When I was in school, I was taught that the first rule of statutory interpretation was "read." The second rule was "read on."

In thinking about the first question you raise, I went back to my copy of Systemic inflammatory mediators in post-traumatic complex regional pain syndrome (CRPS I) - longitudinal investigations and differences to control groups, Schinkel C, Scherens A, Köller M, Roellecke G, Muhr G, Maier C, Eur J Med Res. 2009 Mar 17;14(3):130-5 [ABSTRACT].

Let's just say it set me back. I had relied on the abstract for close to three years - where the full-text journal only recently becoming available to the respective online university libraries of USC and UCLA - and had not previously picked up on cautionary language from the article that wasn't included in the abstract's remarkably detailed statement of the authors' findings. Possibly because that cautionary language was inserted as part of the editorial process, while the authors' abstract was allowed to go through unscathed. In any event, it became obvious to me that, although I had looked over the PDF when I got it on July 30th, I hadn't looked closely enough, and continued to rely on the literal language of the abstract, for which I can offer no real justification. In any event, the relevant language from p. 134 is as follows:

Up to now the results on systemic inflammatory cytokine responses are very inconsistent and vary between the different study populations and settings. High intra- and interindividual variations were shown in our studies. There is no clinical relevance proven so far that measurement of plasma cytokines is helpful in diagnostic or follow-up of patients with CRPS I.

* * *

Recent studies have proven local involvement of inflammatory mediators, where as systemic responses are very inconsistent which might be due to irregular occurring systemic overspill of local mediators. A clear correlation between acute or chronic stages of disease and systemic inflammatory mediators is not yet shown. This holds true especially if those groups are compared to healthy controls, patients with forearm fractures or neuralgia.

Further studies on local inflammatory responses will elucidate the role of inflammatory components in the pathogenesis of CRPS I. Additional larger longitudinal studies in patients and relevant control groups are warranted before any clinical use for diagnostics or follow-up can be recommended.[Emphasis added.]

As such, my earlier speculation that someone looking to see if they might have a "fresh case" of CRPS might be able to rely on diagnostic testing of those cytokines for which the FDA has approved diagnostic testing in the first place, say, TNF-[alpha] antibodies for Crone's Disease, was at best premature.

Then too, although the rheumatologist who initially suggested my CRPS Dx in 2001 raised on on number of occasions the possibility of treatment with Remicade (infliximab), the drug mentioned in one of two the articles at the top of this thread - Successful Intravenous Regional Block with Low-Dose Tumor Necrosis Factor-[Alpha] Antibody Infliximab for Treatment of Complex Regional Pain Syndrome 1, Bernateck M, Rolke R, Birklein F, Treede RD, Fink M, Karst M, Int Anesth Res Soc. 2007;105(4):1148-1151 - I was put off at the time by the drug's possibly very serious side-effects, even though he was using it all the time on his rheumatology patients. And by the time the article came out five years later, I no longer had anything approaching an acute case of CRPS. So the issue was moot from my perspective.

I'm laying this out for you as best I can, so that no one is disappointed if told in Philadelphia that anti-TNF-[alpha] agents aren't yet ready for prime time in the treatment of CRPS. Still, you should by all means ask. The world has hopefully come a long way since 2006 when neuro-immunologists at both the Mayo Clinic and Johns Hopkins refused to see me as I was seen by other physicians at those institutions, because it was "well known that CRPS [was] not an autoimmune disorder." (Or so I would like to think.)

Good luck!

Mike