Fibromyalgia Support Group
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I found this on a CFS forum about a study on Fibro and inflammation posted by someone a lot more knowledgeable than I am:
Fibromyalgia pain, inflammation and cytokines: IL-8On cytokines, inflammation, pain and fibromyalgia.
Cytokines are inter-cellular chemical messengers produced mostly by white blood cells. Some are generally pro-inflammatory (inflammatory cytokines turn inflammation on) while others are generally anti-inflammatory (they turn inflammation off).
High levels of inflammatory cytokines indicate an ongoing inflammatory process. There might not be the appearance of inflammation as we generally think of it but there is a type of inflammation at work the inflammatory response system is active the process of inflammation has begun.
The primary study referenced below is important because it provides good evidence that inflammation (inflammatory cytokines, or the inflammatory response system) plays a significant role in fibromyalgia.
Specifically, circulating levels of IL-8 (a pro-inflammatory cytokine) were found to be elevated in those with fibromyalgia. Thats important, but whats more significant is that the severity of pain was observed to correlate with the level of IL-8. That is, when there was more IL-8 there was more pain. When there was less IL-8 there was less pain. Does IL-8 cause the diffuse pain of fibromyalgia? Lets see.
Inflammatory cytokine IL-8 seems to play an important role in fibromyalgia.
In the study summarized below, 20 fibromyalgia patients and 80 healthy controls were monitored over the course of six months. Circulating levels of various markers of inflammation (inflammatory cytokines IL-6, IL-8 and TNF, as well as anti-inflammatory cytokines IL-4 and IL-10) were evaluated over time. Any changes in response to therapy were noted.
At the beginning of the study, before any treatment was administered, fibromyalgia patients were found to have substantially higher than normal levels of IL-8 and TNF (tumor necrosis factor another inflammatory cytokine.) No other cytokine differences were observed.
Once treatment was initiated (multi-modal therapy including oral pain medications) the level of TNF quickly decreased to normal within 10 days. But the decrease in TNF had no impact on pain. TNF dropped but pain remained high. So the inflammatory cytokine TNF may not be all that important in fibromyalgia at least not as a direct cause of pain. (IL-8 levels were unchanged at this point.)
What happened next?
Over the remaining 6 months of therapy, IL-8 decreased in most patients, but only by a little, and only very slowly. At the end of six months most patients still had relatively high levels of both IL-8 and pain.
But a few patients had a much more substantial decrease in their IL-8 level. What happened to them?
Those patients with significantly lower IL-8 at the end of the study also had significantly less pain!
Not only that, but it turns out those with the highest levels of IL-8 at the end of the study also had the most pain.
How closely did pain severity track with IL-8? Well, a perfect correlation (as these things are defined) would be 1.0. The actual correlation in this study was 0.78 which is very high. That suggests a strong link between IL-8 and pain.
July, 2008
Circulating cytokine levels compared to pain in patients with fibromyalgia a prospective longitudinal study over 6 months.
Summary of the abstract
This prospective study examined circulating cytokines in patients with fibromyalgia over six months. Correlations between serum cytokine concentrations and pain intensity were investigated in fibromyalgia patients undergoing multi-disciplinary therapy.
On admission, fibromyalgia patients had elevated levels of IL-8 and TNF, but not IL-6.
There were no significant differences observed in fibromyalgia patients for circulating levels of IL-4 or IL-10.
High IL-8 levels remained consistent during the followup, but within 10 days, TNF levels returned to normal.
After 6 months of treatment, IL-8 levels were significantly lower, but remained elevated relative to healthy controls.
IL-8 but not TNF blood levels were found to correlate with pain intensity in fibromyalgia patients.
These results suggest the importance of IL-8 in fibromyalgia.
What Im thinking is this isnt the kind of inflammation that shows up in the common tests for inflammation. By my foggy-brained reading, inflammation and fibromyalgia is a very current line of research. I also recall some new research that some depression might also be related to inflammation. How this might relate to food allergy or intolerances is beyond my ken. I was fortunate enough to find in myself a food group that increases my pain greatly, so that I could avoid it. It maybe that I am the only one who would find helpful the very strict elimination diets that I went on. But it only took four days this kind of diet to see this as something worth exploring for myself. I havent found my personal perfect anti-inflammatory diet, but I intend to keep at it.
Fibromyalgia pain, inflammation and cytokines: IL-8On cytokines, inflammation, pain and fibromyalgia.
