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The Relationship of Endocannabinoidome Lipid Mediators With Pain and Psychological Stress in Women With Fibromyalgia: A Case-Control Study
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
Karolinska Inst, Sweden; Scandinavian Ctr Orofacial Neurosci, Sweden.
Univ Gothenburg, Sweden.
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2018 (English)In: Journal of Pain, ISSN 1526-5900, E-ISSN 1528-8447, Vol. 19, no 11, p. 1318-1328Article in journal (Refereed) Published
Abstract [en]

Characterized by chronic widespread pain, generalized hyperalgesia, and psychological stress, fibromyalgia (FM) is difficult to diagnose and lacks effective treatments. Endocannabinoids arachidonoylethanolamide (AEA), 2-arachidonoylglycerol (2-AG), and the related oleoylethanolamide (OEA), palmitoylethanolamide (PEA), and stearoylethanolamide (SEA) are endogenous lipid mediators with analgesic and anti-inflammatory characteristics, in company with psychological modulating properties (eg, stress and anxiety), and are included in a new emerging "ome," the endocannabinoidome. This case-control study compared the concentration differences of AEA, OEA, PEA, SEA, and 2 AG in 104 women with FM and 116 healthy control subjects. All participants rated their pain, anxiety, depression, and current health status. The relationships between the lipid concentrations and the clinical assessments were investigated using powerful multivariate data analysis and traditional bivariate statistics. The concentrations of OEA, PEA, SEA, and 2-AG were significantly higher in women with FM than in healthy control subjects; significance remained for OEA and SEA after controlling for body mass index and age. 2-AG correlated positively with FM duration and body mass index, and to some extent negatively with pain, anxiety, depression, and health status. In FM, AEA correlated positively with depression ratings. The elevated circulating levels of endocannabinoidome lipids suggest that these lipids play a role in the complex pathophysiology of FM and might be signs of ongoing low-grade inflammation in FM. Although the investigated lipids are significantly altered in FM, their biological roles are uncertain with respect to the clinical manifestations of FM. Thus plasma lipids alone are not good biomarkers for FM. Perspective: This study reports about elevated plasma levels of endocannabinoidome lipid mediators in FM. The lipids suitability to work as biomarkers for FM in the clinic were low; however, their altered levels indicate that a metabolic asymmetry is ongoing in FM, which could serve as a baseline during explorative FM pain management. (C) 2018 by the American Pain Society

Place, publisher, year, edition, pages
CHURCHILL LIVINGSTONE , 2018. Vol. 19, no 11, p. 1318-1328
Keywords [en]
Fibromyalgia; chronic; widespread pain; anxiety; depression; endocannabinoidome; 2-arachidonoylglycerol; N-acylethanolamines
National Category
Neurology
Identifiers
URN: urn:nbn:se:liu:diva-153180DOI: 10.1016/j.jpain.2018.05.008ISI: 000450244400008PubMedID: 29885369OAI: oai:DiVA.org:liu-153180DiVA, id: diva2:1267310
Note

Funding Agencies|Swedish Rheumatism Association; Health and Medical Care Executive Board of Vastra Gotaland Region; ALF-LUA at Sahlgrenska University Hospital; Region Ostergotland (ALF); Swedish Research Council [K2013-52X-22199-01-3, K2015-99x-21874-05-4, 521-2010-2893]; Karolinska Institute Foundation; AFA Insurance [140341]; Stockholm County Council (ALF); Linkoping University Hospital Research

Available from: 2018-12-01 Created: 2018-12-01 Last updated: 2019-05-01

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Stensson, Niclas

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