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Inferrera F, Marino Y, D'Amico R, Impellizzeri D, Cordaro M, Siracusa R, Gugliandolo E, Fusco R, Cuzzocrea S, Di Paola R. Impaired mitochondrial quality control in fibromyalgia: Mechanisms involved in skeletal muscle alteration. Arch Biochem Biophys 2024; 758:110083. [PMID: 38969196 DOI: 10.1016/j.abb.2024.110083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/04/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
Fibromyalgia (FMS) is a persistent syndrome marked by widespread musculoskeletal pain and behavioural symptoms. Given the hypothesis linking FMS aetiology to mitochondrial dysfunction and oxidative stress, we examined the biochemical correlation among these factors by studying specific proteins associated with mitochondrial homeostasis in muscle. Additionally, this study investigated the role of Boswellia serrata gum resin extract (BS), known for its various functions, including the potent induction of antioxidant enzymes, in determining protective or reparative mechanisms in the muscle cells. Sprague-Dawley rats were injected with reserpine to induce FMS. These animals exhibited moderate changes in hind limb skeletal muscles, experiencing mobility difficulties. Additionally, there were noteworthy morphological and ultrastructural alterations, along with the expression of myogenin, mitochondrial enzymes and oxidative stress markers in the gastrocnemius muscle. Interestingly, BS demonstrated a reduction in spontaneous motor activity difficulties. Moreover, BS showed a positive impact on musculoskeletal morphostructural aspects, as well as a decrease in oxidative stress and mitochondrial alterations. In particular, BS restored the mRNA expression of citrate synthase and cytochrome-c oxidase subunit II and the activity of electron transfer chain complexes. BS also influenced mitochondrial biogenesis, upregulating PGC-1α expression and the related transcription factors (Nrf1, Tfam, Nrf2, FOXO3a, SIRT3, GCLC, NQO1, SOD2 and GPx4), oxidative stress (lipid peroxidation, GSH levels and GSH-Px activity) and mitochondrial dynamics and function (Mnf2 expression and CoQ10 levels). Overall, this study underlined the key role of the mitochondrial alteration in FMS and that BS had a very high antioxidant effect in these organelles and also in the cells.
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Affiliation(s)
- Francesca Inferrera
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Ylenia Marino
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Ramona D'Amico
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Daniela Impellizzeri
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Marika Cordaro
- Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, 98125, Messina, Italy.
| | - Rosalba Siracusa
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Enrico Gugliandolo
- Department of Veterinary Science, University of Messina, 98168, Messina, Italy.
| | - Roberta Fusco
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166, Messina, Italy.
| | - Rosanna Di Paola
- Department of Veterinary Science, University of Messina, 98168, Messina, Italy.
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Beyaztas H, Aktas S, Guler EM, Ata E. Oxidative stress may be a contributing factor in fibromyalgia patients' pain mechanisms. Reumatismo 2023; 75. [PMID: 37721351 DOI: 10.4081/reumatismo.2023.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 06/29/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVE The pathophysiology of fibromyalgia (FM), a continuously painful syndrome with no known origin, has been related to mitochondrial dysfunction, oxidative stress, and inflammation. Recent studies have shown that FM may be associated with an oxidative balance disorder. The objective of this study was to measure the levels of oxidative stress in FM patients and try to understand the association between FM and free radicals. METHODS This study was performed on 100 volunteers admitted to the University of Health Sciences, Sultan 2, Abdulhamid Han Health Application and Research Center Physical Therapy and Rehabilitation Clinic, including 50 healthy controls and 50 patients with FM. To analyze oxidative stress biomarkers, total oxidant status (TOS) and total antioxidant status (TAS) levels were measured. Total thiol (TT) and native thiol (NT) concentrations were measured to determine the relationship between thiol groups. Disulfide (DIS) and oxidative stress index (OSI) were calculated with mathematical formulas. RESULTS While TOS and OSI levels were statistically higher in FM patients, TAS levels were significantly lower compared to the healthy control group (p<0.001). In comparison to the healthy control group, FM patients had considerably decreased TT and NT levels. DIS levels were significantly higher in FM patients than in controls (p<0.001). CONCLUSIONS Reactive oxygen species have several negative impacts on the human body. As a result of the measurements we analyzed, the relationship between FM and oxidative stress should be studied in terms of disease progression and may help improve the treatment process.
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Affiliation(s)
- H Beyaztas
- Department of Medical Biochemistry, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul.
| | - S Aktas
- Department of Biostatistics and Medical Informatics, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul; Department of Biostatistics, Istanbul Cerrahpasa University .
| | - E M Guler
- Department of Medical Biochemistry, Hamidiye Faculty of Medicine, University of Health Sciences, Istanbul; Haydarpasa Numune Health Application and Research Center, University of Health Sciences, Istanbul .
| | - E Ata
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Sultan Abdulhamid Han Education and Research Hospital, Istanbul.
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González-Flores D, López-Pingarrón L, Castaño MY, Gómez MÁ, Rodríguez AB, García JJ, Garrido M. Melatonin as a Coadjuvant in the Treatment of Patients with Fibromyalgia. Biomedicines 2023; 11:1964. [PMID: 37509603 PMCID: PMC10377739 DOI: 10.3390/biomedicines11071964] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
Fibromyalgia syndrome (FMS) is a chronic widespread pain syndrome that is accompanied by fatigue, sleep disturbances, anxiety, depression, lack of concentration, and neurocognitive impairment. As the currently available drugs are not completely successful against these symptoms and frequently have several side effects, many scientists have taken on the task of looking for nonpharmacological remedies. Many of the FMS-related symptoms have been suggested to be associated with an altered pattern of endogenous melatonin. Melatonin is involved in the regulation of several physiological processes, including circadian rhythms, pain, mood, and oxidative as well as immunomodulatory balance. Preliminary clinical studies have propounded that the administration of different doses of melatonin to patients with FMS can reduce pain levels and ameliorate mood and sleep disturbances. Moreover, the total antioxidant capacity, 6-sulfatoxymelatonin and urinary cortisol levels, and other biological parameters improve after the ingestion of melatonin. Recent investigations have proposed a pathophysiological relationship between mitochondrial dysfunction, oxidative stress, and FMS by looking at certain proteins involved in mitochondrial homeostasis according to the etiopathogenesis of this syndrome. These improvements exert positive effects on the quality of life of FMS patients, suggesting that the use of melatonin as a coadjuvant may be a successful strategy for the management of this syndrome.
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Affiliation(s)
- David González-Flores
- Department of Anatomy, Cell Biology and Zoology, Science Faculty, University of Extremadura, 06006 Badajoz, Spain
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
| | - Laura López-Pingarrón
- Oxidative Stress and Aging Research Group, Department of Pharmacology, Physiology, Legal and Forensic Medicine, University of Zaragoza, 50009 Zaragoza, Spain
| | - María Yolanda Castaño
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
- Department of Nursing, Merida University Center, University of Extremadura, 06006 Badajoz, Spain
| | - María Ángeles Gómez
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
- Department of Physiology, Science Faculty, University of Extremadura, 06006 Badajoz, Spain
| | - Ana B Rodríguez
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
- Department of Physiology, Science Faculty, University of Extremadura, 06006 Badajoz, Spain
| | - Joaquín J García
- Oxidative Stress and Aging Research Group, Department of Pharmacology, Physiology, Legal and Forensic Medicine, University of Zaragoza, 50009 Zaragoza, Spain
| | - María Garrido
- Neuroimmunophysiology and Chrononutrition Research Group, University of Extremadura, 06006 Badajoz, Spain
- Department of Physiology, Science Faculty, University of Extremadura, 06006 Badajoz, Spain
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dos Santos JM, Rodrigues Lacerda AC, Ribeiro VGC, Scheidt Figueiredo PH, Fonseca SF, da Silva Lage VK, Costa HS, Pereira Lima V, Sañudo B, Bernardo-Filho M, da Cunha de Sá Caputo D, Mendonça VA, Taiar R. Oxidative Stress Biomarkers and Quality of Life Are Contributing Factors of Muscle Pain and Lean Body Mass in Patients with Fibromyalgia. BIOLOGY 2022; 11:biology11060935. [PMID: 35741454 PMCID: PMC9220414 DOI: 10.3390/biology11060935] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/30/2022] [Accepted: 06/15/2022] [Indexed: 12/04/2022]
Abstract
Simple Summary Fibromyalgia (FM) is a disease that primarily affects women and causes pain all over the body, as well as anxiety, depression, fatigue, weight gain, a decreased quality of life, and difficulties doing daily duties. Although the cause of this disease has yet to be identified, research have been completed or are under underway with the goal of uncovering clues that can explain the disease’s symptoms and proper treatment. Our research looked into whether factors that increase inflammation in the body cause disease symptoms to worsen. Pain, lean mass, quality of life, sleep quality, muscle strength, depression, and probable factors that cause these symptoms to aggravate were assessed in the blood. Women with FM with more pain had a lower quality of life, and women with FM with lower lean mass had muscle weakness in addition to a lower quality of life. Our results recommend that initiatives be implemented to reduce inflammation, improve muscle mass and strength gain and increase the quality of life of these women. Abstract (1) The evidence points to an increase in oxygen reactive species as one of the possible causes of fibromyalgia (FM). In addition, it is plausible that an imbalance in redox markers can be associated with pain amplification and dynapenia in FM patients. The aim of our study was to investigate possible factors associated with muscle pain and lean body mass in FM patients. (2) Methods: This was a quantitative, exploratory and cross-sectional study of 47 patients with FM (53.45 + 7.32 years). We evaluated self-perceptions of muscle pain, lean body mass, body composition, quality of life, sleep quality, depression index, muscle performance and oxidative stress biomarkers. (3) Results: We observed that lower blood levels of antioxidants and poor quality of life explained 21% of the greater muscle pain. In addition, high blood levels of oxidative stress, worse muscle performance and poor quality of life explained 27% of the lower lean mass in patients with FM. (4) Conclusions: Larger amounts of lipid peroxidation and reductions in antioxidant levels, in addition to lower muscle performance and poor life quality, are possible independent contributors to greater muscle pain and lower lean body mass in FM patients.
