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Natural Alternative & Fibromyalgia Leave a comment

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

 

References:

1.     Chaitow L. Fibromyalgia and Muscle Pain. Thorsons Pub; 1995:1-205.
2.     Staud R. Evidence of involvement of central neural mechanisms in generating fibromyalgia pain. Curr Rheumatol Rep. 2002;4:299–305. doi: 10.1007/s11926-002-0038-5.
3.     Lucas HJ, Brauch CM, Settas L, Theoharides TC. Fibromyalgia–new concepts of pathogenesis and treatment. Int J Immunopathol Pharmacol. 2006;19:5–10.
4.     Salemi S, Rethage J, Wollina U, Michel BA, Gay RE, Gay S, Sprott H. Detection of interleukin lbeta (IL-lbeta), IL-6, and tumor necrosis factor-alpha in skin of patients with fibromyalgia. J Rheumatol. 2003;30:146–150.
5.     Wallace DJ, Linker-Israeli M, Hallegua D, Silverman S, Silver D, Weisman MH. Cytokines play an aetiopathogenetic role in fibromyalgia: a hypothesis and pilot study. Rheumatology (Oxford) 2001;40:743–749.
6.     Gur A, Oktayoglu P. Status of immune mediators in fibromyalgia. Curr Pain Headache Rep. 2008;12:175–181. doi: 10.1007/s11916-008-0031-4.
7.     Wang H, Moser M, Schiltenwolf M, Buchner M. Circulating cytokine levels compared to pain in patients with fibromyalgia — a prospective longitudinal study over 6 months. J Rheumatol. 2008 Jul;35(7):1366-70.
8.     Gore M, Sadosky A, Zlateva G, Clauw D. Initial use of pregabalin, patterns of pain-related pharmacotherapy, and healthcare resource use among older patients with fibromyalgia. Am J Manag Care. 2010 May;16(5 Suppl):S144-53.
9.     Kroenke K, Krebs EE, Bair MJ. Pharmacotherapy of chronic pain: a synthesis of recommendations from systematic reviews. Gen Hosp Psychiatry. 2009 May-Jun;31(3):206-19.
10.  Shaver JL, Wilbur J, Lee H, Robinson FP, Wang E. Self-reported medication and herb/supplement use by women with and without fibromyalgia.  J Womens Health (Larchmt). 2009 May;18(5):709-16.
11.  Kee WH, Tan SL, Lee V, Salmon YM. The treatment of breast engorgement with Serrapeptase (Danzen): a randomised double-blind controlled trial. Singapore Med J. 1989; 30(1):48-54.
12.  Mazzone A, Catalani M, Costanzo M, et al. Evaluation of Serratia peptidase in acute or chronic inflammation of otorhinolaryngology pathology: a multicentre, double-blind, randomized trial versus placebo. J Int Med Res. 1990; 18(5):379-88.
13.  Onken JE, Greer PK, Calingaert B, et al. Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon biopsies in vitro. Clin Immunol. 2008; 126(3):345-352.
14.     Secor ER, Carson WF, Singh A, et al. (2008) Oral bromelain attenuates inflammation in an ovalbumin-induced murine model of asthma. Evid Based Complement Alternat Med. 2008; 5(1):61-69.

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