.
• Statistical analysis using repeated measures mixed models.

Main Results:

• In women, higher peritraumatic E2 levels were significantly associated with lower CPTP severity over time (β = -0.280, P = 0.043).
• An E2 * BMI interaction was found in men from a motor vehicle collision cohort: obese men with higher E2 levels had increased CPTP risk.
• No significant E2-CPTP relationship was observed in nonobese men or men from a thermal burn cohort.

Conclusions:

• Peritraumatic E2 levels are a significant predictor of CPTP vulnerability in women trauma survivors.
• Findings suggest potential therapeutic implications for E2 administration in women to mitigate CPTP.
• Further research is warranted to explore E2's role and therapeutic potential in CPTP management, particularly considering sex and BMI differences.