Elevated Serum Levels of Monocyte Chemotactic Protein-1/Chemokine C-C Motif Ligand 2 are Linked to Disease Severity in Patients with Fibromyalgia Syndrome

Pain and the biochemistry of fibromyalgia: patterns of peripheral cytokines and chemokines contribute to the differentiation between fibromyalgia and controls and are associated with pain, fat infiltration and content

Objectives

This explorative study analyses interrelationships between peripheral compounds in saliva, plasma, and muscles together with body composition variables in healthy subjects and in fibromyalgia patients (FM). There is a need to better understand the extent cytokines and chemokines are associated with body composition and which cytokines and chemokines differentiate FM from healthy controls.

Methods

Here, 32 female FM patients and 30 age-matched female healthy controls underwent a clinical examination that included blood sample, saliva samples, and pain threshold tests. In addition, the subjects completed a health questionnaire. From these blood and saliva samples, a panel of 68 mainly cytokines and chemokines were determined. Microdialysis of trapezius and erector spinae muscles, phosphorus-31 magnetic resonance spectroscopy of erector spinae muscle, and whole-body magnetic resonance imaging for determination of body composition (BC)-i.e., muscle volume, fat content and infiltration-were also performed.

Results

After standardizing BC measurements to remove the confounding effect of Body Mass Index, fat infiltration and content are generally increased, and fat-free muscle volume is decreased in FM. Mainly saliva proteins differentiated FM from controls. When including all investigated compounds and BC variables, fat infiltration and content variables were most important, followed by muscle compounds and cytokines and chemokines from saliva and plasma. Various plasma proteins correlated positively with pain intensity in FM and negatively with pain thresholds in all subjects taken together. A mix of increased plasma cytokines and chemokines correlated with an index covering fat infiltration and content in different tissues. When muscle compounds were included in the analysis, several of these were identified as the most important regressors, although many plasma and saliva proteins remained significant.

Discussion

Peripheral factors were important for group differentiation between FM and controls. In saliva (but not plasma), cytokines and chemokines were significantly associated with group membership as saliva compounds were increased in FM. The importance of peripheral factors for group differentiation increased when muscle compounds and body composition variables were also included. Plasma proteins were important for pain intensity and sensitivity. Cytokines and chemokines mainly from plasma were also significantly and positively associated with a fat infiltration and content index.

Conclusion

Our findings of associations between cytokines and chemokines and fat infiltration and content in different tissues confirm that inflammation and immune factors are secreted from adipose tissue. FM is clearly characterized by complex interactions between peripheral tissues and the peripheral and central nervous systems, including nociceptive, immune, and neuroendocrine processes.

Neurospecific markers of brain damage in infants

Timely diagnosis of brain lesions in infants is important for preventing the development and progression of neurological diseases.

Purpose. The study aimed at investigation of neurospecific laboratory parameters in children of 1 year of age with structural changes in the brain.

Material and methods. The clinical and laboratory examination of 50 children of 1 year of age, born at full term, was carried out. Serum concentrations of neurotrophic growth factor (BDNF), fractalkine (CX3CL-1), monocytic chemotactic protein (CCL2), trigger receptor expressed on myeloid cells-1, 2 (TREM-1, TREM-2), transforming growth factor-ȕ1 (TGF-ȕ1), nerve growth factor-ȕ (ȕ-NGF), visinin-like protein-1 (VILIP-1), vascular endothelial growth factor (VEGF), glycosylation end product receptor (sRAGE), interleukin (IL)-6, IL-18, and tumor necrosis factor Į (TNF-Į).

Results. Predictors of brain damage in full-term infants have been identified. The level of TGFB-1 in children with structural changes in the brain exceeded that of the control group by 1.4 [1.1; 1.6] times, the level of AntiGRIN2A — 1.6 [1.1; 2.0] times, which makes it possible to consider these parameters as biomarkers of brain damage.

Conclusion. Based on the results obtained, an additional laboratory examination of children who have undergone ante- and intranatal hypoxia is recommended, including the determination of the level of neurodamage biomarkers such as: TGFB-1 and AntiGRIN2A. This study will contribute to the timely detection of disorders of the central nervous system and the initiation of therapy to prevent the development and progression of neurological pathology in childhood. 

Perfectionism and Pain Intensity in Women with Fibromyalgia: Its Influence on Activity Avoidance from The Contextual Perspective

Given the scarcity of studies regarding perfectionism from a contextual perspective, this study aims to analyze its role in the relationship between pain and activity avoidance and its differential effect among patients with different fibromyalgia severity. A cross-sectional study with 228 women with fibromyalgia classified into two disease severity groups (low/moderate vs. high) was carried out. Moderation analyses were conducted; perfectionism was used as moderator, pain (in high and low pain situations) as independent variable, and activity avoidance as the outcome. Among the high disease severity group, analyses showed direct contributions of perfectionism (p < 0.001) but not of pain (p > 0.05); moderation effects were found in high pain situations (p = 0.002) (for low levels of perfectionism, a positive association was found between pain intensity and avoidance). Among the low severity group, direct effects of perfectionism (p < 0.05) and pain intensity (p = 0.04) were found (although the latter only for high pain situations); moderation effects were found in high pain situations (p = 0.018) (for high levels of perfectionism a positive and significant association was found between pain intensity and avoidance). Perfectionism has been found to be a key variable in the differential relationship between pain intensity (in high pain situations) and activity avoidance in groups with high and low disease severity.