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1.
Int J Mol Sci ; 20(17)2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31470635

RESUMO

Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, and physical and emotional symptoms. Although its pathophysiology is largely unknown, immune-inflammatory pathways may be involved. We examined serum interleukin (IL)-6, high sensitivity C-reactive protein (hs-CRP), CXCL-8, and IL-10 in 67 female FM patients and 35 healthy women while adjusting for age, body mass index (BMI), and comorbid disorders. We scored the Fibromyalgia Severity Score, Widespread Pain Index (WPI), Symptom Severity Scale (SSS), Hospital Anxiety (HADS-A), and Depression Scale and the Perceived Stress Scale (PSS-10). Clinical rating scales were significantly higher in FM patients than in controls. After adjusting for covariates, IL-6, IL-10, and CXCL-8 were lower in FM than in HC, whereas hs-CRP did not show any difference. Binary regression analyses showed that the diagnosis FM was associated with lowered IL-10, quality of sleep, aerobic activities, and increased HADS-A and comorbidities. Neural networks showed that WPI was best predicted by quality of sleep, PSS-10, HADS-A, and the cytokines, while SSS was best predicted by PSS-10, HADS-A, and IL-10. Lowered levels of cytokines are associated with FM independently from confounders. Lowered IL-6 and IL-10 signaling may play a role in the pathophysiology of FM.


Assuntos
Fibromialgia/sangue , Fibromialgia/imunologia , Aprendizado de Máquina , Transdução de Sinais/imunologia , Ansiedade/sangue , Ansiedade/psicologia , Proteína C-Reativa/metabolismo , Citocinas/sangue , Citocinas/imunologia , Depressão/sangue , Depressão/psicologia , Feminino , Fibromialgia/psicologia , Humanos , Mediadores da Inflamação/sangue , Mediadores da Inflamação/imunologia , Pessoa de Meia-Idade , Análise Multivariada , Dor/sangue , Dor/diagnóstico , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários
2.
J Rehabil Med ; 51(10): 779-787, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31544950

RESUMO

BACKGROUND: The pathophysiology of fibromyalgia includes central and peripheral factors. Neurotrophins, such as nerve growth factor and brain-derived neurotrophic factor, are involved in peripheral and central nervous system development of pain and hyperalgesia. Few studies have examined circulating nerve growth factor and brain-derived neurotrophic factor in fibromyalgia or have investigated whether exercise interventions affect the levels of these peptides. OBJECTIVES: To compare plasma levels of nerve growth factor and brain-derived neurotrophic factor in fibromy-algia and in healthy controls, to investigate correlations between levels of nerve growth factor, brain-derived neurotrophic factor, and cytokines and clinical variables, and to investigate the effect of exercise on these levels. SUBJECTS AND METHODS: A total of 75 women with fibromyalgia participated in blood tests at baseline and after the 15-week intervention, and 25 healthy controls participated at baseline. Patients were randomized to a 15-week progressive resistance exercise intervention or a relaxation intervention. RESULTS: Brain-derived neurotrophic factor level was significantly higher (p < 0.001) and nerve growth factor level was significantly lower (p < 0.001) in fibromyalgia than in healthy controls. Neither resistance exercise nor relaxation interventions affected the levels of brain-derived neurotrophic factor or nerve growth factor. No significant correlations were found between brain-derived neurotrophic factor or nerve growth factor plasma levels in fibromyalgia and cytokine levels or clinical variables. CONCLUSION: Changes in circulating nerve growth factor and brain-derived neurotrophic factor levels may affect nociception/pain in fibromyalgia. Clinical improvements were achieved following the exercise intervention, but the levels of brain-derived neurotrophic factor and nerve growth factor were not normalized.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Fibromialgia , Fator de Crescimento Neural/sangue , Treinamento de Resistência , Feminino , Fibromialgia/sangue , Fibromialgia/terapia , Humanos
3.
Braz J Med Biol Res ; 52(8): e8688, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31389493

RESUMO

The objective of this study was to investigate the effect of whole body vibration (WBV) exercise on oxidative stress markers in a group of women with fibromyalgia (FM) compared to a group of healthy women (CT). Twenty-one women diagnosed with FM and 21 age- and weight-matched healthy women were enrolled the study. Plasma oxidative stress markers (primary outcomes) were evaluated at rest and after WBV, and included thiobarbituric acid reactive substances (TBARS), iron reduction capacity (FRAP), superoxide dismutase antioxidant enzymes activity (SOD), and catalase (CAT). At rest, the FM group had higher TBARS (P<0.001) and FRAP (P<0.001), and lower CAT (P=0.005) compared to the CT. In the CT group, the WBV had no effect on TBARS (P=0.559) and FRAP (P=0.926), whereas it increased both SOD (P<0.001) and CAT (P<0.001). In the FM group, the WBV reduced TBARS (p <0.001), FRAP (P<0.001), and CAT (P=0.005), while it increased SOD (P=0.019). There was an interaction effect (moments vs groups) in the TBARS (effect size=1.34), FRAP (effect size=0.93), CAT (effect size=1.45), and SOD (effect size=1.44) (P<0.001). A single trial of WBV exercise improved all oxidant and antioxidant parameters towards a greater adaptation to the stress response in FM women.


