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Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis
OBJECTIVES: The aetiology of primary chronic pain syndromes (CPS) is highly disputed. We performed a systematic review and meta-analysis aiming to assess differences in circulating cytokine levels in patients with diffuse CPS (fibromyalgia) vs healthy controls (HC). METHODS: Human studies published...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213433/ https://www.ncbi.nlm.nih.gov/pubmed/33576773 http://dx.doi.org/10.1093/rheumatology/keab146 |
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author | O’Mahony, Luke Furtado Srivastava, Arnav Mehta, Puja Ciurtin, Coziana |
author_facet | O’Mahony, Luke Furtado Srivastava, Arnav Mehta, Puja Ciurtin, Coziana |
author_sort | O’Mahony, Luke Furtado |
collection | PubMed |
description | OBJECTIVES: The aetiology of primary chronic pain syndromes (CPS) is highly disputed. We performed a systematic review and meta-analysis aiming to assess differences in circulating cytokine levels in patients with diffuse CPS (fibromyalgia) vs healthy controls (HC). METHODS: Human studies published in English from the PubMed, MEDLINE/Scopus and Cochrane databases were systematically searched from inception up to January 2020. We included full text cross-sectional or longitudinal studies with baseline cytokine measurements, reporting differences in circulating cytokine levels between fibromyalgia patients and HC. Random-effects meta-analysis models were used to report pooled effects and 95% CIs. This study is registered with PROSPERO (CRD42020193774). RESULTS: Our initial search yielded 324 papers and identified 29 studies (2458 participants) eligible for systematic review and 22 studies (1772 participants) suitable for meta-analysis. The systematic analysis revealed reproducible findings supporting different trends of cytokine levels when fibromyalgia patients were compared with HC, while the chemokine eotaxin, was consistently raised in fibromyalgia. Meta-analysis showed significantly increased TNF-α [standardized mean difference (SMD) = 0.36, 95% CI: 0.12, 0.60, P = 0.0034; I(2) = 71%, Q(2)P = 0.0002], IL-6 (SMD = 0.15, 95% CI: 0.003, 0.29, P = 0.045; I(2) = 39%, Q(2)P = 0.059), IL-8 (SMD = 0.26, 95% CI: 0.05, 0.47, P = 0.01; I(2) = 61%, Q(2)P = 0.005) and IL-10 (SMD = 0.61, 95% CI: 0.34, 0.89, P < 0.001; I(2) = 10%, Q(2)P = 0.34) in fibromyalgia patients compared with HC. CONCLUSION: We found evidence of significant differences in the peripheral blood cytokine profiles of fibromyalgia patients compared with HC. However, the distinctive profile associated with fibromyalgia includes both pro-inflammatory (TNF-α, IL-6, IL-8) and anti-inflammatory (IL-10) cytokines in pooled analysis, as well as chemokine (eotaxin) signatures. Further research is required to elucidate the role of cytokines in fibromyalgia. |
format | Online Article Text |
id | pubmed-8213433 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-82134332021-06-21 Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis O’Mahony, Luke Furtado Srivastava, Arnav Mehta, Puja Ciurtin, Coziana Rheumatology (Oxford) Systematic Review and Meta-Analysis OBJECTIVES: The aetiology of primary chronic pain syndromes (CPS) is highly disputed. We performed a systematic review and meta-analysis aiming to assess differences in circulating cytokine levels in patients with diffuse CPS (fibromyalgia) vs healthy controls (HC). METHODS: Human studies published in English from the PubMed, MEDLINE/Scopus and Cochrane databases were systematically searched from inception up to January 2020. We included full text cross-sectional or longitudinal studies with baseline cytokine measurements, reporting differences in circulating cytokine levels between fibromyalgia patients and HC. Random-effects meta-analysis models were used to report pooled effects and 95% CIs. This study is registered with PROSPERO (CRD42020193774). RESULTS: Our initial search yielded 324 papers and identified 29 studies (2458 participants) eligible for systematic review and 22 studies (1772 participants) suitable for meta-analysis. The systematic analysis revealed reproducible findings supporting different trends of cytokine levels when fibromyalgia patients were compared with HC, while the chemokine eotaxin, was consistently raised in fibromyalgia. Meta-analysis showed significantly increased TNF-α [standardized mean difference (SMD) = 0.36, 95% CI: 0.12, 0.60, P = 0.0034; I(2) = 71%, Q(2)P = 0.0002], IL-6 (SMD = 0.15, 95% CI: 0.003, 0.29, P = 0.045; I(2) = 39%, Q(2)P = 0.059), IL-8 (SMD = 0.26, 95% CI: 0.05, 0.47, P = 0.01; I(2) = 61%, Q(2)P = 0.005) and IL-10 (SMD = 0.61, 95% CI: 0.34, 0.89, P < 0.001; I(2) = 10%, Q(2)P = 0.34) in fibromyalgia patients compared with HC. CONCLUSION: We found evidence of significant differences in the peripheral blood cytokine profiles of fibromyalgia patients compared with HC. However, the distinctive profile associated with fibromyalgia includes both pro-inflammatory (TNF-α, IL-6, IL-8) and anti-inflammatory (IL-10) cytokines in pooled analysis, as well as chemokine (eotaxin) signatures. Further research is required to elucidate the role of cytokines in fibromyalgia. Oxford University Press 2021-02-12 /pmc/articles/PMC8213433/ /pubmed/33576773 http://dx.doi.org/10.1093/rheumatology/keab146 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Systematic Review and Meta-Analysis O’Mahony, Luke Furtado Srivastava, Arnav Mehta, Puja Ciurtin, Coziana Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis |
title | Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis |
title_full | Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis |
title_fullStr | Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis |
title_full_unstemmed | Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis |
title_short | Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis |
title_sort | is fibromyalgia associated with a unique cytokine profile? a systematic review and meta-analysis |
topic | Systematic Review and Meta-Analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213433/ https://www.ncbi.nlm.nih.gov/pubmed/33576773 http://dx.doi.org/10.1093/rheumatology/keab146 |
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