Salemi Souzan, Rethage Janine, Wollina Uwe, Michel Beat A, Gay Renate E, Gay Steffen, Sprott Haiko
Center of Experimental Rheumatology, Department of Rheumatology and Institute of Physical Medicine, University Hospital, Zürich, Switzerland .
J Rheumatol. 2003 Jan;30(1):146-50.
To determine if abnormal collagen metabolism is correlated with neurogenic inflammation, a potential activator of collagen metabolism, in patients with fibromyalgia (FM).
The presence of inflammatory cytokines, interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-a was investigated in skin tissues by using reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. Fifty-three skin biopsies from female patients with FM (30-65 years of age) were examined and compared to skin biopsies of 10 age and sex matched healthy controls. Biopsies were obtained from the left deltoid region. Rheumatoid arthritis synovial fibroblasts and tissues were used as positive controls for the expression of cytokines. Total RNA isolated from the tissue samples were reverse transcribed (RT) by random hexamers as the primer for RT followed by PCR amplification using specific primers for IL-1beta, IL-6 or TNF-a. Expression of IL-1beta, and TNF-a protein was investigated in the skin by immunohistochemistry using specific antibodies (avidin-biotin method).
Positive signals (RT-PCR) were detected in skin tissues of 19/50 (38%) FM patients for IL-1beta, in 14/51 FM patients (27%) for IL-6, and in 17/53 patients (32%) for TNF-a. None of the cytokines could be detected in healthy control skin. Immunoreactivity for IL-1beta and TNF-a was demonstrated in certain skin tissues of our FM patients.
The detection of cytokines in FM skin indicates the presence of inflammatory foci (neurogenic inflammation) in the skin of certain patients (about 30% of FM patients), suggesting an inflammatory component in the induction of pain. This may explain the response to nonsteroidal antiinflammatory therapy in a subset of FM patients.
确定在纤维肌痛（FM）患者中，异常的胶原蛋白代谢是否与神经源性炎症（胶原蛋白代谢的潜在激活剂）相关。
采用逆转录聚合酶链反应（RT-PCR）和免疫组织化学方法，研究皮肤组织中炎性细胞因子白细胞介素（IL）-1β、IL-6和肿瘤坏死因子（TNF）-α的存在情况。对53例年龄在30 - 65岁的女性FM患者的皮肤活检样本进行检查，并与10例年龄和性别匹配的健康对照者的皮肤活检样本进行比较。活检样本取自左侧三角肌区域。类风湿性关节炎滑膜成纤维细胞和组织用作细胞因子表达的阳性对照。从组织样本中分离的总RNA用随机六聚体作为逆转录（RT）引物进行逆转录，随后使用IL-1β、IL-6或TNF-α的特异性引物进行PCR扩增。采用特异性抗体（抗生物素蛋白-生物素法）通过免疫组织化学研究皮肤中IL-1β和TNF-α蛋白的表达。
在50例FM患者的19例（38%）皮肤组织中检测到IL-1β的阳性信号（RT-PCR），在51例FM患者的14例（27%）中检测到IL-6的阳性信号，在53例患者的17例（32%）中检测到TNF-α的阳性信号。在健康对照者的皮肤中未检测到任何细胞因子。在我们的FM患者的某些皮肤组织中证实了IL-1β和TNF-α的免疫反应性。
在FM皮肤中检测到细胞因子表明在某些患者（约30%的FM患者）的皮肤中存在炎性病灶（神经源性炎症），提示在疼痛诱导中存在炎症成分。这可能解释了一部分FM患者对非甾体抗炎治疗的反应。