Assuntos
Biomarcadores/sangue , Fibromialgia/sangue , Estresse Oxidativo/fisiologia , Vibração , Estudos de Casos e Controles , Feminino , Fibromialgia/fisiopatologia , Humanos , Pessoa de Meia-Idade
4.
Am J Case Rep ; 20: 659-663, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31064976

RESUMO

BACKGROUND Fibromyalgia (FM) is a common disorder of diffuse musculoskeletal pain. It is distinctly different from polymyalgia rheumatica (PMR), a disease seen in people over the age of 50 years. Hallmark features of PMR are the presence of elevated erythrocytes sedimentation rate (ESR) and/or C-reactive protein (CRP). These markers are normal in FM. Obesity in itself can be associated with elevated CRP and ESR, and when obese patients present with myalgia and elevated inflammatory markers, diagnostic confusion can ensue. CASE REPORT We describe a case of 38-year-old female with diffuse musculoskeletal pain and elevated ESR and CRP who was initially misdiagnosed with PMR and responded partially to steroids. She developed severe adverse effects from chronic steroid use. She was ultimately diagnosed with FM. CONCLUSIONS We highlight features to help clinicians avoid the pitfall of diagnosing PMR in young obese patients with FM and elevated inflammatory markers. In this case report, we discuss the features of FM, PMR, PMR-like symptoms presentation, and the association of obesity with elevated inflammatory markers.


Assuntos
Sedimentação Sanguínea , Proteína C-Reativa/análise , Fibromialgia/diagnóstico , Mialgia/etiologia , Obesidade/complicações , Adulto , Biomarcadores/sangue , Erros de Diagnóstico , Feminino , Fibromialgia/sangue , Humanos , Mialgia/complicações , Polimialgia Reumática/sangue , Polimialgia Reumática/diagnóstico
5.
Indian J Med Res ; 149(1): 47-50, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31115374

RESUMO

Background & objectives: : Fibromyalgia syndrome (FMS) is one of the most common chronic pain conditions of unknown aetiology. Mitochondrial dysfunction has been reported in FMS with some studies reporting the presence of mitochondrial mutation namely A3243G, which also causes mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes. This pilot study was conducted to assess this mutation and also detect large deletions in mitochondrial DNA (mtDNA) in patients with FMS. Methods: : Thirty female patients with FMS participated and 30 matched controls were included. Genomic DNA was subjected to polymerase chain reaction (PCR) amplification using specific primers followed by restriction digestion with Apa I enzyme to detect the specific A3243G mtDNA mutation. Long-range PCR was done in two sets to detect the large deletions in the mtDNA. Biochemical parameters including thyroid-stimulating hormone and vitamin D levels were also looked at. Results: : None of the patients were found to carry the common mutation or large deletions. Low vitamin D level was a common finding. Hypothyroidism was found in a few patients. Interpretation & conclusions: : Although the common mutation or large mtDNA deletions were not detected in blood mtDNA in the FMS patients, mutations in the muscle and sequence variation in mtDNA remained a possibility. Future studies in both blood and muscle tissue including mtDNA sequencing are warranted in such patients to determine if a subset of FMS patients have mitochondrial myopathy.


Assuntos
Dor Crônica/genética , DNA Mitocondrial/genética , Fibromialgia/genética , Mitocôndrias/genética , Adulto , Idoso , Dor Crônica/sangue , Dor Crônica/fisiopatologia , DNA Mitocondrial/sangue , Feminino , Fibromialgia/sangue , Fibromialgia/fisiopatologia , Humanos , Pessoa de Meia-Idade , Mitocôndrias/patologia , Mutação/genética , Fenótipo , Projetos Piloto , Deleção de Sequência/genética , Vitamina D/sangue , Vitamina D/genética
6.
Neurosci Lett ; 706: 105-109, 2019 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-31100426

