Two more studies on Fibromyalgia

Anandamide and neutrophil function in patients with fibromyalgia.

Psychoneuroendocrinology. 2008 Apr 4 [Epub ahead of print]

Kaufmann I, Schelling G, Eisner C, Richter HP, Krauseneck T, Vogeser
M, Hauer D, Campolongo P, Chouker A, Beyer A, Thiel M.

Clinic of Anaesthesiology, Klinikum Großhadern,
Ludwig-Maximilians-University, Marchioninistrasse 15, 81366 Munich, Germany.

PMID: 18395993


Fibromyalgia (FM) is a common stress-related painful disorder. There
is considerable evidence of neuroimmunologic alterations in FM which
may be the consequence of chronic stress and pain or causally
involved in the development of this disorder. The endocannabinoid
system has been shown to play a pivotal role in mammalian
nociception, is activated under stressful conditions and can be an
important signaling pathway for immune modulation. The
endocannabinoid system could therefore be involved in the complex
pathophysiology of FM.

We tested this hypothesis by evaluating the effects of stress
hormones and the endocannabinoid anandamide on neutrophil function in
patients with FM. We determined plasma levels of catecholamines,
cortisol and anandamide in 22 patients with primary FM and 22 age-
and sex-matched healthy controls. Neutrophil function was
characterized by measuring the hydrogen peroxide (H(2)O(2)) release
(oxidative stress) and the ingestion capabilities of neutrophils
(microbicidal function).

FM patients had significantly higher norepinephrine and anandamide
plasma levels. Neutrophils of FM patients showed an elevated
spontaneous H(2)O(2) production. The ability of neutrophils to adhere
was negatively correlated with serum cortisol levels. Adhesion and
phagocytosis capabilities of neutrophils correlated positively with
anandamide plasma levels.

In conclusion, patients with FM might benefit from pharmacologic
manipulation of endocannabinoid signaling which should be tested in
controlled studies.

 

Illness experience in fibromyalgia syndrome: A metasynthesis of
qualitative studies.

Soc Sci Med. 2008 Apr 17 [Epub ahead of print]

Sim J, Madden S.

Primary Care Musculoskeletal Research Centre, Keele University,
Keele, Staffordshire ST5 5BG, United Kingdom.

PMID: 18423826


There is growing interest in synthesizing qualitative research.
Despite certain philosophical and methodological difficulties, such
syntheses are potentially useful in enriching the insights of
empirical qualitative work in a particular area. This paper reports
an interpretive review of research into the subjective experience of
fibromyalgia syndrome (FMS), utilizing principles of metasynthesis.

Twenty-three separate studies were identified. Each study was
evaluated using methodological criteria to provide a context for
interpretation of substantive findings. Principal findings were
extracted and synthesized under four broad categories: experience of
symptoms, search for diagnosis, legitimacy, and coping.

Our findings re-emphasised the point that pain in FMS is ambiguous
and invisible, raising questions of credibility and legitimacy.
People with a diagnosis of FMS appear to frame the experience of
symptoms within the biomedical model, where FMS is viewed as an
organic entity potentially identifiable through biomedical tests. The
subjective meaning and perceived legitimacy of the diagnostic label
appear to be important factors in the subjective experience of FMS.
Coping strategies adopted can be subsumed under Mannerkorpi, K.,
Kroksmark, T., Ekdahl, C. [1999. How patients with fibromyalgia
experience their symptoms in everyday life. Physiotherapy Research
International, 4(2), 110-122.] notions of 'struggling', 'adapting',
'in despair' and 'giving up'. Most studies had at least one
identified methodological shortcoming, though it is not
straightforward to identify the significance of such shortcomings.

We conclude that there is scope for further research into the
subjective experience of FMS, and into the methodology of
metasynthesis, especially in relation to methodological appraisal.