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Affiliation(s)
- Jousielle Márcia dos Santos
- Brazilian Society of Physiology, Multicentric Postgraduate Program in Physiological Sciences (PPGMCF), Diamantina 39100-000, Brazil; (J.M.d.S.); (A.C.R.L.); (V.G.C.R.); (S.F.F.); (V.K.d.S.L.); (V.A.M.)
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Postgraduate Program in Functional Performance and Rehabilitation (PPGReab), Diamantina 39100-000, Brazil; (P.H.S.F.); (H.S.C.); (V.P.L.)
| | - Ana Cristina Rodrigues Lacerda
- Brazilian Society of Physiology, Multicentric Postgraduate Program in Physiological Sciences (PPGMCF), Diamantina 39100-000, Brazil; (J.M.d.S.); (A.C.R.L.); (V.G.C.R.); (S.F.F.); (V.K.d.S.L.); (V.A.M.)
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Postgraduate Program in Functional Performance and Rehabilitation (PPGReab), Diamantina 39100-000, Brazil; (P.H.S.F.); (H.S.C.); (V.P.L.)
- Department Basic Sciences, Federal University of the Jequitinhonha and Mucuri Valleys, Postgraduate Program in Health Sciences (PPGCS), Diamantina 39100-000, Brazil
| | - Vanessa Gonçalves César Ribeiro
- Brazilian Society of Physiology, Multicentric Postgraduate Program in Physiological Sciences (PPGMCF), Diamantina 39100-000, Brazil; (J.M.d.S.); (A.C.R.L.); (V.G.C.R.); (S.F.F.); (V.K.d.S.L.); (V.A.M.)
| | - Pedro Henrique Scheidt Figueiredo
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Postgraduate Program in Functional Performance and Rehabilitation (PPGReab), Diamantina 39100-000, Brazil; (P.H.S.F.); (H.S.C.); (V.P.L.)
| | - Sueli Ferreira Fonseca
- Brazilian Society of Physiology, Multicentric Postgraduate Program in Physiological Sciences (PPGMCF), Diamantina 39100-000, Brazil; (J.M.d.S.); (A.C.R.L.); (V.G.C.R.); (S.F.F.); (V.K.d.S.L.); (V.A.M.)
| | - Vanessa Kelly da Silva Lage
- Brazilian Society of Physiology, Multicentric Postgraduate Program in Physiological Sciences (PPGMCF), Diamantina 39100-000, Brazil; (J.M.d.S.); (A.C.R.L.); (V.G.C.R.); (S.F.F.); (V.K.d.S.L.); (V.A.M.)
| | - Henrique Silveira Costa
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Postgraduate Program in Functional Performance and Rehabilitation (PPGReab), Diamantina 39100-000, Brazil; (P.H.S.F.); (H.S.C.); (V.P.L.)
| | - Vanessa Pereira Lima
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Postgraduate Program in Functional Performance and Rehabilitation (PPGReab), Diamantina 39100-000, Brazil; (P.H.S.F.); (H.S.C.); (V.P.L.)
| | - Borja Sañudo
- Department of Physical Education and Sports, Universidad de Sevilla, 41001 Seville, Spain;
| | - Mário Bernardo-Filho
- Biophysics and Biometrics Department, Institute of Biology’s Mechanical Vibration Laboratory and Integrative Practices (LAVIMPI), Rio de Janeiro 20021-000, Brazil; (M.B.-F.); (D.d.C.d.S.C.)
| | - Danúbia da Cunha de Sá Caputo
- Biophysics and Biometrics Department, Institute of Biology’s Mechanical Vibration Laboratory and Integrative Practices (LAVIMPI), Rio de Janeiro 20021-000, Brazil; (M.B.-F.); (D.d.C.d.S.C.)
| | - Vanessa Amaral Mendonça
- Brazilian Society of Physiology, Multicentric Postgraduate Program in Physiological Sciences (PPGMCF), Diamantina 39100-000, Brazil; (J.M.d.S.); (A.C.R.L.); (V.G.C.R.); (S.F.F.); (V.K.d.S.L.); (V.A.M.)
- Department of Physiotherapy, Federal University of the Jequitinhonha and Mucuri Valleys, Postgraduate Program in Functional Performance and Rehabilitation (PPGReab), Diamantina 39100-000, Brazil; (P.H.S.F.); (H.S.C.); (V.P.L.)
- Department Basic Sciences, Federal University of the Jequitinhonha and Mucuri Valleys, Postgraduate Program in Health Sciences (PPGCS), Diamantina 39100-000, Brazil
| | - Redha Taiar
- MATériaux et Ingénierie Mécanique (MATIM), Université de Reims Champagne Ardenne, 51100 Reims, France
- Correspondence: or
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Fajar JK, Ilmawan M, Mamada SS, Mutiawati E, Husnah M, Yusuf H, Nainu F, Sirinam S, Keam S, Ophinni Y, Rosiello F, Fahriani M, Rosa SGV. Global prevalence of persistent neuromuscular symptoms and the possible pathomechanisms in COVID-19 recovered individuals: A systematic review and meta-analysis. NARRA J 2021; 1:e48. [PMID: 38450213 PMCID: PMC10914045 DOI: 10.52225/narra.v1i3.48] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/26/2021] [Indexed: 02/05/2023]
Abstract
This study was conducted to determine the prevalence of prolonged neuromuscular symptoms, including fatigue, anosmia, headache, myalgia, and joint pain in COVID-19 survivors hospitalized with mild, moderate, or severe infections worldwide. The search was conducted up to January 30th, 2021 using three databases (PubMed, Scopus, and Web of Science) to identify potentially eligible studies. Data on study characteristics, follow-up characteristics, and severity of COVID-19 during hospitalization were collected in accordance with PRISMA guidelines. The Newcastle-Ottawa scale was used to assess the quality of relevant articles. The estimated prevalence of specific prolonged neuromuscular symptoms and the association between COVID-19 severity and occurrence of prolonged neuromuscular symptoms was analyzed wherever appropriate. Database search yielded 4,050 articles and 22 articles were included for meta-analysis. The estimated prevalence of prolonged fatigue was recorded in 21.2% (95%CI: 11.9%- 34.8%) of 3,730 COVID-19 survivors. Persistent anosmia was recorded in 239 of 2,600 COVID-19 survivors (9.7%, 95%CI: 6.1%-15.2%). In 84 out of 2,412 COVID-19 survivors (8.9%, 95%CI: 3.2%-22.6%), prolonged headache was observed. A total of 53 out of 1,125 COVID-19 patients (5.6%, 95%CI: 2.1%-14.2%) complained of persistent myalgia even after being discharged from the hospital. The prevalence of prolonged joint pain was in 15.4% (95%CI: 8.2%-27.2%) of subjects. Due to data scarcity on COVID-19 severity and prolonged neuromuscular symptoms, association analysis could not be conducted. Widespread concern regarding long-term impacts of COVID-19 was raised after several studies reported prolonged symptoms in COVID-19 survivors. Numerous theories have been proposed to address this concern; however, as the research on this pandemic is still ongoing, no explanation is definitive yet. Therefore, follow-up studies in COVID-19 survivors after recovery from COVID-19 are warranted to determine the pathogenesis of prolonged symptoms. PROSPERO registration: CRD42021242332.
