Before its official establishment in 1976, fibromyalgia was most commonly known by the name fibrositis, where “itis” implied an inflammatory component. Despite the understanding of the contribution of inflammatory pathways to pain, clinical research was unable to identify the role of inflammation in fibromyalgia for many years.1
Within the last decade, fibromyalgia research has once again been focusing on the possible contribution of inflammation to disease progression, and is finding some new and interesting results.
Clinical studies have produced evidence that fibromyalgia is associated with the immune system’s improper regulation of proinflammatory cytokines that circulate in the bloodstream, contributing to the dysfunction of the central nervous system and pain-related neurotransmitters.2 Changes in proinflammatory cytokine levels have been seen in the blood work and biopsies of fibromyalgia patients.3,4 In addition, increased levels of IL-1Ra and IL-6 have been found in the cells from fibromyalgia patients in vitro stimulation and cellular proliferation studies.5 Cytokines, depending on their concentration, induce symptoms, such as fatigue, fever, sleep, pain, and muscle pain,6 all of which develop in fibromyalgia patients.
These findings are uncovering new possibilities in research for fibromyalgia causation, as well as treatment options. Some experimental pain reduction therapies have been examined and shown positive results, correlating with decreased proinflammatory cytokine levels.7 Anticonvulsant drugs, analgesics, opiods and anti-depressants are commonly prescribed to fibromyalgia patients, but tend to carry side effects reflective of the syndrome itself,8,9 and many of which lack evidence for effectiveness.10
Limited treatment options have led to an increasing use of systemic enzyme therapy as a means to alleviate symptoms and improve quality of life. Certain proteolytic (protein digesting) enzymes have been identified to have extremely beneficial actions when applied to inflammation and pain related to this condition.
Serrapeptase has demonstrated anti-inflammatory and fibrinolytic activity, and acts rapidly on localized inflammation with no reports of adverse effects.11,12 Bromelain, a proteolytic enzyme extracted from pineapple, has also been found to be effective in reducing inflammation by blocking cytokine production and activity.13,14
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