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Fibromyalgia Rational Biological Source Of Pain Found

Discussion in 'Fibromyalgia' started by Ecoclimber, Jun 20, 2013.

  1. Ecoclimber

    Ecoclimber Senior Member

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    Pain Med. 2013 May 20. doi: 10.1111/pme.12139. [Epub ahead of print]Excessive Peptidergic Sensory Innervation of Cutaneous Arteriole-Venule Shunts (AVS) in the Palmar Glabrous Skin of Fibromyalgia Patients: Implications for Widespread Deep Tissue Pain and Fatigue.
    Albrecht PJ, Hou Q, Argoff CE, Storey JR, Wymer JP, Rice FL.
    Source
    Integrated Tissue Dynamics, LLC, Rensselaer, New York, USA; Center for Neuropharmacology & Neuroscience, Albany Medical College, Albany, New York, USA.
    Abstract

    OBJECTIVE:

    To determine if peripheral neuropathology exists among the innervation of cutaneous arterioles and arteriole-venule shunts (AVS) in fibromyalgia (FM) patients.
    SETTING:

    Cutaneous arterioles and AVS receive a convergence of vasoconstrictive sympathetic innervation, and vasodilatory small-fiber sensory innervation. Given our previous findings of peripheral pathologies in chronic pain conditions, we hypothesized that this vascular location may be a potential site of pathology and/or serotonergic and norepinephrine reuptake inhibitors (SNRI) drug action.
    SUBJECTS:

    Twenty-four female FM patients and nine female healthy control subjects were enrolled for study, with 14 additional female control subjects included from previous studies. AVS were identified in hypothenar skin biopsies from 18/24 FM patient and 14/23 control subjects.
    METHODS:

    Multimolecular immunocytochemistry to assess different types of cutaneous innervation in 3 mm skin biopsies from glabrous hypothenar and trapezius regions.
    RESULTS:

    AVS had significantly increased innervation among FM patients. The excessive innervation consisted of a greater proportion of vasodilatory sensory fibers, compared with vasoconstrictive sympathetic fibers. In contrast, sensory and sympathetic innervation to arterioles remained normal. Importantly, the sensory fibers express α2C receptors, indicating that the sympathetic innervation exerts an inhibitory modulation of sensory activity.
    CONCLUSIONS:

    The excessive sensory innervation to the glabrous skin AVS is a likely source of severe pain and tenderness in the hands of FM patients. Importantly, glabrous AVS regulate blood flow to the skin in humans for thermoregulation and to other tissues such as skeletal muscle during periods of increased metabolic demand. Therefore, blood flow dysregulation as a result of excessive innervation to AVS would likely contribute to the widespread deep pain and fatigue of FM. SNRI compounds may provide partial therapeutic benefit by enhancing the impact of sympathetically mediated inhibitory modulation of the excess sensory innervation.
    Wiley Periodicals, Inc.
    Fibromyalgia, a painful condition affecting approximately 10 million people in the U.S., is not imaginary after all, as some doctors have believed. A discovery, published this month in PAIN MEDICINE (the journal of the American Academy of Pain Medicine), clearly now demonstrates that fibromyalgia may have a rational biological basis located in the skin.....​
    ...Now, a breakthrough discovery by scientists at Integrated Tissue Dynamics LLC (Intidyn), as part of a fibromyalgia study based at Albany Medical College, has provided a biological rationale for this enigmatic disease. The small biotechnology research company, founded by neuroscientists Dr. Frank L. Rice and Dr. Phillip J. Albrecht, reports on a unique peripheral neurovascular pathology consistently present in the skin of female fibromyalgia patients which may be a driving source of the reported symptoms.​
    Additional Information here:​
    and​
    Eco​
    redrachel76, Bob, Shell and 1 other person like this.
  2. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

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  3. Ecoclimber

    Ecoclimber Senior Member

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    Also if you click on the title at the top of my post, it will take you to the science article on it.

    Caveat: The research is not in a top tier research magazine and there are competing interests with the authors and the pharmaceutical industries.

    Eco
  4. PhoenixDown

    PhoenixDown Senior Member

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    As with any of these findings, they won't account for 100% of fibromyalgia patients (I doubt it's anywhere above 50% in clinical practice), in any case a new disease name would be the best thing for the patients found to have this abnormality.

    I really think these figures are conflating, misleading, and generally muddying the waters. I suppose that's what you get for defining a disorder by idiopathic pain.
  5. Kina

    Kina Moderation Team Lead

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    I do wish that such grandiose and definitive conclusions weren't drawn from a subject pool of 'twenty-four female FM patients and nine female healthy control subjects'. These results really aren't significant until they test larger and larger pools of subjects.

    And, I wish the would stop prefacing these studies that find something physiological with 'see, it's real after all'. :(
    WillowJ and Valentijn like this.
  6. PhoenixDown

    PhoenixDown Senior Member

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    Yes, it plays right into the hands of those who wish to discredit us by playing the "stigmatizing mental illness" card, and of course it's real whether mechanism is discovered or not.
    Valentijn and Kina like this.
  7. Ecoclimber

    Ecoclimber Senior Member

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    This research is different from Dr. Oaklander's research on small fiber neuropathy (SNF) located in this thread here:

    http://forums.phoenixrising.me/index.php?threads/many-fibromyalgia-patients-have-small-fiber-polyneuropathy.19953/#post-340664 and here https://www.ncbi.nlm.nih.gov/pubmed/23478869

    What is interesting is that In addition to involvement in temperature regulation, an enormous proportion of our blood flow normally goes to our hands and feet. Far more than is needed for their metabolism” noted Dr. Rice. “As such, the hands and the feet act as a reservoir from which blood flow can be diverted to other tissues of the body, such as muscles when we begin to exercise. Therefore, the pathology discovered among these shunts in the hands could be interfering with blood flow to the muscles throughout the body. This mismanaged blood flow could be the source of muscular pain and achiness, and the sense of fatigue which are thought to be due to a build-up of lactic acid and low levels of inflammation fibromyalgia patients. This, in turn, could contribute to the hyperactvity in the brain.”

    Dr. Albrecht also points out that alterations of normal blood flow may underlie other fibromyalgia symptoms, such as non-restful sleep or cognitive dysfunctions. “The data do appear to fit with other published evidence demonstrating blood flow alterations to higher brain centers and the cerebral cortex of fibromyalgia patients” he stated.

    They have not conducted research into any genetic possibilities at this time nor the underlying cause of this condition.

    Other links
    http://www.intidyn.com/Newsroom/News_Releases.html

    There is Ninth Worled Congress on Myofascail Pain & Fibromyalgia Syndrome in Seattle. I spoke to Dr. Rich and he will be attending this conference. His focus is primarily on vascular research.
    http://www.myopain.org/2013_MyoPain_PC.pdf

    Keep in mind the focus is on Fibromyalgia Only. The research from other areas are bits and pieces of a much larger puzzle which could overlap and give researchers a better understanding concerning the cause of ME/CFS or at least a subset.

    Eco
    Attachments explain this condition

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