RESUMO

Central sensitivity syndrome (CSS) consists of adaptive pathophysiological changes associated with neuroplasticity in some chronic pain disorders. It could be grouped in two main conceptual conditions: one includes those chronic pain patients without overt structural pathology such as fibromyalgia, and the other subgroup includes conditions with recognizable structural abnormalities, both somatic (osteoarthritis) and visceral (endometriosis). In order to understand the role of neuromodulators in CCS we aim to determine whether brain-derived neurotrophic factor (BDNF) and S100B are associated to specific chronic pain disorders. Serum BDNF and S100B were measured in chronic pain women with different diagnosis: 88 with osteoarthritis, 36 with endometriosis, 117 with fibromyalgia, 33 with chronic tension type headache and in 41 healthy controls. ANCOVA analysis followed by heteroscedasticity-consistent covariance matrix was performed to evaluate BDNF and S100B levels, adjusted for depression severity, pain levels and use of analgesics according different pathologies. Serum BDNF concentrations were higher and not different in patients with fibromyalgia and headache, the CSS group without structural pathology. In contrast, the concentrations of S100B were higher in patients with osteoarthritis and endometriosis, in comparison to controls, fibromyalgia and tensional headache patients. This study supports the hypothesis that BDNF and S100B neuromodulators present different serum levels according to the background disease associated to the chronic pain. These have the potential to be studied as markers of active disease or treatment evolution.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Dor Crônica/sangue , Subunidade beta da Proteína Ligante de Cálcio S100/sangue , Adulto , Biomarcadores/sangue , Estudos Transversais , Endometriose/sangue , Feminino , Fibromialgia/sangue , Humanos , Osteoartrite/sangue , Cefaleia do Tipo Tensional/sangue
7.
Acta Medica (Hradec Kralove) ; 62(1): 12-18, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30931891

RESUMO

BACKGROUND: Fibromyalgia syndrome (FMS) is an extra-articular rheumatological disease, characterized by widespread pain and somatic symptoms. The etiology has not yet been clarified. Oxidative stress may play an important role in FMS etiology. Thiol group is a very strong antioxidant. We aimed to investigate whether thiol/disulfide homeostasis in FMS is altered or not. MATERIAL AND METHODS: A total of 80 female FMS patients and 64 healthy female control individuals were included in this study. Thiol and disulfide values were measured by Erel's novel methods. RESULTS: Native thiol (330.6 ± 46.1 vs. 356.8 ± 55.5 µmol/L, p = 0.005) and native thiol/total thiol (89.4 ± 3.2 vs. 93.3 ± 4.0, p < 0.001) levels of FMS patients were significantly lower when compared to the values of control group. However, disulfide (19.4 ± 6.3 vs. 12.2 ± 6.3 µmol/L, p < 0.001) levels of FMS patients were significantly higher than healthy individuals. A negative correlation was found between the native thiol/total thiol and fibromyalgia impact questionnaire (FIQ) score among the FMS patients. A positive correlation was found between disulfide values and FIQ score among the patients. CONCLUSIONS: In FMS patients, there was a significant correlation between the decrease in the thiol levels and an increase in the disulfide levels with the FIQ scores. We determined that thiol-disulfide rate was deteriorated in FMS patients and it increases in favor of disulfide amounts.


Assuntos
Dissulfetos/sangue , Fibromialgia/sangue , Fibromialgia/fisiopatologia , Homeostase , Compostos de Sulfidrila/sangue , Adulto , Antioxidantes/metabolismo , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Estresse Oxidativo/fisiologia
8.
PLoS One ; 14(2): e0211824, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30785911

RESUMO

The objective of this study was to verify the effects of aerobic exercise associated with tryptophan (TRP) supplementation on hyperalgesia, as well as on cortisol, IL-6 and TNF concentrations in female rats with experimental fibromyalgia (FM). Female Wistar rats (initial body weight: ~ 350 g; age: 12 months) were randomly divided into 5 groups: CON (Control); F (Fibromyalgia induced); FE (Fibromyalgia induced plus exercise); FES (Fibromyalgia induced plus exercise and TRP supplementation) and FS (Fibromyalgia induced plus TRP supplementation). Fibromyalgia was induced with two injections (20 µL) of acidic saline (pH 4.0) into the right gastrocnemius muscle with a 3-day interval. Control animals received the same doses of neutral saline (pH 7.4). The exercised animals underwent progressive low-intensity aerobic exercise (LIAE) on a treadmill (10-12 m/min, 30-45 min/day, 5 days/week) for three weeks. During this period, the supplemented animals received a TRP supplemented diet (210 g/week), while the others received a control diet. Mechanical hyperalgesia was evaluated weekly and serum cortisol and muscle IL-6 and TNF concentrations were assessed after three weeks of interventions. Experimental FM caused bilateral hind paw hyperalgesia and augmented serum cortisol and muscle IL-6 concentrations. After 3 weeks of interventions, LIAE alone reduced hyperalgesia (151%) and reduced serum cortisol concentrations (72%). Tryptophan supplementation itself diminished hyperalgesia (57%) and reduced serum cortisol concentrations (67%). Adding TRP supplementation to LIAE did not further reduce hyperalgesia significantly (11%), which was followed by an important decrease in muscle IL-6 concentrations (68%), though reduction in serum cortisol pulled back to 45%. Muscle TNF concentrations were not affected. In conclusion, the association of TRP supplementation to LIAE does not potentiate significantly the reduction of bilateral mechanical hyperalgesia promoted by LIAE in female rats with experimental FM, however an important decrease in IL-6 is evident.


