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Collagen cross-links in fibromyalgia (FM) syndrome

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By Sprott H, Muller A, Heine H • www.ProHealth.com • March 15, 1998


OBJECTIVE: The acceptance of fibromyalgia as a disease entity and
its definitive diagnosis have been hampered by a dearth of
knowledge concerning the underlying pathophysiology of this
disease and the lack of specific biochemical markers
applicable to its diagnosis. To determine whether abnormal
collagen metabolism is a characteristic of fibromyalgia, we
have analyzed collagen metabolites in the urine and serum of
patients with fibromyalgia.

METHODS: The diagnosis of
fibromyalgia was made according to the American College of
Rheumatology criteria. Urine and serum were collected under
standardized conditions from 39 patients and 55 age- and
sex-matched controls. Pyridinoline (Pyd) and deoxypyridinoline
(Dpyd), which represent products of lysyl oxidase-mediated
cross-linking in collagen and are indicators of connective
tissue and bone degradation, respectively, were analyzed by
ion-paired and gradient HPLC method with fluorescence
detection (HPLC). Levels of hydroxypyroline (Hyp), a collagen
turnover marker, were also measured. The findings were related
to creatinine levels and the Pyd/Dpyd ratio determined.

RESULTS: The Pyd/Dpyd ratios in the urine and serum and the
Hyp in the urine were significantly lower in patients with
fibromyalgia than in healthy controls.

CONCLUSION: Decreased
levels of collagen cross-linking may contribute to remodeling
of the extracellular matrix and collagen deposition around the
nerve fibers in fibromyalgia and contribute to the lower pain
threshold at the tender points. Analysis of altered collagen
metabolism either by histologic examination on biopsy or,
preferably, by HPLC analysis of collagen metabolites in urine
or serum may aid to understand more about the pathogenesis of
fibromyalgia.




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