Department of Internal Medicine, Valle del Nalón Hospital, 33920, Riaño-Langreo, Principado de Asturias, Spain.
Clin Rheumatol. 2010 Feb;29(2):189-97. doi: 10.1007/s10067-009-1318-5. Epub 2009 Nov 19.
Abnormalities in blood inflammatory markers have been associated with clinical manifestations and the pathogenesis of the fibromyalgia syndrome (FMS); a relationship between inherited alpha1-antitrypsin deficiency (AATD) and FMS has also been recently raised. In this study, plasma levels of inflammatory markers in FMS patients with and without AATD have been investigated. Blood samples from 138 age-matched females (79 FMS) and 59 general population (GP), with normal MM [n = 82 (59.4%)] and with MS, MZ, SZ, and ZZ AATD genotypes [n = 56 (40.6%)], were analyzed by ELISA for monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-alpha (TNFalpha), soluble TNFalpha receptors I and II, interleukin-8, and vascular endothelial growth factor (VEGF). Plasma levels of MCP-1, VEGF, and TNFalpha were significantly lower in FMS and GP subjects with AATD compared with those with normal MM-AAT genotypes. Moreover, plasma levels of MCP-1, VEGF, and TNFalpha were lower in AATD subjects with FMS than in those without FMS (P = 0.000, 0.000, and 0.046, respectively). No statistical differences were found for the other substances measured. Furthermore, a logistic regression model based on plasma MCP-1 cutoff value of <or=130 pg/ml allowed us to discriminate between FMS and GP subjects with a sensitivity of about 93% and a specificity of 79%. Low plasma levels of MCP-1, VEGF, and TNFalpha are related to AATD, although more markedly in FMS patients. Thus, hypotheses considering FMS as an inflammatory condition related to high plasma levels of inflammatory biomarkers cannot be supported.
血液炎症标志物的异常与纤维肌痛综合征 (FMS) 的临床表现和发病机制有关；最近还提出了遗传性α1-抗胰蛋白酶缺乏症 (AATD) 与 FMS 之间的关系。在这项研究中，研究了 FMS 患者中有无 AATD 的炎症标志物的血浆水平。通过 ELISA 分析了 138 名年龄匹配的女性（79 名 FMS）和 59 名普通人群（GP）的血液样本，其中 MM 正常[n = 82（59.4%）]和 MS、MZ、SZ 和 ZZ AATD 基因型[n = 56（40.6%）]，用于检测单核细胞趋化蛋白-1（MCP-1）、肿瘤坏死因子-α（TNFalpha）、可溶性 TNFalpha 受体 I 和 II、白细胞介素-8 和血管内皮生长因子（VEGF）。与 MM-AAT 正常基因型相比，FMS 和 GP 中 AATD 患者的 MCP-1、VEGF 和 TNFalpha 血浆水平显着降低。此外，FMS 中 AATD 患者的 MCP-1、VEGF 和 TNFalpha 血浆水平低于无 FMS 的患者（分别为 P = 0.000、0.000 和 0.046）。对于测量的其他物质未发现统计学差异。此外，基于血浆 MCP-1 截断值<或=130 pg/ml 的逻辑回归模型使我们能够以约 93%的敏感性和 79%的特异性区分 FMS 和 GP 患者。MCP-1、VEGF 和 TNFalpha 的低血浆水平与 AATD 有关，尽管在 FMS 患者中更为明显。因此，将 FMS 视为与高炎症生物标志物血浆水平相关的炎症性疾病的假说不能得到支持。
