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The immune-inflammatory pathophysiology of fibromyalgia (FM): increased serum

  [ 93 votes ]   [ Discuss This Article ] • May 1, 1999

Fibromyalgia is a chronic, painful musculoskeletal disorder
characterized by widespread pain, pressure hyperalgesia,
morning stiffness and by an increased incidence of depressive
symptoms. The etiology, however, has remained elusive. The aim
of the present study was to examine the inflammatory response
system (IRS) in fibromyalgia. Serum interleukin-6 (IL-6),
soluble IL-6 receptor (sIL-6R), sgp130, sIL- 1R antagonist
(IL-1RA) and sCD8 were determined in 33 healthy volunteers and
in 21 fibromyalgia patients, classified according to the
American College of Rheumatology criteria. Severity of illness
was measured with several pain scales, dolorimetry and the
Hamilton Depression Rating Scale (HDRS). Serum sgp130 was
significantly higher and serum sCD8 significantly lower in
fibromyalgia patients than in healthy volunteers. Serum sIL-6R
and sIL-1RA were significantly higher in fibromyalgia patients
with an increased HDRS score (> or = 16) than in normal
volunteers and fibromyalgia patients with a HDRS score < 16.

In fibromyalgia patients, an important part of the variance in
sCD8 (50.3%) and IL-1RA (19.3%) could be explained by the HDRS
score; 74.3% of the variance in sIL-6R was explained by the
combined effects of pain symptoms and the HDRS score; and
25.9% of the variance in serum sgp130 was explained by
stiffness. The results support the contention that pain and
stiffness in fibromyalgia may be accompanied by a suppression
of some aspects of the IRS and that the presence of clinically
significant depressive symptoms in fibromyalgia is associated
with some signs of IRS activation.

Maes M, Libbrecht I, Van Hunsel F, Lin AH, De Clerck L, Stevens W,
Kenis G, de Jongh R, Bosmans E, Neels H

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