The Study of Blood Biomarkers in the Pathogenesis of Fibromyalgia: A Case-Control Study
Abstract
Fibromyalgia (FM) is a chronic musculoskeletal syndrome characterized by pain and fatigue; however, its etiology remains unknown, and various hypotheses and biomarkers have been proposed. This study it is aimed to investigate blood biomarkers in the pathogenesis of FM. The current case-control study has been conducted on 45 females with the documented diagnosis of FM and 45 healthy controls referring to the outpatient clinic of rheumatology in 2018-19. The serum levels of dehydroepiandrosterone (DHEAS), erythrocytic sedimentation rate (ESR), C-reactive protein (CRP), complete blood count (CBC), and thyroid-stimulating hormone (TSH) was measured and compared between the groups. DHEAS serum levels in cases and controls were 27.55±18.80 and 33.55±21.80, (P=0.16), ESR was 29.17±9.75 and 17.37±2.82 (P<0.001), CRP was 4.17±1.53 and 3.53±1.15 (P=0.02), TSH was 3.307±0.27 and 3.41±0.22 (P=0.09), respectively. The two groups were similar in CBC indices, including hemoglobin, hematocrit, white blood cell, lymphocyte, neutrophil, and platelet count (P>0.05). DHEAS was slightly, but insignificantly, lower among the females with FM than healthy cases. On the other hand, the serum ESR and CRP levels were remarkably higher among the females with FM; however, in the normal range, a fact representing the possible traces of inflammation in the pathogenesis of FM.
2. Hyland ME. A new paradigm to explain functional disorders and the adaptive network theory of chronic fatigue syndrome and fibromyalgia syndrome. In: Sullivan GB, Cresswell J, Ellis B, Morgan M, Schraube E, eds. Resistance and renewal in theoretical psychology. Concord, ON: Captus University Publications; 2017:21-31.
3. Goldenberg DL. Fibromyalgia syndrome a decade later: what have we learned? Arch Intern Med 1999;159:777-85.
4. Theoharides TC, Tsilioni I, Arbetman L, Panagiotidou S, Stewart JM, Gleason RM, et al. Fibromyalgia syndrome in need of effective treatments. J Pharmacol Exp Ther 2015;355:255-63.
5. Finckh A, Berner IC, Aubry-Rozier B, So AK. A randomized controlled trial of dehydroepiandrosterone in postmenopausal women with fibromyalgia. J Rheumatol 2005;32:1336-40.
6. Legrain S, Massien C, Lahlou N, Roger M, Debuire B, Diquet B, et al. Dehydroepiandrosterone replacement administration: pharmacokinetic and pharmacodynamic studies in healthy elderly subjects. J Clin Endocrinol Metab 2000;85:3208-17.
7. Arlt W, Callies F, van Vlijmen JC, Koehler I, Reincke M, Bidlingmaier M, et al. Dehydroepiandrosterone replacement in women with adrenal insufficiency. N Engl J Med 1999;341:1013-20.
8. Štrac DŠ, Jembrek MJ, Erhardt J, Kos KM, Peričić D. Modulation of recombinant GABAA receptors by neurosteroid dehydroepiandrosterone sulfate. Pharmacology 2012;89:163-71.
9. Semiz EA, Hizmetli S, Semiz M, Karadağ A, Adalı M, Tuncay MS, et al. Serum cortisol and dehydroepiandrosterone-sulfate levels after balneotherapy and physical therapy in patients with fibromyalgia. Saudi Med J 2016;37:544-50.
10. Peixoto C, Nelson Devicari Cheda J, Egidio Nardi A, Barciela Veras A, Cardoso A. The effects of dehydroepiandrosterone (DHEA) in the treatment of depression and depressive symptoms in other psychiatric and medical illnesses: a systematic review. Curr Drug Targets 2014;15:901-14
11. de Abreu Freitas RP, Lemos TM, Spyrides MH, de Sousa MB. Influence of cortisol and DHEA-S on pain and other symptoms in post menopausal women with fibromyalgia. J Back Musculoskelet Rehabil 2012;25:245-52.
12. Wolfe F, Clauw DJ, Fitzcharles M-A, Goldenberg DL, Häuser W, Katz RL, et al., editors. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 2016;46:319-29.
13. Dessein P, Shipton E, Joffe B, Hadebe D, Stanwix A, Van der Merwe B. Hyposecretion of adrenal androgens and the relation of serum adrenal steroids, serotonin and insulin-like growth factor-1 to clinical features in women with fibromyalgia. Pain 1999;83:313-9.
14. Geenen R, Jacobs JW, Bijlsma JW. Evaluation and management of endocrine dysfunction in fibromyalgia. Rheum Dis Clin North Am 2002;28:389-404.
15. Tanriverdi F, Karaca Z, Unluhizarci K, Kelestimur F. The hypothalamo–pituitary–adrenal axis in chronic fatigue syndrome and fibromyalgia syndrome. Stress 2007;10:13-25.
16. Van Houdenhove B, Luyten P. Stress, depression and fibromyalgia. Acta Neurologica Belgica 2006;106:149-56.
17. Genc A, Tur BS, Aytur YK, Oztuna D, Erdogan MF. Does aerobic exercise affect the hypothalamic-pituitary-adrenal hormonal response in patients with fibromyalgia syndrome? J Phys Ther Sci 2015;27:2225-31.
18. McLean SA, Williams DA, Harris RE, Kop WJ, Groner KH, Ambrose K, et al. Momentary relationship between cortisol secretion and symptoms in patients with fibromyalgia. Arthritis Rheum 2005;52:3660-9.
19. Mortaud S, Nicolas L, Pinoteau W, Tordjman S, Carlier M, Roubertoux PL. Brain pathways mediating the pro-aggressive effect of the steroid sulfatase (Sts) gene. Behav Genet 2010;40:211-9.
20. Xiao Y, Haynes WL, Michalek JE, Russell IJ. Elevated serum high-sensitivity C-reactive protein levels in fibromyalgia syndrome patients correlate with body mass index, interleukin-6, interleukin-8, erythrocyte sedimentation rate. Rheumatol Int 2013;33:1259-64.
21. Sturgeon JA, Darnall BD, Zwickey HL, Wood LJ, Hanes DA, Zava DT, et al. Proinflammatory cytokines and DHEA-S in women with fibromyalgia: impact of psychological distress and menopausal status. J Pain Res 2014;7:707-16.
22. Häuser W, Ablin J, Perrot S, Fitzcharles MA. Management of fibromyalgia: practical guides from recent evidence-based guidelines. Pol Arch Intern Med. 2017;127:47-56.
23. Jahan F, Nanji K, Qidwai W, Qasim R. Fibromyalgia syndrome: an overview of pathophysiology, diagnosis and management. Oman Med J 2012;27:192-5.
| Files | ||
| Issue | Vol 60, No 5 (2022) | |
| Section | SHORT COMMUNICATION | |
| DOI | https://doi.org/10.18502/acta.v60i5.9553 | |
| Keywords | ||
| Fibromyalgia Dehydroepiandrosterone (DHEAS) Pain | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