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Affiliation(s)
- Jonny K Fajar
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | | | - Sukamto S Mamada
- Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar, Indonesia
| | - Endang Mutiawati
- Department of Neurology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
- Department of Neurology, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia
| | - Milda Husnah
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Hanifah Yusuf
- Department of Pharmacology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Tamalanrea, Makassar, Indonesia
| | - Salin Sirinam
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Synat Keam
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Youdiil Ophinni
- Ragon Institute of MGH, MIT and Harvard, Harvard Medical School, Harvard University, Cambridge, MA, USA
- Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Francesco Rosiello
- Department of Public Health and Infectious Disease, Sapienza-University of Rome, Rome, Italy
| | - Marhami Fahriani
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Sandro G V Rosa
- Diretoria de Patentes, Divisão De Farmácia - Instituto Nacional Da Propriedade Industrial, Rio de Janeiro, Brasil
- Programa De Pós-Graduação Em Ciências Aplicadas a Produtos Para Saúde, Faculdade De Farmácia, Universidade Federal Fluminense, Brasil
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Shukla V, Das SK, Mahdi AA, Agarwal S, Alok R, Ansari JA, Khandpur S. Metal-induced oxidative stress level in patients with fibromyalgia syndrome and its contribution to the severity of the disease: A correlational study. J Back Musculoskelet Rehabil 2021; 34:319-326. [PMID: 33427731 DOI: 10.3233/bmr-200102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is an extra-articular rheumatological disease characterised by widespread chronic musculoskeletal pain. Metal-induced oxidative stress contributes to the severity of FMS. AIMS First, this study evaluated the association between plasma levels of toxic heavy metals and essential metals with oxidative stress (OS) markers. Second, the OS markers and metal contents were correlated with the disease severity by assessing the Fibromyalgia Impact Questioner Revised (FIQR) and tender points (TP). METHOD A total of 105 FMS patients and 105 healthy controls of similar age and sex were recruited. OS parameter such as lipid peroxidation (LPO), protein carbonyl group (PCG), nitric oxide (NO) and essential metals such as zinc (Zn), magnesium (Mg), manganese (Mn), copper (Cu) and toxic heavy metals such as aluminium (Al), arsenic (As), lead (Pb) were estimated. RESULTS Levels of LPO, PCG, NO (p< 0.001) and Cu, Mn, and Al (p< 0.001), were significantly higher, and Mg (p< 0.001) and Zn (p< 0.001) were significantly lower in patients compared to controls. A positive association was observed between OS parameters, FIQR and TP with Cu, Al and Mn. A significant negative association was observed between Zn and Mg with FIQR, TP and OS parameters. CONCLUSION Heavy metals such as Al induce OS parameters and decrease the levels of essential trace elements such as Mg and Zn, which may be responsible for the severity of FMS.
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Affiliation(s)
- Varsha Shukla
- Department of Rheumatology, King George's Medical University, Lucknow, India
| | - Siddharth Kumar Das
- Department of Rheumatology, King George's Medical University, Lucknow, India
| | - Abbas Ali Mahdi
- Department of Biochemistry, King George's Medical University, Uttar Pradesh, India
| | - Shweta Agarwal
- Department of Medicine Career Institute of Medical Sciences and Hospital, Lucknow, India
| | - Ragini Alok
- Department of Rheumatology, King George's Medical University, Lucknow, India
| | - Jamal Akhtar Ansari
- Department of Biochemistry, King George's Medical University, Uttar Pradesh, India
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Mohiuddin M, Pivetta B, Gilron I, Khan JS. Efficacy and Safety of N-acetylcysteine for the Management of Chronic Pain in Adults: A Systematic Review & Meta-analysis. PAIN MEDICINE 2021; 22:2896-2907. [PMID: 33560443 DOI: 10.1093/pm/pnab042] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the efficacy and safety of N-acetylcysteine in the treatment of chronic pain. METHODS A systematic search was carried out until April 2020 for clinical studies of N-acetylcysteine in the management of any persistent or recurrent chronic pain condition for adults ≥ 18 years old. Risk of Bias was assessed using the validated risk of bias tools. When appropriate, a meta-analysis using a random-effects model was performed, with a fixed-effect model for sensitivity analysis. RESULTS Nine studies (n = 863) were included (5 randomized controlled trials [RCTs], 2 open-label non-comparative studies and 2 comparative studies), that evaluated patients with sickle cell disease (3), complex regional pain syndrome (1), pelvic pain/endometriosis (2), rheumatoid arthritis (1), diabetic neuropathy (1), and chronic neuropathic pain (1). In the pooled analysis of 3 RCTs, N-acetylcysteine did not reduce pain intensities (SMD -0.21, 95% CI -0.33 to 0.75, random-effects), improve functional outcomes (SMD 0.21, 95% CI -0.33 to 0.75) or quality of life (SMD 0.60, 95% CI -4.44 to 5.64); however, sensitivity analysis with a fixed effect model demonstrated an effect for pain intensities and function. Due to adverse events being inconsistently reported, no conclusion could be made regarding safety of N-acetylcysteine in chronic pain. CONCLUSIONS While there is some evidence to indicate N-acetylcysteine may provide analgesic efficacy for certain pain conditions, there is insufficient evidence to provide definitive evidence on NAC in chronic pain management. Larger-size RCTs spanning a variety of chronic pain conditions are needed to determine N-acetylcysteine's role, if any, in pain medicine.
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Affiliation(s)
| | - Bianca Pivetta
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Ian Gilron
- Department of Anesthesiology and Perioperative Medicine, Kingston General Hospital, Queen's University Kingston, Canada
| | - James S Khan
- Mount Sinai Hospital, Department of Anesthesia and Pain Medicine, University of Toronto, Toronto, Canada
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8
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Madariaga VI, Jasim H, Ghafouri B, Ernberg M. Myogenous temporomandibular disorders and salivary markers of oxidative stress-A cross-sectional study. J Oral Rehabil 2020; 48:1-9. [PMID: 32979853 PMCID: PMC7820944 DOI: 10.1111/joor.13100] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND The clinical care of chronic pain requires personalised understanding of the mechanisms involved. Temporomandibular disorders (TMD) are the most common chronic orofacial pain conditions, and oxidative stress has been proposed to be implicated in their pathophysiology, especially in arthrogenous TMD. However, few studies have explored oxidative stress in myogenous TMD (TMDM). OBJECTIVE The aims of this study were to compare the salivary oxidative stress profiles between individuals with TMDM and healthy controls, and to explore associations of these markers with clinical characteristics. METHODOLOGY Saliva samples were collected from 39 individuals with TMDM and 37 age and sex-matched healthy volunteers. Psychological stress levels and clinical characteristics were assessed in all participants. The samples were analysed for total oxidant status (TOS), total antioxidative capacity (TAC) and superoxide dismutase activity (SODa). Comparisons between groups were performed using parametric and non-parametric tests depending on data distribution. RESULTS Psychological stress was higher in TMDM compared to controls (P < .001). TAC levels were significantly higher (P < .05) whereas TOS levels were significantly lower (P < .05) in TMDM compared to controls. There were no differences in SODa levels between groups and no correlations were found between clinical characteristics and oxidative stress markers. CONCLUSION Individuals with TMDM showed higher levels of antioxidative markers, but lower levels of oxidative markers. These results can be explained in part by chronicity and adaptation to the disease and other factors, such as psychological stress. Longitudinal studies must be conducted to clarify the role of oxidative stress in TMDM.
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Affiliation(s)
- Víctor Ignacio Madariaga
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet and Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Hajer Jasim
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet and Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Malin Ernberg
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet and Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
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9
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Santos HO, Genario R, Gomes GK, Schoenfeld BJ. Cherry intake as a dietary strategy in sport and diseases: a review of clinical applicability and mechanisms of action. Crit Rev Food Sci Nutr 2020; 61:417-430. [PMID: 32126807 DOI: 10.1080/10408398.2020.1734912] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Cherries are fruits rich in phytochemical compounds, particularly anthocyanins. Thus, consumption of cherries has gained attention in both clinical and sport-related fields for their antioxidant and anti-inflammatory properties. Mechanistically, anthocyanins from the intake of cherries may help to attenuate pain and decrease blood concentrations of biomarkers linked to skeletal muscle degradation, which in turn may provide ergogenic effects. In addition, the ability of anthocyanins to balance the redox state represents a conceivable target for rheumatic disorders (e.g. gout and arthritis). Moreover, cherry anthocyanins are emerging as a potential non-pharmacological remedy for cardiometabolic diseases (hypertension and dyslipidemia). Herein, we summarize the effects of cherry intake in sport and diseases, and discuss their purported mechanisms of action to provide insights into practical application.
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Affiliation(s)
- Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Rafael Genario
- School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Gederson K Gomes
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
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Stacchiotti A, Favero G, Rodella LF. Impact of Melatonin on Skeletal Muscle and Exercise. Cells 2020; 9:cells9020288. [PMID: 31991655 PMCID: PMC7072499 DOI: 10.3390/cells9020288] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/14/2020] [Accepted: 01/22/2020] [Indexed: 12/18/2022] Open
Abstract
Skeletal muscle disorders are dramatically increasing with human aging with enormous sanitary costs and impact on the quality of life. Preventive and therapeutic tools to limit onset and progression of muscle frailty include nutrition and physical training. Melatonin, the indole produced at nighttime in pineal and extra-pineal sites in mammalians, has recognized anti-aging, anti-inflammatory, and anti-oxidant properties. Mitochondria are the favorite target of melatonin, which maintains them efficiently, scavenging free radicals and reducing oxidative damage. Here, we discuss the most recent evidence of dietary melatonin efficacy in age-related skeletal muscle disorders in cellular, preclinical, and clinical studies. Furthermore, we analyze the emerging impact of melatonin on physical activity. Finally, we consider the newest evidence of the gut-muscle axis and the influence of exercise and probably melatonin on the microbiota. In our opinion, this review reinforces the relevance of melatonin as a safe nutraceutical that limits skeletal muscle frailty and prolongs physical performance.
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Affiliation(s)
- Alessandra Stacchiotti
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (G.F.); (L.F.R.)
- Interdepartmental University Center of Research “Adaptation and Regeneration of Tissues and Organs (ARTO)”, University of Brescia, 25123 Brescia, Italy
- Correspondence: ; Tel.: +39-030-3717478; Fax: +39-030-3717486
| | - Gaia Favero
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (G.F.); (L.F.R.)
| | - Luigi Fabrizio Rodella
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy; (G.F.); (L.F.R.)