Assuntos
Fibromialgia , Hiperalgesia , Interleucina-6/sangue , Condicionamento Físico Animal , Triptofano/farmacologia , Fator de Necrose Tumoral alfa/sangue , Animais , Modelos Animais de Doenças , Feminino , Fibromialgia/sangue , Fibromialgia/fisiopatologia , Fibromialgia/terapia , Hiperalgesia/sangue , Hiperalgesia/fisiopatologia , Hiperalgesia/terapia , Inflamação/sangue , Inflamação/fisiopatologia , Inflamação/terapia , Ratos , Ratos Wistar
9.
Biol Res Nurs ; 21(2): 224-230, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30654628

RESUMO

OBJECTIVES: The aim of this study was to investigate thrombosis-related parameters (blood coagulation parameters, platelet indices, red blood cell [RBC] count, and inflammatory markers) in patients with fibromyalgia (FM). METHOD: We carried out a case-control study with 35 women with FM and 12 age-matched healthy volunteers to analyze fibrinogen levels, prothrombin time, cephaline time, platelet count, platelet distribution width (PDW), mean platelet volume (MPV), RBC count, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (PLR). RESULTS: The results showed significantly increased fibrinogen levels ( p < .05), platelet count ( p < .05), PDW ( p = .059), RBC count ( p < .05), and PLR ( p < .05) in women with FM versus the healthy volunteers. Prothrombin time ( p < .05) and MPV ( p < .05) were significantly lower in patients with FM than in the controls. CONCLUSIONS: Elevated platelet and RBC counts, PDW values, and fibrinogen levels as well as decreased prothrombin time are all indicative of a prothrombotic state in FM patients, which may be enhanced by an increased inflammatory tone. This prothrombotic state may increase the risk of thrombosis-related cardiovascular disease in patients with FM.


Assuntos
Fibromialgia/sangue , Fibromialgia/patologia , Inflamação/sangue , Protrombina/análise , Trombose/diagnóstico , Trombose/patologia , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Inflamação/patologia , Linfócitos/patologia , Volume Plaquetário Médio , Pessoa de Meia-Idade , Neutrófilos/patologia , Contagem de Plaquetas
10.
Gen Hosp Psychiatry ; 57: 23-28, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30669022

RESUMO

OBJECTIVES: There is no consensus over the effect size of cognitive behavioral therapy (CBT) in the treatment of fibromyalgia (FM). This study aims to evaluate the effect of CBT on FM patients, through assessing circulating proinflammatory cytokines. METHODS: A controlled, single-blind, parallel clinical trial was performed with 21 FM patients in each group. Sixteen FM patients in the intervention group (CBT) and 17 FM patients in the control group (waiting-list) completed the study. For the intervention group, traditional face-to-face CBT was performed for groups of 10 and 11 patients in 20 sessions. Fibromyalgia Impact Questionnaire (FIQ), widespread pain index (WPI), circulating IL-6, IL-8, and TNF-α level were evaluated before and after the intervention using enzyme-linked immunosorbent assay. Intention-to-treat analysis was performed as the primary analysis. RESULTS: The average changes of factors examined were as follows: FIQ score -0.61 ±â€¯5.5 in the waiting-list group and 10.2 ±â€¯14.9 in the CBT group (p = 0.012); WPI -0.33 ±â€¯1.1 in the waiting-list group and 2.4 ±â€¯3.1 in the CBT group (p = 0.002); serum IL-6 level -0.05 ±â€¯0.86 pg/ml in the waiting-list group and 1.5 ±â€¯2.4 pg/ml in the CBT group (p = 0.002); serum IL-8 level - 0.55 ±â€¯0.2.5 pg/ml in the waiting-list group and 5 ±â€¯5.9 pg/ml in the CBT group (p = 0.002); serum TNF-α level 0.67 ±â€¯1.8 pg/ml in the waiting-list group and 0.7 ±â€¯1.6 pg/ml in the CBT group (p = 0.89). CONCLUSION: Reductions in proinflammatory cytokines after CBT compared with a waiting-list control group confirm the potential value of these biomarkers as surrogate outcome measures in FM.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Citocinas/sangue , Fibromialgia/sangue , Fibromialgia/terapia , Inflamação/sangue , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Método Simples-Cego
11.
Int J Rheum Dis ; 22(1): 47-54, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30168259

