Disease relevance of Fibromyalgia

• METHODS: Analyses of self reported data from 713 patients with rheumatoid arthritis, osteoarthritis, or fibromyalgia [1].
• The concentration of keratan sulfate (KS) epitope was measured in the serum of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) by enzyme-linked immunosorbent assay and compared with that in the serum of patients with primary fibromyalgia syndrome (PFS) and of controls who had no joint disease [2].
• Thus, it seems unlikely that parvovirus B19 plays a role in CFS, even though it has been associated with fibromyalgia, a clinically similar syndrome [3].
• There was a significant, approximately 30%, reduction in the ACTH and epinephrine responses to hypoglycemia in women with fibromyalgia compared with controls [4].
• However, in spite of this heterogeneity and other methodological problems it is clear that a wide range of pain conditions are responsive to antidepressant drug treatment, in particular: headache, migraine, facial pain, neurogenic pain, fibrositis, and probably arthritis and rheumatoid arthritis [5].

Psychiatry related information on Fibromyalgia

• Twenty-five subjects with primary fibromyalgia syndrome and 22 subjects with rheumatoid arthritis were compared on measures of psychological distress, pain, health status, life stress, sleep disturbance, and coping strategies [6].
• Both the rate of major affective disorder and the familial prevalence of major affective disorder were significantly higher in the fibromyalgia patients than the rheumatoid arthritis patients [7].
• The effect of electroconvulsive therapy (ECT) as pain remedication in cases of fibromyalgia without major depressive disorder was studied in a prospective trial lasting three months [8].
• In our studies, this reduction in platelet 5-HT transporter binding is not due to prior antidepressant treatment of hypercortisolemia and is not observed in mania, Alzheimer disease, schizophrenia, panic disorder, fibromyalgia, or atypical depression [9].
• Pregabalin (PGB) is a novel drug under development for the treatment of epilepsy, neuropathic pain, fibromyalgia, and generalized anxiety disorder [10].

High impact information on Fibromyalgia

• Fluoxetine and fibromyalgia [11].
• This study evaluated the effect of symptoms of depression and/or clinically diagnosed major depressive disorder (MDD) on pain processing in patients with fibromyalgia (FM) [12].
• Momentary relationship between cortisol secretion and symptoms in patients with fibromyalgia [13].
• OBJECTIVE: To assess the efficacy and safety of pramipexole, a dopamine 3 receptor agonist, in patients with fibromyalgia [14].
• A randomized, double-blind, placebo-controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications [14].

Chemical compound and disease context of Fibromyalgia

• OBJECTIVE: To assess the efficacy and safety of duloxetine, a serotonin and norepinephrine reuptake inhibitor, in subjects with primary fibromyalgia, with or without current major depressive disorder [15].
• Is Chiari malformation associated with increased levels of substance P and clinical symptoms in persons with fibromyalgia [16]?
• Duloxetine treatment improved fibromyalgia symptoms and pain severity regardless of baseline status of major depressive disorder [15].
• METHODS: In this 14-week, single-center, double-blind, placebo-controlled, parallel-group, escalating-dose trial, 60 patients with fibromyalgia were randomized 2:1 (pramipexole:placebo) to receive 4.5 mg of pramipexole or placebo orally every evening [14].
• Treatment of primary fibrositis/fibromyalgia syndrome with ibuprofen and alprazolam. A double-blind, placebo-controlled study [17].

Biological context of Fibromyalgia

• A total of 207 subjects meeting the American College of Rheumatology criteria for primary fibromyalgia were enrolled (89% female, 87% white, mean age 49 years, 38% with current major depressive disorder) [15].
• Combination therapy in the treatment of major depressive disorder complicated by fibromyalgia and menopause [18].
• OBJECTIVE: This study examined the influence of the menstrual cycle on pain and emotion in women with fibromyalgia (FM) as compared with women with rheumatoid arthritis (RA) and to healthy controls [19].
• Calcium ions have a key role in the physiology of muscular contraction: changes in calcium ion concentration may be involved in the pathogenesis of fibromyalgia [20].
• The treatment for FUS was the same as that for fibromyalgia: cyclobenzaprine or diazepam and nonsteroidal anti-inflammatory drugs with a partial response in both pathologies [21].

Anatomical context of Fibromyalgia

• To measure, and seek clinical correlates with, levels of substance P (SP) in the cerebrospinal fluid (CSF) of fibromyalgia syndrome (FMS) patients [22].
• Possible concomitant fibromyalgia in systemic lupus erythematosus patients with overt central nervous system disease but with cognitive deficits: comment on the article by Kozora et al [23].
• Unlike normal IL-2 secretion, which was higher after removal of CD8+ T cells, the pattern and degree of IL-2 secretion by cells from fibromyalgia patients were not changed following removal of CD8+ T cells [24].
• NO-mediated alterations in skeletal muscle nutritive blood flow and lactate metabolism in fibromyalgia [25].
• Increase in peripheral benzodiazepine receptors on monocytes in fibromyalgia [26].

Gene context of Fibromyalgia

• MMP-3 levels were normal in fibromyalgia, osteoarthritis, ankylosing spondylitis, and acute inflammatory controls [27].
• The median (IQR) CD64 expression in control patients (osteoarthritis and fibromyalgia) was 505 (359-599) [28].
• Our findings indicate that fibromyalgia, along with ACTH hyperreactivity, also exhibits a distinct disturbance in the GH-somatomedin C axis [29].
• Pituitary release of growth hormone and prolactin in the primary fibromyalgia syndrome [29].
• Mutational analysis of serotonin receptor genes: HTR3A and HTR3B in fibromyalgia patients [30].

Analytical, diagnostic and therapeutic context of Fibromyalgia

• CONCLUSION: In a subset of patients with fibromyalgia, approximately 50% of whom required narcotic analgesia and/or were disabled, treatment with pramipexole improved scores on assessments of pain, fatigue, function, and global status, and was safe and well-tolerated [14].
• Tramadol/acetaminophen-treated subjects also had significantly less pain at the end of the study (53 +/- 32 vs. 65 +/- 29 on a visual analog scale of 0 to 100, P <0.001), and better pain relief (1.7 +/- 1.4 vs. 0.8 +/- 1.3 on a scale of -1 to 4, P <0.001) and Fibromyalgia Impact Questionnaire scores (P = 0.008) [31].
• Effects on muscle pain by intramuscular injection of granisetron in patients with fibromyalgia [32].
• CONCLUSIONS: An abnormal lactulose breath test is more common in fibromyalgia than IBS [33].
• The immune-inflammatory pathophysiology of fibromyalgia: increased serum soluble gp130, the common signal transducer protein of various neurotrophic cytokines [34].

References