- Interdepartmental University Center of Research “Adaptation and Regeneration of Tissues and Organs (ARTO)”, University of Brescia, 25123 Brescia, Italy
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Karatas G, Gunduz R, Haskul I, Ustun B, Neselioglu S, Karatas F, Akyuz M, Erel O. Dynamic thiol and disulphide homoeostasis in fibromyalgia. Arch Med Sci 2020; 16:597-602. [PMID: 32399108 PMCID: PMC7212223 DOI: 10.5114/aoms.2019.87052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/30/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Thiol and disulphide levels are biomarkers that provide useful information about oxidative stress and antioxidant capacity, showing a different homoeostasis in inflammatory and proliferative diseases. We aimed to clarify the possible aetiology of this disease by using thiol and disulphide levels in patients with fibromyalgia, the basis of which has not yet been clearly elucidated. MATERIAL AND METHODS A total of 156 individuals: 86 patients with fibromyalgia and 70 age-matched controls were included in this prospective non-randomised case-control study. Demographic characteristics including smoking status, body mass index (BMI), the duration of complaints, and pain levels were carefully recorded. Dynamic thiol-disulphide homoeostasis in blood samples was determined by an automatic-spectrophotometric method. The Mann-Whitney U and Student's t-test were used to determine the differences between the groups. RESULTS Sex, BMI, and smoking status were similar between the groups (p = 0.62, p = 0.09, and p = 0.64, respectively). While native thiol levels were found to be high in patients with fibromyalgia (p = 0.018), disulphide levels and the rates of disulphide/native thiol and disulphide/total thiol were significantly low (p = 0.049, p = 0.007, and p = 0.007, respectively). Correlation analysis showed no significant relationship between thiol-disulphide levels and duration of complaints or pain level. CONCLUSIONS Thiol-disulphide balance in fibromyalgia was found to be similar to benign proliferative diseases, suggesting that the underlying mechanism is more likely to be of proliferative pattern rather than inflammatory. Additionally, fibromyalgia is not directly associated with increase in oxidative stress. The molecular mechanisms need to be elucidated.
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Affiliation(s)
- Gulsah Karatas
- Department of Physical Medicine and Rehabilitation, Karabuk University Education and Research Hospital, Karabuk, Turkey
| | - Ramazan Gunduz
- Department of Physical Medicine and Rehabilitation, Karabuk University Education and Research Hospital, Karabuk, Turkey
| | - Ismail Haskul
- Department of Biochemistry, Karabuk University Education and Research Hospital, Karabuk, Turkey
| | - Betul Ustun
- Department of Physical Medicine and Rehabilitation, Karabuk University Education and Research Hospital, Karabuk, Turkey
| | - Salim Neselioglu
- Department of Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Fatih Karatas
- Department of Internal Medicine and Medical Oncology, Karabuk University, Education and Research Hospital, Karabuk, Turkey
| | - Müfit Akyuz
- Department of Physical Medicine and Rehabilitation, Karabuk University Education and Research Hospital, Karabuk, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
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Favero G, Bonomini F, Franco C, Rezzani R. Mitochondrial Dysfunction in Skeletal Muscle of a Fibromyalgia Model: The Potential Benefits of Melatonin. Int J Mol Sci 2019; 20:ijms20030765. [PMID: 30754674 PMCID: PMC6386947 DOI: 10.3390/ijms20030765] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 12/24/2022] Open
Abstract
Fibromyalgia syndrome (FMS) is considered a musculoskeletal disorder associated to other symptoms including chronic pain. Since the hypothesis of FMS etiogenesis is consistent with mitochondrial dysfunction and oxidative stress, we evaluated the pathophysiological correlation among these factors studying some proteins involved in the mitochondrial homeostasis. We focused our attention on the roles of peroxisome proliferator activated receptor gamma coactivator-1alpha (PGC-1α), mitofusin2 (Mfn2), and coenzyme Q10 (CoQ10) in reserpine-induced myalgic (RIM) rats that manifest fibromyalgia-like chronic pain symptoms. First, we underlined that RIM rats are a good model for studying the pathophysiology of FMS and moreover, we found that PGC-1α, Mfn2, and CoQ10 are involved in FMS. In fact, their expressions were reduced in gastrocnemius muscle determining an incorrect mitochondrial homeostasis. Today, none of the currently available drugs are fully effective against the symptoms of this disease and they, often, induce several adverse events; hence, many scientists have taken on the challenge of searching for non-pharmacological treatments. Another goal of this study was therefore the evaluation of the potential benefits of melatonin, an endogenous indoleamine having several functions including its potent capacity to induce antioxidant enzymes and to determine the protective or reparative mechanisms in the cells. We observed that melatonin supplementation significantly preserved all the studied parameters, counteracting oxidative stress in RIM rats and confirming that this indoleamine should be taken in consideration for improving health and/or counteract mitochondrial related diseases.
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Affiliation(s)
- Gaia Favero
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Francesca Bonomini
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Caterina Franco
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
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Pro-inflammatory Cytokines and Oxidized Low-Density-Lipoprotein in Patients With Fibromyalgia. Arch Rheumatol 2018; 34:123-129. [PMID: 31497758 DOI: 10.5606/archrheumatol.2019.6733] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 05/05/2018] [Indexed: 12/24/2022] Open
Abstract
Objectives This study aims to evaluate the differences in serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), (IL-8), and oxidized low-density lipoprotein (Ox-LDL) between female fibromyalgia (FM) patients and healthy females and also to examine a possible relationship between the cytokines/biomarker and the severity of pain and clinical features of FM. Patients and methods This case-control study included 48 female patients (mean age 26.51±6.98 years; range, 18 to 50 years) who were diagnosed with FM according to the American College of Rheumatology criteria and 43 healthy female subjects (mean age 23.93±4.22 years; range, 18 to 50 years). Serum levels of TNF-α, IL-1β, IL-8, and Ox-LDL were measured by enzyme-linked immunosorbent assay in both groups. Fibromyalgia Impact Questionnaire, Visual Analog Scale, symptom severity scale, and widespread pain index were carried out and also their relationships with TNF-α, IL-1β, IL-8, and Ox-LDL levels were evaluated. Results There was no difference in levels of the serum TNF-α, IL-1β, IL-8, and Ox-LDL between FM patients and healthy controls (p>0.05). The severity of pain was significantly associated with TNF-α (r=0.338; p=0.021) and IL-8 (r=0.299; p=0.043) levels, and Ox-LDL (r=0.415; p=0.006) level was found to be related to symptom severity of FM. Conclusion Our results suggest that serum levels of TNF-α and IL-8 may be involved in the occurrence of pain in FM. The level of Ox-LDL may play an important role in the severity of symptoms. Future studies are needed to determine whether and how Ox-LDL plays a role in FM.
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Favero G, Trapletti V, Bonomini F, Stacchiotti A, Lavazza A, Rodella LF, Rezzani R. Oral Supplementation of Melatonin Protects against Fibromyalgia-Related Skeletal Muscle Alterations in Reserpine-Induced Myalgia Rats. Int J Mol Sci 2017; 18:ijms18071389. [PMID: 28661421 PMCID: PMC5535882 DOI: 10.3390/ijms18071389] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 06/19/2017] [Accepted: 06/27/2017] [Indexed: 12/11/2022] Open
Abstract
Fibromyalgia is a chronic syndrome characterized by widespread musculoskeletal pain and an extensive array of other symptoms including disordered sleep, fatigue, depression and anxiety. Important factors involved in the pathogenic process of fibromyalgia are inflammation and oxidative stress, suggesting that ant-inflammatory and/or antioxidant supplementation might be effective in the management and modulation of this syndrome. Recent evidence suggests that melatonin may be suitable for this purpose due to its well known ant-inflammatory, antioxidant and analgesic effects. Thus, in the current study, the effects of the oral supplementation of melatonin against fibromyalgia-related skeletal muscle alterations were evaluated. In detail, 90 Sprague Dawley rats were randomly treated with reserpine, to reproduce the pathogenic process of fibromyalgia and thereafter they received melatonin. The animals treated with reserpine showed moderate alterations at hind limb skeletal muscles level and had difficulty in moving, together with significant morphological and ultrastructural alterations and expression of inflammatory and oxidative stress markers in the gastrocnemius muscle. Interestingly, melatonin, dose and/or time dependently, reduced the difficulties in spontaneous motor activity and the musculoskeletal morphostructural, inflammatory, and oxidative stress alterations. This study suggests that melatonin in vivo may be an effective tool in the management of fibromyalgia-related musculoskeletal morphofunctional damage.
