alpha1-Antitrypsin and fibromyalgia: new data in favour of the inflammatory hypothesis of fibromyalgia.

Authors: Blanco LE (1) , de Serres FJ (2) , Fernańdez-Bustillo E (3) , Kassam DA (4) , Arbesú D (5) , Rodríguez C (6) , Torre JC (7)
Affiliations:
(1) Department of Internal Medicine, Hospital Valle del Nalón (2) National Institute of Environmental Health Sciences, P.O. Box 12233, Laboratory of Molecular Toxicology, Environmental Toxicology Program, Research Triangle Park (3) Bio-statistics Unit, Hospital Universitario Central de Asturias (4) Department of Clinical Biochemistry, Hospital Valle del Nalón (5) Department of Rehabilitation, Hospital Valle del Nalón (6) Department of Clinical Biochemistry, Instituto Nacional de Silicosis, Hospital Universitario Central de Asturias (7) Department of Rheumatology, Hospital Monte Naranco, Hospital Universitario Central de Asturias
Source: Med Hypotheses. 2005;64(4):759-69.
DOI: 10.1016/j.mehy.2004.10.005 Publication date: Not specified E-Publication date: Dec. 8, 2004 Availability: abstract Copyright: © 2004 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
Language: 2005-01-01 Countries: Not specified Location: Not specified Correspondence address: Blanco LE :
Department of Internal Medicine, Hospital Valle del Nalón, 33920 Riaño-Langreo, Principado de Asturias, Spain.
Email : ignacio.blanco@sespa.princast.es

Keywords

Article abstract

alpha1-Antitrypsin (AAT) circulates in high serum concentrations, and impregnates most body tissues. AAT has a broad anti-inflammatory spectrum, and modulates most inflammatory reactions occurring in human body. Recently, a possible relationship between AAT deficiency (AAT-D) and fibromyalgia (FM) has been raised, with the finding that intravenous infusions of purified human AAT efficiently controlled FM symptoms in two patients with severe hereditary AAT-D. On the other hand, functional magnetic resonance imaging has detected a significant greater activity in pain sensitive areas of the brain in patients with FM, in response to cutaneous stimuli, providing further evidence for a physiological explanation for FM pain. In recent studies abnormal profiles of inflammation markers in serum and biopsies have been found in FM patients. Since most of these inflammation mediators can be inhibited by AAT, these observations would suggest that at least a subset of the FM syndrome could be related to an inflammatory process, possibly due to an imbalance between inflammatory and anti-inflammatory substances, in the soft body tissues. Future directions of research would be: (1) to develop epidemiological studies to determine the gene frequency of AAT deficiency alleles in FM patients; (2) implementation of a double-blind placebo-controlled clinical trial to determine the specific role of AAT augmentation therapy in AAT-D patients with FM; (3) identification of specific laboratory markers for diagnostic and clinical evaluation purposes in FM; (4) application of the newest medical imaging techniques for diagnosis; and (5) identification of genetic, familial, and environmental risk factors suspected to participate in the FM syndrome development.

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