Relationship of substance P, 5-hydroxyindole acetic acid & tryptophan in serum of fibromyalgia (FM) patients

The serotonergic system has repeatedly been discussed to be

involved in the pathophysiology of fibromyalgia (FM), which is

a syndrome of widespread pain and sleep disturbance. Elevated

levels of substance P (SP), a mediator of nociception, have

been described in FM. In this study the possible relationship

between SP and serotonin (5-HT) together with its precursor

tryptophan (TRP) and its metabolite 5- hydroxyindoleacetic

acid (5-HIAA) was evaluated in 51 serum samples of

fibromyalgia patients. These parameters were compared with

clinical data such as pain intensity or sleep quality. A

strong negative correlation between SP and 5-HIAA (P = .000)

as well as between SP and TRP (P = .009) could be

demonstrated. High serum concentrations of 5- HIAA and TRP

showed a significant relation to low pain scores (5-HIAA: P =

.030; TRP: P = .014). Moreover, 5-HIAA was strongly related to

good quality of sleep (P = .000), while SP was related to

sleep disturbance (P = .005). These data are valid to support

the hypothesis of a systemic involvement of 5-HT and SP in


Schwarz MJ, Spath M, Muller-Bardorff H, Pongratz DE, Bondy B,

Ackenheil M

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