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Affiliation(s)
- Gaia Favero
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Valentina Trapletti
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Francesca Bonomini
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Alessandra Stacchiotti
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Antonio Lavazza
- OIE Reference Laboratory for RHD, Istituto Zooprofilattico Sperimentale della Lombardia e Emilia Romagna, 25124 Brescia, Italy.
| | - Luigi Fabrizio Rodella
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
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Dynamic Thiol/Disulphide Homeostasis in Patients With Fibromyalgia. Arch Rheumatol 2017; 32:112-117. [PMID: 30375563 DOI: 10.5606/archrheumatol.2017.5931] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 07/16/2016] [Indexed: 01/05/2023] Open
Abstract
Objectives This study aims to investigate dynamic thiol/disulphide homeostasis in patients with fibromyalgia syndrome (FMS). Patients and methods Fifty female patients with FMS (mean age 40.5±7.2 years; range 21 to 55 years) and 40 healthy female controls (mean age 39±9.4 years, range 22 to 55 years) were included in the study. Pain visual analog scale, tender points, Fibromyalgia Impact Questionnaire, and Beck Depression Inventory were evaluated. Age, body mass index (BMI), and symptom durations were also recorded. Native thiol, disulphide and total thiol levels were measured with a novel automated method. Results Serum disulphide levels were 14.7±3.4 μmol/L and 22.2±3.6 μmol/L in the FMS and control groups, respectively (p<0.001). Native thiol levels were 452.1±33.8 μmol/L and 433.5±37.6 μmol/L in the FMS and control groups, (p=0.015), while total thiol levels were 481.7±35.6 μmol/L and 477.5±38.9 μmol/L in the FMS and control groups, respectively (p=0.593). In the FMS group, disulphide/native thiol percent ratios and disulphide/ total thiol percent ratios were statistically significantly lower and native/total thiol percent ratios were statistically significantly higher than those of the control group. There were no correlations between serum thiol/disulphide profiles and pain scores & clinical variables in patients with FMS. Conclusion Because of the decreased disulphide and increased native thiol levels, the thiol/disulphide balance has shifted to the reductive side. This metabolic disturbance may have a role in the pathogenesis of FMS.
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Soliman AF, El-Olemy GG, Hassan WA, Shaker RHM, Abdullah OA. Impact of an intensive dynamic exercise program on oxidative stress and on the outcome in patients with fibromyalgia. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2016. [DOI: 10.4103/1110-161x.189642] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Bårdsen K, Nilsen MM, Kvaløy JT, Norheim KB, Jonsson G, Omdal R. Heat shock proteins and chronic fatigue in primary Sjögren's syndrome. Innate Immun 2016; 22:162-7. [PMID: 26921255 PMCID: PMC4804286 DOI: 10.1177/1753425916633236] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 01/18/2016] [Indexed: 12/19/2022] Open
Abstract
Fatigue occurs frequently in patients with cancer, neurological diseases and chronic inflammatory diseases, but the biological mechanisms that lead to and regulate fatigue are largely unknown. When the innate immune system is activated, heat shock proteins (HSPs) are produced to protect cells. Some extracellular HSPs appear to recognize cellular targets in the brain, and we hypothesize that fatigue may be generated by specific HSPs signalling through neuronal or glial cells in the central nervous system. From a cohort of patients with primary Sjögren’s syndrome, 20 patients with high and 20 patients with low fatigue were selected. Fatigue was evaluated with a fatigue visual analogue scale. Plasma concentrations of HSP32, HSP60, HSP72 and HSP90α were measured and analysed to determine if there were associations with the level of fatigue. Plasma concentrations of HSP90α were significantly higher in patients with high fatigue compared with those with low fatigue, and there was a tendency to higher concentrations of HSP72 in patients with high fatigue compared with patients with low fatigue. There were no differences in concentrations of HSP32 and HSP60 between the high- and low-fatigue groups. Thus, extracellular HSPs, particularly HSP90α, may signal fatigue in chronic inflammation. This supports the hypothesis that fatigue is generated by cellular defence mechanisms.
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Affiliation(s)
- Kjetil Bårdsen
- Research Department, Stavanger University Hospital, Stavanger, Norway
| | | | - Jan Terje Kvaløy
- Research Department, Stavanger University Hospital, Stavanger, Norway Department of Mathematics and Natural Sciences, University of Stavanger, Stavanger, Norway
| | - Katrine Brække Norheim
- Clinical Immunology Unit, Department of Internal Medicine, Stavanger University, Hospital, Stavanger, Norway
| | - Grete Jonsson
- Department of Medical Biochemistry, Stavanger University Hospital, Stavanger, Norway
| | - Roald Omdal
- Clinical Immunology Unit, Department of Internal Medicine, Stavanger University, Hospital, Stavanger, Norway Department of Medical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Surowiec I, Gjesdal CG, Jonsson G, Norheim KB, Lundstedt T, Trygg J, Omdal R. Metabolomics study of fatigue in patients with rheumatoid arthritis naïve to biological treatment. Rheumatol Int 2016; 36:703-11. [DOI: 10.1007/s00296-016-3426-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/12/2016] [Indexed: 12/19/2022]
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Engen DJ, McAllister SJ, Whipple MO, Cha SS, Dion LJ, Vincent A, Bauer BA, Wahner-Roedler DL. Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2015; 13:306-13. [PMID: 26343101 DOI: 10.1016/s2095-4964(15)60195-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Fibromyalgia is a syndrome characterized by chronic pain, fatigue, depression, and sleep disturbances. Its primary cause is unclear. Several studies have reported decreased intracellular magnesium levels in patients with fibromyalgia and have found negative correlation between magnesium levels and fibromyalgia symptoms. OBJECTIVE To gather preliminary data on whether transdermal magnesium can improve quality of life for women who have fibromyalgia. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS This is a patient questionnaires and survey in a fibromyalgia clinic at a tertiary medical center. Forty female patients with the diagnosis of fibromyalgia were enrolled. Each participant was provided a spray bottle containing a transdermal magnesium chloride solution and asked to apply 4 sprays per limb twice daily for 4 weeks. Participants were asked to complete the Revised Fibromyalgia Impact Questionnaire, SF-36v2 Health Survey, and a quality-of-life analog scale at baseline, week 2, and week 4. MAIN OUTCOME MEASURE Questionnaire and survey scores, evaluated through intent-to-treat and per-protocol analyses. RESULTS Twenty-four patients completed the study (mean [SD] age, 57.2 [7.6] years; white, 95%; mean body mass index, 31.3 kg/m2). With intention-to-treat analysis, Revised Fibromyalgia Impact Questionnaire subscale and total scores were significantly improved at week 2 and week 4 (total score, P=0.001). Per-protocol analysis results were similar: all subscales of the Revised Fibromyalgia Impact Questionnaire were significantly improved at week 2 and week 4 (total score, P=0.001). CONCLUSION This pilot study suggests that transdermal magnesium chloride applied on upper and lower limbs may be beneficial to patients with fibromyalgia. TRIAL REGISTRATION ClinicalTrials.gov.ldentifier NCT01968772.
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Affiliation(s)
- Deborah J Engen
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota 55905, USA
| | | | - Mary O Whipple
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Stephen S Cha
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Liza J Dion
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Ann Vincent
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
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Black CN, Bot M, Scheffer PG, Cuijpers P, Penninx BWJH. Is depression associated with increased oxidative stress? A systematic review and meta-analysis. Psychoneuroendocrinology 2015; 51:164-75. [PMID: 25462890 DOI: 10.1016/j.psyneuen.2014.09.025] [Citation(s) in RCA: 466] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 09/23/2014] [Accepted: 09/24/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND It has been suggested that depressed persons have increased oxidative stress and decreased anti-oxidant defences. 8-Hydroxy-2'-deoxyguanosine (8-OHdG) and F2-isoprostanes, measures of oxidative DNA and lipid damage respectively, are among the most reliable oxidative stress markers, but studies on their association with depression show conflicting results. This meta-analysis quantifies the association between depression and these markers and explores factors that may explain inconsistencies in the results. METHODS A systematic literature search was conducted in PubMed, EMBASE and PsycINFO. Studies assessing the association of 8-OHdG or F2-isoprostanes with elevated depressive symptoms, major depressive disorder (MDD) or bipolar disorder (BD) were pooled in two random-effect models. RESULTS The pooled effect size (Hedges' g) for the association of depression with oxidative stress was 0.31 (p=0.01, I(2)=75%) for 8-OHdG (10 studies, 1308 subjects) and 0.48 (p=0.001, I(2)=73%) for F2-isoprostanes (8 studies, 2471 subjects), indicating that both markers are increased in depression. There was no indication of publication bias for either marker. The F2-isoprostane results did not differ by type of depression, biological specimen, laboratory method or quality, however subgroup analyses in the 8-OHdG studies showed significantly stronger associations in plasma/serum vs. urine samples (p<0.01), in measurements performed with immuno-assay vs. chromatography-mass spectrometry (p<0.01) and weaker associations in high quality studies vs. low (p=0.02). CONCLUSION This meta-analysis finds that oxidative stress, as measured by 8-OHdG and F2-isoprostanes, is increased in depression. Larger-scale studies are needed to extend the evidence on oxidative stress in depression, and examine the potential impact of treatment.
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Affiliation(s)
- Catherine N Black
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
| | - Mariska Bot
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Peter G Scheffer
- Department of Clinical Chemistry, Metabolic Laboratory, VU University Medical Center, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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Maynard S, Keijzers G, Gram M, Desler C, Bendix L, Budtz-Jørgensen E, Molbo D, Croteau DL, Osler M, Stevnsner T, Rasmussen LJ, Dela F, Avlund K, Bohr VA. Relationships between human vitality and mitochondrial respiratory parameters, reactive oxygen species production and dNTP levels in peripheral blood mononuclear cells. Aging (Albany NY) 2014; 5:850-64. [PMID: 24304678 PMCID: PMC3868727 DOI: 10.18632/aging.100618] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Low vitality (a component of fatigue) in middle-aged and older adults is an important complaint often identified as a symptom of a disease state or side effect of a treatment. No studies to date have investigated the potential link between dysfunctional mitochondrial ATP production and low vitality. Therefore, we measured a number of cellular parameters related to mitochondrial activity in peripheral blood mononuclear cells (PBMCs) isolated from middle-aged men, and tested for association with vitality. These parameters estimate mitochondrial respiration, reactive oxygen species (ROS) production, and deoxyribonucleotide (dNTP) balance in PBMCs. The population was drawn from the Metropolit cohort of men born in 1953. Vitality level was estimated from the Medical Outcomes Study Short Form 36 (SF-36) vitality scale. We found that vitality score had no association with any of the mitochondrial respiration parameters. However, vitality score was inversely associated with cellular ROS production and cellular deoxythymidine triphosphate (dTTP) levels and positively associated with deoxycytidine triphosphate (dCTP) levels. We conclude that self-reported persistent low vitality is not associated with specific aspects of mitochondrial oxidative phosphorylation capacity in PBMCs, but may have other underlying cellular dysfunctions that contribute to dNTP imbalance and altered ROS production.