RESUMO

AIM: Current studies demonstrate red blood cell distribution width (RDW) as a possible surrogate biomarker of inflammation. The objectives of the present study were to examine RDW in patients with osteoarthritis (OA), fibromyalgia (FM), rheumatoid arthritis (RA) and spondyloarthritis (SpA) and to evaluate its clinical importance. METHODS: Six hundred and ninety-nine ambulatory patients were evaluated. RDW, hemoglobin, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed. In order to compare groups, a Kruskall-Wallis test with post hoc Dunn's test was applied. A multiple logistic regression analysis was used to evaluate anisocytosis explanatory variables. RESULTS: Red blood cell distribution width values differed significantly among groups. Post hoc analysis demonstrated a significant increase in RDW within RA versus OA groups (P < 0.001), active SpA versus OA (P < 0.001), RA versus FM (P < 0.001) and active SpA versus FM groups (P = 0.001). Presence of anisocytosis was useful to discriminate between active articular inflammatory versus non-inflammatory diseases with 48-95% sensitivity and 66-95% specificity. Multivariate analysis showed a six-fold increase in anisocytosis for the presence of a possible articular inflammatory disease. CONCLUSION: In subjects with articular pain, RDW interpretation is a useful tool in clinical practice to distinguish between articular inflammatory and non-inflammatory joint diseases, as with CRP. RDW seems to be a surrogate marker of the inflammatory process.


Assuntos
Artrite Reumatoide/diagnóstico , Índices de Eritrócitos , Fibromialgia/diagnóstico , Osteoartrite/diagnóstico , Espondilartrite/diagnóstico , Adulto , Idoso , Artrite Reumatoide/sangue , Biomarcadores/sangue , Sedimentação Sanguínea , Proteína C-Reativa/análise , Estudos Transversais , Diagnóstico Diferencial , Feminino , Fibromialgia/sangue , Humanos , Mediadores da Inflamação/sangue , Masculino , Pessoa de Meia-Idade , Osteoartrite/sangue , Valor Preditivo dos Testes , Fatores de Risco , Espondilartrite/sangue
12.
J Biol Chem ; 294(7): 2555-2568, 2019 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-30523152

RESUMO

Diagnosis and treatment of fibromyalgia (FM) remains a challenge owing to the lack of reliable biomarkers. Our objective was to develop a rapid biomarker-based method for diagnosing FM by using vibrational spectroscopy to differentiate patients with FM from those with rheumatoid arthritis (RA), osteoarthritis (OA), or systemic lupus erythematosus (SLE) and to identify metabolites associated with these differences. Blood samples were collected from patients with a diagnosis of FM (n = 50), RA (n = 29), OA (n = 19), or SLE (n = 23). Bloodspot samples were prepared, and spectra collected with portable FT-IR and FT-Raman microspectroscopy and subjected to metabolomics analysis by ultra-HPLC (uHPLC), coupled to a photodiode array (PDA) and tandem MS/MS. Unique IR and Raman spectral signatures were identified by pattern recognition analysis and clustered all study participants into classes (FM, RA, and SLE) with no misclassifications (p < 0.05, and interclass distances > 2.5). Furthermore, the spectra correlated (r = 0.95 and 0.83 for IR and Raman, respectively) with FM pain severity measured with fibromyalgia impact questionnaire revised version (FIQR) assessments. Protein backbones and pyridine-carboxylic acids dominated this discrimination and might serve as biomarkers for syndromes such as FM. uHPLC-PDA-MS/MS provided insights into metabolites significantly differing among the disease groups, not only in molecular m/z + and m/z - values but also in UV-visible chromatograms. We conclude that vibrational spectroscopy may provide a reliable diagnostic test for differentiating FM from other disorders and for establishing serologic biomarkers of FM-associated pain.


