Rheumatologists are recognizing the inflammatory component of fibromyalgia and that has led to studies using disease state primary cells to determine the best treatment approaches.
Fibromyalgia is a chronic condition that is commonly considered a neurologic problem with multifocal pain as an important feature of the disease. However, rheumatologists are recognizing the inflammatory component of fibromyalgia and that pain my not be the primary feature of the condition. Other significant aspects of fibromyalgia are fatigue, sleep disorders, and cognitive impairments. Results of studies in patients with fibromyalgia suggest that excessive cytokine release may be the central cause of the development and symptomology of fibromyalgia.
Dr. Jarred Younger of the University of Alabama at Birmingham says that the brain’s microglia cells may be responsible for the development of fibromyalgia. Microglia cells are the central nervous system’s (CNS’s) macrophages and are the main immune defense for the brain and other areas of the CNS. He hypothesizes that these cells release proinflammatory cytokines when disturbed during an infection or other physiological trauma. This cytokine release then eventually affects neurotransmitter release leading to the neurologic effects seen in people with fibromyalgia.
Results of a clinical study conducted by Dr. Younger and Dr. Parkitny show that treating patients with fibromyalgia with naltrexone, used to block opioid effects, is associated with a decrease in various proinflammatory cytokines including various interleukins, interferon-alpha, transforming growth factor-alpha (and beta), tumor necrosis factor-alpha, and granulocyte-colony stimulating factor. Younger indicated that treatments for fibromyalgia should be able to target the microglia cells without completely disabling them.
Studies to determine the role of microglia cells in the inflammatory process of fibromyalgia may shed more light on its pathogenesis. Obtaining disease state primary cells from patients with fibromyalgia may represent valuable tools to better determine the role of inflammatory processes and microglia cell changes in the development of the disease. Microglia cells can be differentiated in vitro from bone marrow-derived stem cell. Data derived from studies using disease state primary cells can help determine the best treatment approaches that may modulate cytokine release and possibly relieve fibromyalgia-related pain and debilitating neurologic symptoms.
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Reference:Fibromyalgia best treated as inflammatory disease. (2018). Healio.com. Retrieved 19 June 2018, from https://www.healio.com/rheumatology/fibromyalgia/news/online/%7Bdffc5ca2-6e38-4484-8481-2c4fbe07bb15%7D/fibromyalgia-best-treated-as-inflammatory-disease