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Affiliation(s)
- Scott Maynard
- Center for Healthy Aging at the University of Copenhagen, 2200 Copenhagen N, Denmark
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Sarıfakıoğlu B, Güzelant AY, Güzel EC, Güzel S, Kızıler AR. Effects of 12-week combined exercise therapy on oxidative stress in female fibromyalgia patients. Rheumatol Int 2014; 34:1361-7. [PMID: 24610539 DOI: 10.1007/s00296-014-2978-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 02/25/2014] [Indexed: 11/25/2022]
Abstract
The aims of this study were to investigate the effect of exercise therapy on the oxidative stress in fibromyalgia patients and relationship between oxidative stress and fibromyalgia symptoms. Thirty women diagnosed with fibromyalgia according to the American College of Rheumatology preliminary criteria, and 23 healthy women whose age- and weight-matched women were enrolled the study. Pain intensity with visual analog scale (VAS), the number of tender points, the fibromyalgia impact questionnaire (FIQ), the Beck depression inventory (BDI) were evaluated. The oxidative stress parameters thiobarbituric acid reactive substances, protein carbonyls, and nitric oxide, and antioxidant parameters thiols and catalase were investigated in patients and control group. After, combined aerobic and strengthen exercise regimen was given to fibromyalgia group. Exercise therapy consisted of a warming period of 10 min, aerobic exercises period of 20 min, muscle strengthening exercises for 20 min, and 10 min cooling down period. Therapy was lasting 1 h three times per week over a 12-week period. All parameters were reevaluated after the treatment in the patient group. The oxidative stress parameters levels were significantly higher, and antioxidant parameters were significantly lower in patients with fibromyalgia than in the controls. VAS, FIQ, and BDI scores decreased significantly with exercise therapy. The exercise improved all parameters of oxidative stress and antioxidant parameters. Also, all clinical parameters were improved with exercise. We should focus on oxidative stress in the treatment for fibromyalgia with the main objective of reducing oxidative load.
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Affiliation(s)
- Banu Sarıfakıoğlu
- Department of Physical Medicine and Rehabilitation, School of Medicine, Namik Kemal University, 100, Yıl Mah, Barbaros Cad. Merkez, Tekirdağ, Turkey,
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Measurement of malondialdehyde, glutathione, and glutathione peroxidase in SLE patients. Methods Mol Biol 2014; 1134:193-9. [PMID: 24497363 DOI: 10.1007/978-1-4939-0326-9_14] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Oxidative stress contributes to chronic inflammation of tissues and plays a central role in immunomodulation, which may lead to autoimmune diseases such as systemic lupus erythematosus (SLE) and antiphospholipid syndrome. Markers of oxidative damage include malondialdehyde (MDA), antioxidant scavengers as glutathione (GSH), and glutathione peroxidase (GSH Px), which all correlate well with SLE disease activity. Amelioration of some clinical manifestations of SLE may be expected by targeting lipid peroxidation with dietary or pharmacological antioxidants. Here, we describe the detection of the key players of oxidant/antioxidant imbalance in SLE.
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Abstract
Oxidative stress is a condition in which oxidant metabolites exert their toxic effect because of an increased production or an altered cellular mechanism of protection; oxidative stress is rapidly gaining recognition as a key phenomenon in chronic diseases. Antioxidants terminate these chain reactions by removing free radical intermediates, and inhibit other oxidation reactions by being oxidized themselves. Endogenous defence mechanisms are inadequate for the complete prevention of oxidative damage, and different sources of dietary antioxidants may be especially important. This article calls attention to the dietary antioxidants, such as vitamins A, C, and E and polyphenols. Compelling evidence has led to the conclusion that diet is a key environmental factor and a potential tool for the control of chronic diseases. More specifically, fruits and vegetables have been shown to exert a protective effect. The high content of minerals and natural antioxidant as vitamins A, C, and E and polyphenols in fruits and vegetables may be a main factor responsible for these effects.
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Affiliation(s)
- J M Landete
- Departamento de Biotecnología de Alimentos, Instituto de Agroquímica y Tecnología de Alimentos-IATA, Consejo Superior de Investigaciones Científicas-CSIC, Avda. Agustín Escardino 7, 46980 Paterna-Valencia, España.
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Miyamae T, Seki M, Naga T, Uchino S, Asazuma H, Yoshida T, Iizuka Y, Kikuchi M, Imagawa T, Natsumeda Y, Yokota S, Yamamoto Y. Increased oxidative stress and coenzyme Q10 deficiency in juvenile fibromyalgia: amelioration of hypercholesterolemia and fatigue by ubiquinol-10 supplementation. Redox Rep 2013; 18:12-9. [PMID: 23394493 DOI: 10.1179/1351000212y.0000000036] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Fibromyalgia (FM) is characterized by generalized pain and chronic fatigue of unknown etiology. To evaluate the role of oxidative stress in this disorder, we measured plasma levels of ubiquinone-10, ubiquinol-10, free cholesterol (FC), cholesterol esters (CE), and free fatty acids (FFA) in patients with juvenile FM (n=10) and in healthy control subjects (n=67). Levels of FC and CE were significantly increased in juvenile FM as compared with controls, suggesting the presence of hypercholesterolemia in this disease. However, plasma level of ubiquinol-10 was significantly decreased and the ratio of ubiquinone-10 to total coenzyme Q10 (%CoQ10) was significantly increased in juvenile FM relative to healthy controls, suggesting that FM is associated with coenzyme Q10 deficiency and increased oxidative stress. Moreover, plasma level of FFA was significantly higher and the content of polyunsaturated fatty acids (PUFA) in total FFA was significantly lower in FM than in controls, suggesting increased tissue oxidative damage in juvenile FM. Interestingly, the content of monoenoic acids, such as oleic and palmitoleic acids, was significantly increased in FM relative to controls, probably to compensate for the loss of PUFA. Next, we examined the effect of ubiquinol-10 supplementation (100 mg/day for 12 weeks) in FM patients. This resulted in an increase in coenzyme Q10 levels and a decrease in %CoQ10. No changes were observed in FFA levels or their composition. However, plasma levels of FC and CE significantly decreased and the ratio of FC to CE also significantly decreased, suggesting that ubiquinol-10 supplementation improved cholesterol metabolism. Ubiquinol-10 supplementation also improved chronic fatigue scores as measured by the Chalder Fatigue Scale.
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Affiliation(s)
- Takako Miyamae
- Department of Pediatrics, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
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Meeus M, Nijs J, Hermans L, Goubert D, Calders P. The role of mitochondrial dysfunctions due to oxidative and nitrosative stress in the chronic pain or chronic fatigue syndromes and fibromyalgia patients: peripheral and central mechanisms as therapeutic targets? Expert Opin Ther Targets 2013; 17:1081-9. [PMID: 23834645 DOI: 10.1517/14728222.2013.818657] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Chronic fatigue syndrome (CFS) and fibromyalgia (FM) are characterized by persistent pain and fatigue. It is hypothesized that reactive oxygen species (ROS), caused by oxidative and nitrosative stress, by inhibiting mitochondrial function can be involved in muscle pain and central sensitization as typically seen in these patients. AREAS COVERED The current evidence regarding oxidative and nitrosative stress and mitochondrial dysfunction in CFS and FM is presented in relation to chronic widespread pain. Mitochondrial dysfunction has been shown in leukocytes of CFS patients and in muscle cells of FM patients, which could explain the muscle pain. Additionally, if mitochondrial dysfunction is also present in central neural cells, this could result in lowered ATP pools in neural cells, leading to generalized hypersensitivity and chronic widespread pain. EXPERT OPINION Increased ROS in CFS and FM, resulting in impaired mitochondrial function and reduced ATP in muscle and neural cells, might lead to chronic widespread pain in these patients. Therefore, targeting increased ROS by antioxidants and targeting the mitochondrial biogenesis could offer a solution for the chronic pain in these patients. The role of exercise therapy in restoring mitochondrial dysfunction remains to be explored, and provides important avenues for future research in this area.
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Affiliation(s)
- Mira Meeus
- University of Antwerp, Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Pain in Motion Research Group, Antwerp, Belgium.