Assuntos
Fibromialgia/sangue , Fibromialgia/diagnóstico , Dor/sangue , Dor/diagnóstico , Adulto , Biomarcadores , Cromatografia Líquida de Alta Pressão , Feminino , Fibromialgia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Dor/fisiopatologia , Medição da Dor , Espectrofotometria Infravermelho , Inquéritos e Questionários
13.
Croat Med J ; 60(6): 515-520, 2019 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-31894917

RESUMO

AIM: To determine the frequency of ferritin deficiency in individuals with fibromyalgia syndrome (FMS) and to evaluate the association of ferritin level with depression, anxiety, sleep quality, and physical functioning. METHODS: This cross-sectional study, conducted from 2016 to 2017, compared the frequency of ferritin deficiency between 100 non-anemic fibromyalgia patients and 100 non-anemic individuals without FMS. Serum ferritin level of <30 ng/mL indicated iron deficiency. FMS patients filled out demographic questionnaire, Fibromyalgia Impact Questionnaire, Beck Anxiety Inventory, Beck Depression Inventory, and Pittsburg Sleep Quality Index. RESULTS: Median serum ferritin level was 20.95 ng/mL. A total of 64% of patients and 42% of controls had iron deficiency. Beck Anxiety Inventory, Beck Depression Inventory, and Pittsburgh Sleep Quality Index scores were not associated with ferritin levels. FMS patients with poor sleep quality had significantly higher Beck Depression Inventory, Beck Anxiety Inventory, and Fibromyalgia Impact Questionnaire scores (P<0.05). In individuals with poor sleep quality, lower ferritin levels also correlated with higher Beck Depression Inventory scores (r=-0.277, P<0.05). Sleep quality was not significantly associated with age, body mass index, duration of diagnosis, and serum ferritin levels. CONCLUSIONS: Patients with fibromyalgia syndrome have a rather high prevalence of non-anemic iron deficiency. No associations were found between serum ferritin level and anxiety, depression, sleep quality, and physical functioning.


Assuntos
Ferritinas/sangue , Fibromialgia/sangue , Fibromialgia/psicologia , Ferro/deficiência , Sono , Adulto , Ansiedade/sangue , Ansiedade/etiologia , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Depressão/sangue , Depressão/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Inquéritos e Questionários , Adulto Jovem
14.
Niger J Clin Pract ; 21(10): 1271-1277, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30297558

RESUMO

Aim: Central sensitization-related neuroaudiological symptoms are frequently seen in patients with fibromyalgia syndrome (FMS). This study aimed to evaluate the audiological signs and symptoms in patients with FMS and explore their relationship with oxidative stress markers. Methods: This prospective controlled cross-sectional study compared the serum myeloperoxidase, superoxide dismutase, glutathione peroxidase (GPx), nitric oxide (NO), and malondialdehyde (MDA) concentrations in 44 patients with FMS diagnosed according to the 2010 American College of Rheumatology criteria and 44 healthy volunteers. FMS severity was assessed using the visual analog scale and Fibromyalgia Impact Questionnaire. An audiological assessment including vocalizations, vertigo, balance problems, and hearing problems was done to all participants. Results: The two groups were of similar age (P = 0.24), gender (P = 0.40), and weight distribution (P = 0.6). Vertigo, tinnitus, hearing, and balance complaints (P = 0.01/P = 0.00/P = 0.00/P = 0.01) were significantly higher in the FMS group. All subunits and total scores of dizziness handicap inventory were significantly higher (P = 0.00/P = 0.00/P = 0.01/P = 0.01) in the FMS group. An antioxidant GPx and oxidant parameters such as NO and MDA were found to be significantly higher (P = 0.00/P = 0.01/P = 0.02). The hearing assessments at frequencies between 250 and 12,000 Hz showed a significant difference between the two groups (high hearing frequencies in the FMS group) in audiometry. No significant difference was found between the two groups in terms of the presence of stabilo-acoustic reflex, intraaural pressure, and compliance (P = 0.18/P = 0.33/P = 0.41) in tympanogram. Conclusions: Patients with FMS have high levels of oxidative stress markers (GPx, NO, and MDA), highly frequent audiological symptoms with high hearing frequencies in audiometry, independent of disease severity.


