Höcherl K, Färber L, Ladenburger S, Vosshage D, Stratz T, Müller W, Grobecker H
Department of Pharmacology and Clinical Pharmacology, University of Regensburg, Germany.
Scand J Rheumatol Suppl. 2000;113:46-8. doi: 10.1080/030097400446634.
The aim of the study was to assess the influence of the 5HT3-receptor antagonist tropisetron on circulating catecholamines as biochemical markers of the activity of the sympathoadrenal system in fibromyalgia. Moreover, serum concentrations of serotonin, somatomedin C, oxytocin, calcitonin-gene-related-peptide, calcitonin and cholecystokinin were assayed as putative markers in pain-related disorders like primary fibromyalgia.
In 96 patients, who met the ACR classification criteria for fibromyalgia, and in 20 sex and age matched controls concentrations of dopamine, noradrenaline, adrenaline, serotonin and tropisetron were assayed in serum by HPLC with electrochemical detection. All other transmitters were determined by ELISA.
There was with the exception of tropisetron, calcitonin and dopamine, no correlation between doses of tropisetron 5, 10, 15 mg respectively and significant changes in circulating transmitters or other transmitters as putative biochemicals markers in primary fibromyalgia. Regarding the prediction of pain reduction to tropisetron, patients with elevated dopamine and/or reduced plasma 5-HT concentrations tended to show a higher response rate.
Despite these partly disappointing results another prospective pilot study with selected patients vs. age and sex matched controls, double blind and with comparison of other 5HT3-receptor antagonists e.g. dolasetron and granisetron e.g. after i.v. bolus injection is suggested. Still the data obtained in this preliminary paper provide some evidence regarding the present discussion on subgroups of patients with primary fibromyalgia.
本研究旨在评估5-羟色胺3（5HT3）受体拮抗剂托烷司琼对循环儿茶酚胺的影响，儿茶酚胺作为纤维肌痛中交感肾上腺系统活动的生化标志物。此外，还测定了血清中5-羟色胺、生长调节素C、催产素、降钙素基因相关肽、降钙素和胆囊收缩素的浓度，作为原发性纤维肌痛等疼痛相关疾病的假定标志物。
对96例符合美国风湿病学会（ACR）纤维肌痛分类标准的患者以及20例年龄和性别匹配的对照者，采用高效液相色谱-电化学检测法测定血清中多巴胺、去甲肾上腺素、肾上腺素、5-羟色胺和托烷司琼的浓度。所有其他递质通过酶联免疫吸附测定法（ELISA）测定。
除托烷司琼、降钙素和多巴胺外，分别给予5、10、15mg托烷司琼的剂量与原发性纤维肌痛中循环递质或其他作为假定生化标志物的递质的显著变化之间无相关性。关于托烷司琼减轻疼痛的预测，多巴胺升高和/或血浆5-羟色胺浓度降低的患者往往显示出更高的反应率。
尽管这些结果部分令人失望，但仍建议对选定患者与年龄和性别匹配的对照者进行另一项前瞻性初步研究，采用双盲法，并比较其他5HT3受体拮抗剂，如多潘立酮和格拉司琼，例如静脉推注后。不过，本初步论文中获得的数据为目前关于原发性纤维肌痛患者亚组的讨论提供了一些证据。