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Neyal M, Yimenicioglu F, Aydeniz A, Taskin A, Saglam S, Cekmen M, Neyal A, Gursoy S, Erel O, Balat A. Plasma nitrite levels, total antioxidant status, total oxidant status, and oxidative stress index in patients with tension-type headache and fibromyalgia. Clin Neurol Neurosurg 2013; 115:736-40. [DOI: 10.1016/j.clineuro.2012.08.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 05/23/2012] [Accepted: 08/11/2012] [Indexed: 10/27/2022]
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Lozovoy MAB, Simão ANC, Oliveira SR, Iryioda TMV, Panis C, Cecchini R, Dichi I. Relationship between iron metabolism, oxidative stress, and insulin resistance in patients with systemic lupus erythematosus. Scand J Rheumatol 2013; 42:303-10. [PMID: 23424997 DOI: 10.3109/03009742.2012.754942] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the present study was to assess oxidative stress and iron metabolism in systemic lupus erythematosus (SLE) patients with and without insulin resistance (IR). METHOD This study included 236 subjects (125 controls and 111 SLE patients). Patients with SLE were divided in two groups: with (n = 72) or without (n = 39) IR. RESULTS SLE patients with IR showed higher advanced oxidation protein product (AOPP) levels (p = 0.030) and gamma-glutamyltransferase (GGT) levels (p = 0.001) and lower sulfhydryl groups of proteins (p = 0.0002) and total radical-trapping antioxidant parameter (TRAP) corrected by uric acid (UA) levels (p = 0.04) when compared to SLE patients without IR. However, SLE patients with IR presented lower serum 8-isoprostane (p = 0.05) and carbonyl protein levels (p = 0.04) when compared to SLE patients without IR. Serum ferritin levels were significantly higher in SLE patients (p = 0.0006) than in controls, and SLE patients with IR presented higher serum ferritin levels (p = 0.01) than SLE patients without IR. Patients with SLE showed that IR was inversely correlated to TRAP/UA (r = -0.2724, p = 0.0008) and serum ferritin was positively correlated to AOPP (r = 0.2870, p = 0.004). CONCLUSIONS This study found that oxidative stress was higher in the group of SLE patients with IR, and increased ferritin, whether caused by the inflammatory process per se or hyperinsulinaemia, can favour the redox process. In addition, the preset data reinforce the need to measure oxidative stress with several methodologies with different assumptions.
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Affiliation(s)
- M A B Lozovoy
- Department of Clinical Analysis, University North of Paraná (UNOPAR), Paraná, Brazil
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Hidalgo-Tallón J, Menéndez-Cepero S, Vilchez JS, Rodríguez-López CM, Calandre EP. Ozone therapy as add-on treatment in fibromyalgia management by rectal insufflation: an open-label pilot study. J Altern Complement Med 2012; 19:238-42. [PMID: 23046293 DOI: 10.1089/acm.2011.0739] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The objectives of this study were to evaluate the effectiveness and tolerability of ozone therapy by rectal insufflation as add-on therapy in fibromyalgia management. DESIGN Patients with fibromyalgia received 24 sessions of ozone therapy during a 12-week period. At each session, the administered dose of ozone was 8 mg (200 mL of gas, at a concentration of 40 μg/mL). Ozone sessions were given 5 days a week during the first 2 weeks, twice a week from weeks 3-6, and weekly from weeks 7-12. Fibromyalgia Impact Questionnaire (FIQ) was the main outcome measure, and was administered at baseline and at weeks 4, 8, and 12. Secondary outcome measures, administered at baseline and at endpoint, were the Pittsburgh Sleep Quality Index, the Beck Depression Inventory, the State and Trait Anxiety Inventory, and the SF-12, the abbreviated form of the Short Form Health Survey. Emergent adverse reactions to treatment were recorded. RESULTS FIQ total scores decreased significantly during the study period, with the decrease being observed in the first 4 weeks of the study. Significant improvement was also seen both in depression scores and in the Physical Summary Score of the SF-12. Transient meteorism after ozone therapy sessions was the most frequently reported side-effect. CONCLUSIONS At the dose and number of sessions used in this study, ozone therapy by rectal insufflation seems to be beneficial for physical symptoms and depression of fibromyalgia.
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Segal BM, Thomas W, Zhu X, Diebes A, McElvain G, Baechler E, Gross M. Oxidative stress and fatigue in systemic lupus erythematosus. Lupus 2012; 21:984-92. [DOI: 10.1177/0961203312444772] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objective: The objective of this study is to investigate the relationship of oxidative stress to fatigue in systemic lupus erythematosus (SLE). Methods: Patients with a confirmed diagnosis of SLE by ACR criteria and healthy controls completed validated questionnaires to assess depression and fatigue. Fatigue was measured with the Fatigue Severity Scale (FSS) and the Profile of Fatigue (Prof-F). Visual analogue scales (VAS) were also used to assess fatigue and pain. Depression was measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Plasma F2-isoprostane was measured with gas chromatography/mass spectroscopy to assess oxidative stress. Evaluation included medical record review, physical exam and calculation of body mass index (BMI), disease activity (SLEDAI) and damage (SLICC) in the SLE patients. Results: Seventy-one SLE patients with low disease activity (mean SLEDAI = 1.62 standard error (SE) 0.37, range 0–8) were compared to 51 controls. Fatigue-limiting physical activity (defined as FSS ≥ 4) was present in 56% of patients and 12% of controls. F2-isoprostane was higher in SLE patients with fatigue compared to not-fatigued SLE subjects ( p = .0076) who were otherwise similar in ethnicity, disease activity and cardiovascular risk factors. Plasma F2-isoprostane was strongly correlated with FSS and Profile of Somatic Fatigue (Prof-S) ( p < .0001), VAS fatigue ( p = .005), CES-D ( p = .008) and with BMI ( p = .0001.) In a multivariate model, F2-isoprostane was a significant predictor of FSS after adjustment for age, BMI, pain and depression ( p = .0002). Conclusion: Fatigue in SLE patients with low disease activity is associated with increased F2-isoprostane. F2-isoprostane could provide a useful biomarker to explore mitochondrial function and the regulation of oxidative pathways in patients with SLE in whom fatigue is a debilitating symptom.
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Affiliation(s)
- BM Segal
- University of Minnesota, Minneapolis, MN, USA
| | - W Thomas
- University of Minnesota, Minneapolis, MN, USA
| | - X Zhu
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Diebes
- University of Minnesota, Minneapolis, MN, USA
| | | | - E Baechler
- University of Minnesota, Minneapolis, MN, USA
| | - M Gross
- University of Minnesota, Minneapolis, MN, USA
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31
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Bagis S, Karabiber M, As I, Tamer L, Erdogan C, Atalay A. Is magnesium citrate treatment effective on pain, clinical parameters and functional status in patients with fibromyalgia? Rheumatol Int 2012; 33:167-72. [PMID: 22271372 DOI: 10.1007/s00296-011-2334-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 12/20/2011] [Indexed: 11/30/2022]
Abstract
The aims of this study were to investigate the relationship between magnesium levels and fibromyalgia symptoms and to determine the effect of magnesium citrate treatment on these symptoms. Sixty premenopausal women diagnosed with fibromyalgia according to the ACR criteria and 20 healthy women whose age and weight matched the premenopausal women were evaluated. Pain intensity, pain threshold, the number of tender points, the tender point index, the fibromyalgia impact questionnaire (FIQ), the Beck depression and Beck anxiety scores and patient symptoms were evaluated in all the women. Serum and erythrocyte magnesium levels were also measured. The patients were divided into three groups. The magnesium citrate (300 mg/day) was given to the first group (n = 20), amitriptyline (10 mg/day) was given to the second group (n = 20), and magnesium citrate (300 mg/day) + amitriptyline (10 mg/day) treatment was given to the third group (n = 20). All parameters were reevaluated after the 8 weeks of treatment. The serum and erythrocyte magnesium levels were significantly lower in patients with fibromyalgia than in the controls. Also there was a negative correlation between the magnesium levels and fibromyalgia symptoms. The number of tender points, tender point index, FIQ and Beck depression scores decreased significantly with the magnesium citrate treatment. The combined amitriptyline + magnesium citrate treatment proved effective on all parameters except numbness. Low magnesium levels in the erythrocyte might be an etiologic factor on fibromyalgia symptoms. The magnesium citrate treatment was only effective tender points and the intensity of fibromyalgia. However, it was effective on all parameters when used in combination with amitriptyline.
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Affiliation(s)
- Selda Bagis
- Department of Physical Medicine and Rehabilitation, Acıbadem University Medical School, Istanbul, Turkey.
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Norheim KB, Jonsson G, Harboe E, Hanasand M, Gøransson L, Omdal R. Oxidative stress, as measured by protein oxidation, is increased in primary Sjøgren's syndrome. Free Radic Res 2012; 46:141-6. [PMID: 22126431 DOI: 10.3109/10715762.2011.645206] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Oxidative stress is an imbalance between the production of reactive oxygen species (ROS) and physiological antioxidant defences. It occurs frequently in conditions characterized by immune activation and inflammation. Plasma levels of oxidized end products have never been evaluated in primary Sjøgren's syndrome (pSS). The aim of this study was to investigate the level of oxidative stress in primary Sjøgren's syndrome. As a secondary outcome, the association between oxidative stress and fatigue was explored. METHODS A cross-sectional study of 26 pSS patients was carried out. Oxidative stress was assessed using two markers of protein oxidation, protein carbonyl (PC) and advanced oxidation protein products (AOPP). Reference values for the oxidative stress markers were obtained from 15 healthy subjects. RESULTS AOPP and PC levels were increased in the pSS patients compared to the healthy subjects. This is a novel finding. There were no associations between oxidative stress measures and fatigue in the patients. CONCLUSIONS Patients with pSS have increased levels of oxidative stress compared to healthy subjects.