Assuntos
Antioxidantes/metabolismo , Biomarcadores/sangue , Fibromialgia/diagnóstico , Transtornos da Audição/etiologia , Estresse Oxidativo , Superóxido Dismutase/sangue , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Feminino , Fibromialgia/sangue , Fibromialgia/complicações , Glutationa Peroxidase/sangue , Transtornos da Audição/sangue , Humanos , Masculino , Malondialdeído/sangue , Pessoa de Meia-Idade , Nitratos/sangue , Medição da Dor , Peroxidase/sangue , Estudos Prospectivos , Inquéritos e Questionários
16.
Dtsch Med Wochenschr ; 143(16): 1174-1180, 2018 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-30086563

RESUMO

Triiodothyronine (T3) is a key regulator of bone, muscle and articular cartilage. Musculoskeletal symptoms of hyperthyroidism include loss of bone mass finally leading to osteoporosis and weakness of the skeletal musculature. Hypothyroidism on the other side frequently leads to muscle stiffness and cramping and, occasionally, results in rhabdomyolysis. To prevent terminal differentiation of chondrocytes with consecutive cartilage degeneration, cartilage probably depends on exact regulation of local T3 availability by the intracellular deiodinase system. Recent findings underline the importance of local T3 generation by deiodinase type 2 and support the existence of local hypo- or hyperthyroidism.In the review, the implications of the recent literature for current understanding of osteoarthritis, myopathies and diabetic osteoarthropathy will be discussed. Further emphasis will be placed on the association of autoimmune thyroiditis with musculoskeletal diseases and fibromyalgia.


Assuntos
Doença de Hashimoto/diagnóstico , Hipertireoidismo/diagnóstico , Hipotireoidismo/diagnóstico , Artropatias/diagnóstico , Doenças Musculares/diagnóstico , Cartilagem Articular/fisiopatologia , Fibromialgia/sangue , Fibromialgia/diagnóstico , Doença de Hashimoto/sangue , Humanos , Hipertireoidismo/sangue , Hipotireoidismo/sangue , Iodeto Peroxidase/fisiologia , Artropatias/sangue , Doenças Musculares/sangue , Osteoartrite/sangue , Osteoartrite/diagnóstico , Tri-Iodotironina/sangue
17.
Pain Res Manag ; 2018: 7257681, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29861805

RESUMO

FMS patients demonstrate an altered profile of chemokines relative to healthy controls (HC). Eotaxin-2 is a potent chemoattractant distributed in a variety of tissues. The aim of the study was to compare serum levels of eotaxin-2 between FMS patients and HC and to examine a potential correlation between eotaxin-2 levels and clinical parameters of FMS. Methods. 50 patients with FMS and 15 HC were recruited. Data on the severity of FMS symptoms and depression were collected. Serum levels of eotaxin-2 (ELISA) were determined in all participants. High-sensitive CRP (hs-CRP) was measured in the FMS group. Results. The FMS cohort included predominantly females (84%), mean age of 49, and mean disease duration of 6 years. FMS patients exhibited significantly higher eotaxin-2 levels (pg/ml) versus HC: 833 (±384) versus 622 (±149), p=0.04. Mean hs-CRP level among FMS patients was 4.8 ± 6 mg/l, a value not indicative of acute inflammation. No correlation was found between eotaxin-2 and hs-CRP levels. No correlation was found between eotaxin-2 and severity measures of FMS or depression. Conclusion. Eotaxin-2 does not appear to be a candidate for a disease activity biomarker in FMS. Further research is warranted into the role of this chemokine in the pathophysiology of the FMS.


Assuntos
Quimiocina CCL24/sangue , Fibromialgia/sangue , Adulto , Proteína C-Reativa/metabolismo , Estudos de Coortes , Feminino , Fibromialgia/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Escalas de Graduação Psiquiátrica , Adulto Jovem
18.
PLoS One ; 13(6): e0198625, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29927949

RESUMO

BACKGROUND: Fibromyalgia (FM) is a chronic pain syndrome with a high incidence in females that may involve activation of the immune system. We performed exome sequencing on chemokine genes in a region of chromosome 17 identified in a genome-wide family association study. METHODS AND FINDINGS: Exome sequence analysis of 100 FM probands was performed at 17p13.3-q25 followed by functional analysis of SNPs found in the chemokine gene locus. Missense SNPs (413) in 17p13.3-q25 were observed in at least 10 probands. SNPs rs1129844 in CCL11 and rs1719152 in CCL4 were associated with elevated plasma chemokine levels in FM. In a transmission disequilibrium test (TDT), rs1129844 was unequally transmitted from parents to their affected children (p< 0.0074), while the CCL4 SNP was not. The amino acid change (Ala23Thr), resulting from rs1129844 in CCL11, predicted to alter processing of the signal peptide, led to reduced expression of CCL11. The variant protein from CCL4 rs1719152 exhibited protein aggregation and a potent down-regulation of its cognate receptor CCR5, a receptor associated with hypotensive effects. Treatment of skeletal muscle cells with CCL11 produced high levels of CCL4 suggesting CCL11 regulates CCL4 in muscle. The immune association of FM with SNPs in MEFV, a chromosome 16 gene associated with recurrent fevers, had a p< 0.008 TDT for a combined 220 trios. CONCLUSIONS: SNPs with significant TDTs were found in 36% of the cohort for CCL11 and 12% for MEFV, along with a protein variant in CCL4 (41%) that affects CCR5 down-regulation, supporting an immune involvement for FM.