Cytokines are inter-cellular chemical messengers produced mostly by white blood cells. Some are generally pro-inflammatory (inflammatory cytokines turn inflammation on) while others are generally anti-inflammatory (they turn inflammation off).
High levels of inflammatory cytokines indicate an ongoing inflammatory process. There might not be the appearance of inflammation as we generally think of it but there is a type of inflammation at work the inflammatory response system is active the process of inflammation has begun.
The primary study referenced below is important because it provides good evidence that inflammation (inflammatory cytokines, or the inflammatory response system) plays a significant role in fibromyalgia.
Specifically, circulating levels of IL-8 (a pro-inflammatory cytokine) were found to be elevated in those with fibromyalgia. Thats important, but whats more significant is that the severity of pain was observed to correlate with the level of IL-8. That is, when there was more IL-8 there was more pain. When there was less IL-8 there was less pain. Does IL-8 cause the diffuse pain of fibromyalgia? Lets see.
Inflammatory cytokine IL-8 seems to play an important role in fibromyalgia.
In the study summarized below, 20 fibromyalgia patients and 80 healthy controls were monitored over the course of six months. Circulating levels of various markers of inflammation (inflammatory cytokines IL-6, IL-8 and TNF, as well as anti-inflammatory cytokines IL-4 and IL-10) were evaluated over time. Any changes in response to therapy were noted.
At the beginning of the study, before any treatment was administered, fibromyalgia patients were found to have substantially higher than normal levels of IL-8 and TNF (tumor necrosis factor another inflammatory cytokine.) No other cytokine differences were observed.
Once treatment was initiated (multi-modal therapy including oral pain medications) the level of TNF quickly decreased to normal within 10 days. But the decrease in TNF had no impact on pain. TNF dropped but pain remained high. So the inflammatory cytokine TNF may not be all that important in fibromyalgia at least not as a direct cause of pain. (IL-8 levels were unchanged at this point.)
What happened next?
Over the remaining 6 months of therapy, IL-8 decreased in most patients, but only by a little, and only very slowly. At the end of six months most patients still had relatively high levels of both IL-8 and pain.
But a few patients had a much more substantial decrease in their IL-8 level. What happened to them?
Those patients with significantly lower IL-8 at the end of the study also had significantly less pain!
Not only that, but it turns out those with the highest levels of IL-8 at the end of the study also had the most pain.
How closely did pain severity track with IL-8? Well, a perfect correlation (as these things are defined) would be 1.0. The actual correlation in this study was 0.78 which is very high. That suggests a strong link between IL-8 and pain.
July, 2008
Circulating cytokine levels compared to pain in patients with fibromyalgia a prospective longitudinal study over 6 months.
Summary of the abstract
This prospective study examined circulating cytokines in patients with fibromyalgia over six months. Correlations between serum cytokine concentrations and pain intensity were investigated in fibromyalgia patients undergoing multi-disciplinary therapy.
On admission, fibromyalgia patients had elevated levels of IL-8 and TNF, but not IL-6.
There were no significant differences observed in fibromyalgia patients for circulating levels of IL-4 or IL-10.
High IL-8 levels remained consistent during the followup, but within 10 days, TNF levels returned to normal.
After 6 months of treatment, IL-8 levels were significantly lower, but remained elevated relative to healthy controls.
IL-8 but not TNF blood levels were found to correlate with pain intensity in fibromyalgia patients.
These results suggest the importance of IL-8 in fibromyalgia.
What Im thinking is this isnt the kind of inflammation that shows up in the common tests for inflammation. By my foggy-brained reading, inflammation and fibromyalgia is a very current line of research. I also recall some new research that some depression might also be related to inflammation. How this might relate to food allergy or intolerances is beyond my ken. I was fortunate enough to find in myself a food group that increases my pain greatly, so that I could avoid it. It maybe that I am the only one who would find helpful the very strict elimination diets that I went on. But it only took four days this kind of diet to see this as something worth exploring for myself. I havent found my personal perfect anti-inflammatory diet, but I intend to keep at it.
Cytokines are part of the immune system and the studies I've seen involving cytokines are mostly looking at immune responses and fibromyalgia. I was involved in one such study and had the opportunity to talk with the researchers and have a copy of the entire results when it was published.
It's an interesting area of research, but so far has produced only more pieces of the puzzle, not conclusive answers.
All research is good research.