Altered Inflammatory Mediators in Fibromyalgia

Abstract

Fibromyalgia (FM) is a syndrome characterized by widespread chronic pain, tenderness, stiffness, fatigue, and sleep and mood disturbances. Current evidences suggest that inflammatory mediators may have an important role in the pathogenesis of fibromyalgia. Every day new evidences emerging of the role of the immune system and the inflammatory process in the pathophysiology of this disease. Thus, the aim of this work has been review that altered inductors, inflammatory mediators and effectors have been reported in fibromyalgia, and its relationship to disease's symptoms. If in fibromyalgia underlies widespread disruption of most characteristic components on the inflammatorý s process (endogenous inductors, mediators and effectors) is logical to think that fibromyalgia is producing a sustained inflammatory response in time, unregulated, responsible for the disease´s symptoms. Keywords:Fibromyalgia; Inflammation; HMGB1; Age; Inflammasome; Cytokines; Chemokines; Pentraxins; Lipid mediators; Monocytes; Neutrophils FibromyalgiaFibromyalgia (FM) is a chronic disease characterized by a widespread pain, tenderness, stiffness, fatigue, and sleep and mood disturbances. The prevalence of FM in the world ranges between 0.7% and 3.2%. It is more prevalent on women than men with a ratio women/men 20:1 (4.2% prevalence on women compared with 0.2% on men) [1] and it can develop at any age [2].The exact cause of fibromyalgia is unknown, but it has been proposed that the FM is a stress-related disorder that may involve a dysfunction of the hypothalamic-pituitary-adrenal axis (HPA) [3,4]. Thus, adverse life events, such as emotional, physical and sexual abuse on children and adults have been suggested to contribute to the development of FM [5][6][7].Risk factors FM have been the subject of much debate in recent research. There is no doubt that the experience of an abusive relationship, maintained over time, is a stressful situation that could be related to the presence of FM [8,9].Like all physiological systems, the immune system is under the control of the neuro-endocrine system and interacts and works in concert with other regulatory body systems, thus immune cells respond to neuroendocrine signals through specific receptors for hormones, neurotransmitters and neuropeptides. Therefore, dysregulation of the hypothalamic-pituitary-adrenal axis by chronic stress situations necessarily lead to a dysregulation of the immune function. Thus, inflammation is a characteristic process of the immune system, considered a defense response that is induced by infection or trauma. However, inflammation may also be induced by stress and tissue dysfunction in the absence of infection, there is a close relationship between body homeostasis, stress response and inflammation, since inflammation has both a component response to stress as a component defense response. Inflammation and FibromyalgiaIn 2001, Wallace et al. [10] were the first to suggest that inflammatory mediators, such as cytokines, could play a role in fibromyalgia. Prior results...

Evidence of Mitochondrial Dysfunction in Fibromyalgia: Deviating Muscle Energy Metabolism Detected Using Microdialysis and Magnetic Resonance

“…These results were confirmed for the erector spinae in this study (Table 4). Lower ATP levels seem to characterize FM as low ATP levels have also been found in skin, plasma, platelets, neuronal cells, and peripheral blood mononuclear cells of FM patients [65][66][67]. The decreased ATP and PCr levels were parallel in FM as the ATP/PCr ratio was not different between the two groups (Table 4).…”

Nutritional Interventions in the Management of Fibromyalgia Syndrome

“…Various evidence supports the hypothesis that FM is a "central pain disorder", with alterations in central nervous system function leading to increased nociceptive processing [7,8]. Furthermore, recent evidence suggests that low-grade systemic inflammation, a preponderance of prooxidative status and an insufficient antioxidant capacity, could contribute to the development of the disease, reducing the pain threshold and inducing fatigue and mood disorders [9,10]. FM shows strong family aggregation and, although this may be due to shared environmental or behavioural influences, twin studies have revealed that genetic variants and hereditary mechanisms contribute to 50% of the risk of developing chronic pain and related conditions in FM [11][12][13].…”