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Collagen crosslinks in fibromyalgia (FM)

  [ 20 votes ]   [ Discuss This Article ]
By Sprott H, Muller A, Heine H • • August 6, 1997

OBJECTIVE: To determine if abnormal collagen metabolism is a
characteristic of fibromyalgia.

METHODS: The diagnosis of
fibromyalgia was made according to the American College of
Rheumatology criteria. Skin biopsy samples were obtained from
the trapezius region of 8 patients with fibromyalgia. Urine
was collected under standardized conditions from 55 control
subjects and 39 patients with fibromyalgia, and serum was
obtained from 17 controls and 22 patients with fibromyalgia.

Pyridinoline (Pyd), an indicator of connective tissue disease,
and deoxypyridinoline (Dpyd), an indicator of bone
degradation, both of which represent products of lysyl
oxidase-mediated crosslinking in collagen, were analyzed by
ion-paired and gradient high-performance liquid chromatography
(HPLC) methods with fluorescence detection. Levels of
hydroxyproline (Hyp), a collagen turnover marker, were also
measured. The findings were related to creatinine levels, and
the Pyd:Dpyd ratio was determined.

RESULTS: Highly ordered
cuffs of collagen were observed around the terminal nerve
fibers by electron microscopic examination of biopsy tissue
from all 8 patients with fibromyalgia, but were not observed
in any of the control skin samples. The Pyd:Dpyd ratios in the
urine and serum and the Hyp levels in the urine were
significantly lower in patients with fibromyalgia than in
healthy controls.

CONCLUSION: Decreased levels of collagen
crosslinking in fibromyalgia may contribute to remodeling of
the extracellular matrix and collagen deposition around the
nerve fibers, and may 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 in understanding more about the pathogenesis of

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