Assuntos
Quimiocina CCL11/genética , Quimiocina CCL4/genética , Fibromialgia/genética , Polimorfismo de Nucleotídeo Único , Pirina/genética , Alelos , Quimiocina CCL11/sangue , Quimiocina CCL11/farmacologia , Quimiocina CCL4/sangue , Exoma , Fibromialgia/sangue , Predisposição Genética para Doença , Humanos , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/metabolismo
19.
Mediators Inflamm ; 2018: 3985154, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29849487

RESUMO

The aims of this study were to compare circulating cytokines between FM and healthy controls and to investigate the effect on cytokine levels by 15 weeks of progressive resistance exercise or relaxation therapy in FM. Baseline plasma cytokine levels and clinical data were analyzed in 125 women with FM and 130 age-matched healthy women. The FM women were then randomized to progressive resistance exercise (n = 49) or relaxation (n = 43). Baseline IL-2, IL-6, TNF-α, IP-10, and eotaxin were higher in FM than in healthy controls (P < 0.041), whereas IL-1ß was lower (P < 0.001). There were weak correlations between cytokine levels and clinical variables. After both interventions, IL-1ra had increased (P = 0.004), while IL-1ß had increased in the relaxation group (P = 0.002). Changes of IFN-γ, IL-2, IL-4, IL-6, IL-8, and IL-17A were weakly correlated with changes of PPT, but there were no significant correlations between changes of cytokine and changes in other clinical variables. The elevated plasma levels of several cytokines supports the hypothesis that chronic systemic inflammation may underlie the pathophysiology of FM even if the relation to clinical variables was weak. However, 15 weeks of resistance exercise, as performed in this study, did not show any anti-inflammatory effect on neither FM symptoms nor clinical and functional variables. This trial is registered with ClinicalTrials.gov NCT01226784, registered October 21, 2010. The first patient was recruited October 28, 2010.


Assuntos
Citocinas/sangue , Fibromialgia/sangue , Fibromialgia/terapia , Terapia de Relaxamento/métodos , Treinamento de Resistência/métodos , Adulto , Exercício Físico/fisiologia , Feminino , Fibromialgia/imunologia , Humanos , Inflamação/sangue , Inflamação/imunologia , Inflamação/terapia , Interleucina-17/sangue , Interleucina-1beta/sangue , Interleucina-2/sangue , Interleucina-4/sangue , Interleucina-6/sangue , Interleucina-8/sangue , Pessoa de Meia-Idade , Fator de Necrose Tumoral alfa/sangue
20.
Clin Lab ; 64(3): 405-410, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29739097

RESUMO

BACKGROUND: Although the pathophysiology of fibromyalgia has not yet been fully clarified, inflammation and endothelial dysfunction have been suggested to occur in patients with fibromyalgia. In recent years, endocan has been reported as an important biomarker for inflammation and endothelial dysfunction. In this study, we investigated this mechanism by measuring the serum endocan levels in fibromyalgia patients. METHODS: The serum samples collected from 37 female patients diagnosed with fibromyalgia for the first time and 43 healthy women were analysed in terms of the endocan levels and laboratory parameters, and the values from the two groups were compared. RESULTS: In the patient group, the serum endocan level was found to be higher (p < 0.0001). Endocan had a significantly high sensitivity and specificity for the diagnosis of fibromyalgia (area under curve: 0.897, cutoff value: 9.81 ng/mL, sensitivity: 88.5%, specificity: 89.7%). CONCLUSIONS: Subclinical inflammation and endothelial dysfunction are important in the pathophysiology of fibromyalgia. Increased endocan not only elucidates this mechanism but also presents as an important potential marker for fibromyalgia.


Assuntos
Biomarcadores/sangue , Endotélio Vascular/fisiopatologia , Fibromialgia/sangue , Inflamação/sangue , Proteoglicanas/sangue , Adulto , Idoso , Ensaio de Imunoadsorção Enzimática , Feminino , Fibromialgia/diagnóstico , Fibromialgia/fisiopatologia , Humanos , Inflamação/diagnóstico , Inflamação/fisiopatologia , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Adulto Jovem
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