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HASSAN SZ, GHEITA TA, KENAWY SA, FAHIM AT, EL-SOROUGY IM, ABDOU MS. Oxidative stress in systemic lupus erythematosus and rheumatoid arthritis patients: relationship to disease manifestations and activity. Int J Rheum Dis 2011; 14:325-331. [DOI: 10.1111/j.1756-185x.2011.01630.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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De Luca C, Raskovic D, Pacifico V, Thai JCS, Korkina L. The search for reliable biomarkers of disease in multiple chemical sensitivity and other environmental intolerances. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:2770-97. [PMID: 21845158 PMCID: PMC3155329 DOI: 10.3390/ijerph8072770] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 06/10/2011] [Accepted: 06/27/2011] [Indexed: 11/25/2022]
Abstract
Whilst facing a worldwide fast increase of food and environmental allergies, the medical community is also confronted with another inhomogeneous group of environment-associated disabling conditions, including multiple chemical sensitivity (MCS), fibromyalgia, chronic fatigue syndrome, electric hypersensitivity, amalgam disease and others. These share the features of poly-symptomatic multi-organ cutaneous and systemic manifestations, with postulated inherited/acquired impaired metabolism of chemical/physical/nutritional xenobiotics, triggering adverse reactions at exposure levels far below toxicologically-relevant values, often in the absence of clear-cut allergologic and/or immunologic involvement. Due to the lack of proven pathogenic mechanisms generating measurable disease biomarkers, these environmental hypersensitivities are generally ignored by sanitary and social systems, as psychogenic or "medically unexplained symptoms". The uncontrolled application of diagnostic and treatment protocols not corresponding to acceptable levels of validation, safety, and clinical efficacy, to a steadily increasing number of patients demanding assistance, occurs in many countries in the absence of evidence-based guidelines. Here we revise available information supporting the organic nature of these clinical conditions. Following intense research on gene polymorphisms of phase I/II detoxification enzyme genes, so far statistically inconclusive, epigenetic and metabolic factors are under investigation, in particular free radical/antioxidant homeostasis disturbances. The finding of relevant alterations of catalase, glutathione-transferase and peroxidase detoxifying activities significantly correlating with clinical manifestations of MCS, has recently registered some progress towards the identification of reliable biomarkers of disease onset, progression, and treatment outcomes.
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Affiliation(s)
- Chiara De Luca
- Tissue Engineering & Skin Pathophysiology Laboratory and 2nd Dermatology Division, Dermatological Research Institute (IDI IRCCS), Via Monti di Creta 104, Rome 00167, Italy; E-Mails: (D.R.); (V.P.); (L.K.)
| | - Desanka Raskovic
- Tissue Engineering & Skin Pathophysiology Laboratory and 2nd Dermatology Division, Dermatological Research Institute (IDI IRCCS), Via Monti di Creta 104, Rome 00167, Italy; E-Mails: (D.R.); (V.P.); (L.K.)
| | - Valeria Pacifico
- Tissue Engineering & Skin Pathophysiology Laboratory and 2nd Dermatology Division, Dermatological Research Institute (IDI IRCCS), Via Monti di Creta 104, Rome 00167, Italy; E-Mails: (D.R.); (V.P.); (L.K.)
| | - Jeffrey Chung Sheun Thai
- Natural Health Farm, 39 Jalan Pengacara U1/48, Seksyen U1, Temasya Industrial Park, Shah Alam Selangor 40150, Malaysia; E-Mail:
| | - Liudmila Korkina
- Tissue Engineering & Skin Pathophysiology Laboratory and 2nd Dermatology Division, Dermatological Research Institute (IDI IRCCS), Via Monti di Creta 104, Rome 00167, Italy; E-Mails: (D.R.); (V.P.); (L.K.)
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Topal G, Donmez A, Doğan BU, Kucur M, Cengiz DT, Berkoz F, Erdogan N. Asymmetric dimethylarginine (ADMA) levels are increased in patients with fibromyalgia: Correlation with tumor necrosis factor-α (TNF-α) and 8-iso-prostaglandin F2α (8-iso-PGF2α). Clin Biochem 2011; 44:364-7. [DOI: 10.1016/j.clinbiochem.2011.01.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2010] [Revised: 12/24/2010] [Accepted: 01/22/2011] [Indexed: 11/30/2022]
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Laviolette L, Lands LC, Dauletbaev N, Saey D, Milot J, Provencher S, LeBlanc P, Maltais F. Combined Effect of Dietary Supplementation with Pressurized Whey and Exercise Training in Chronic Obstructive Pulmonary Disease: A Randomized, Controlled, Double-Blind Pilot Study. J Med Food 2010; 13:589-98. [DOI: 10.1089/jmf.2009.0142] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Louis Laviolette
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Larry C. Lands
- Respiratory Medicine, Montreal Children's Hospital-McGill University Health Centre, Québec, Québec, Canada
| | - Nurlan Dauletbaev
- Respiratory Medicine, Montreal Children's Hospital-McGill University Health Centre, Québec, Québec, Canada
| | - Didier Saey
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Julie Milot
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Steeve Provencher
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - Pierre LeBlanc
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
| | - François Maltais
- Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada
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Blanco I, Janciauskiene S, Nita I, Fernández-Bustillo E, Cárcaba V, Gallo C, Alvarez-Rico M, de Serres F, Béridze N. Low plasma levels of monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNFalpha), and vascular endothelial growth factor (VEGF) in patients with alpha1-antitrypsin deficiency-related fibromyalgia. Clin Rheumatol 2009; 29:189-97. [PMID: 19924498 DOI: 10.1007/s10067-009-1318-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Revised: 09/09/2009] [Accepted: 11/02/2009] [Indexed: 12/27/2022]
Abstract
Abnormalities in blood inflammatory markers have been associated with clinical manifestations and the pathogenesis of the fibromyalgia syndrome (FMS); a relationship between inherited alpha1-antitrypsin deficiency (AATD) and FMS has also been recently raised. In this study, plasma levels of inflammatory markers in FMS patients with and without AATD have been investigated. Blood samples from 138 age-matched females (79 FMS) and 59 general population (GP), with normal MM [n = 82 (59.4%)] and with MS, MZ, SZ, and ZZ AATD genotypes [n = 56 (40.6%)], were analyzed by ELISA for monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNFalpha), soluble TNFalpha receptors I and II, interleukin-8, and vascular endothelial growth factor (VEGF). Plasma levels of MCP-1, VEGF, and TNFalpha were significantly lower in FMS and GP subjects with AATD compared with those with normal MM-AAT genotypes. Moreover, plasma levels of MCP-1, VEGF, and TNFalpha were lower in AATD subjects with FMS than in those without FMS (P = 0.000, 0.000, and 0.046, respectively). No statistical differences were found for the other substances measured. Furthermore, a logistic regression model based on plasma MCP-1 cutoff value of <or=130 pg/ml allowed us to discriminate between FMS and GP subjects with a sensitivity of about 93% and a specificity of 79%. Low plasma levels of MCP-1, VEGF, and TNFalpha are related to AATD, although more markedly in FMS patients. Thus, hypotheses considering FMS as an inflammatory condition related to high plasma levels of inflammatory biomarkers cannot be supported.
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Affiliation(s)
- Ignacio Blanco
- Department of Internal Medicine, Valle del Nalón Hospital, 33920, Riaño-Langreo, Principado de Asturias, Spain.
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Bazzichi L, Ciregia F, Giusti L, Baldini C, Giannaccini G, Giacomelli C, Sernissi F, Bombardieri S, Lucacchini A. Detection of potential markers of primary fibromyalgia syndrome in human saliva. Proteomics Clin Appl 2009; 3:1296-304. [PMID: 21136951 DOI: 10.1002/prca.200900076] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Revised: 06/29/2009] [Accepted: 07/28/2009] [Indexed: 12/20/2022]
Abstract
In the last few years, many attempts have been carried out for the research of specific biological biomarkers in fibromyalgia (FM) since, so far, no laboratory tests have been appropriately validated for the diagnosis and the prognostic stratification of the disease. In our study for the first time, we carried out a proteomic analysis of the whole saliva of FM patients in order to evaluate salivary biomarkers. Twenty-two FM patients with all fulfilling the American College of Rheumathology diagnostic criteria for FM and 26 sex-and age-matched healthy subjects were enrolled in the study. Proteomic analysis was performed by combining 2-DE and MALDI-TOF-MS. The most relevant observation which emerged from the data analysis was the exclusive and significant over-expression of transaldolase and phosphoglycerate mutase I. These findings were validated by Western blot analysis and the total optical density confirmed the significant up-regulation of transaldolase and phosphoglycerate mutase I in FM samples with respect to healthy subjects. It was noteworthy that seven further salivary proteins resulted differentially expressed, namely: calgranulin A, calgranulin C, cyclophilin A, profilin 1, Rho GDP-dissociation inhibitor 2, proteasome subunit-α-type-2 and haptoglobin-related protein precursor. These preliminary results demonstrated the utility of salivary proteomic analysis in the identification of salivary biomarkers in FM patients and in clarifying some of the pathogenetic aspects of the disease.
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Affiliation(s)
- Laura Bazzichi
- Department of Internal Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
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