以慢性广泛性疼痛为特征,广义痛觉过敏,和心理压力,纤维肌痛(FM)难以诊断,缺乏有效的治疗方法。内源性大麻素-花生四烯酸乙醇胺(AEA),2-花生四酰基甘油(2-AG),和相关的油酰乙醇胺(OEA),棕榈酰乙醇胺(PEA),和硬脂酰乙醇胺(SEA)-是具有镇痛和抗炎特性的内源性脂质介质,与心理调节特性(例如,压力和焦虑),并被包括在一个新出现的\"ome,“内源性大麻素。这项病例对照研究比较了AEA的浓度差异,OEA,PEA,SEA,和2-AG在104名FM女性和116名健康对照受试者中。所有参与者都对他们的疼痛进行了评分,焦虑,抑郁症,以及目前的健康状况。使用强大的多变量数据分析和传统的双变量统计研究了脂质浓度与临床评估之间的关系。OEA的浓度,PEA,SEA,与健康对照组相比,FM女性的2-AG明显更高;控制体重指数和年龄后,OEA和SEA的意义仍然存在。2-AG与FM持续时间和体重指数呈正相关,在某种程度上,疼痛是负面的,焦虑,抑郁症,和健康状况。在FM中,AEA与抑郁评分呈正相关。内源性大麻烯类脂质的循环水平升高表明,这些脂质在FM的复杂病理生理学中起作用,并且可能是FM中持续低度炎症的迹象。尽管所研究的脂质在FM中发生了显着变化,关于FM的临床表现,它们的生物学作用尚不确定。因此,单独的血浆脂质不是FM的良好生物标志物。观点:本研究报道了FM中内源性大麻素脂质介质的血浆水平升高。脂质在临床中作为FM生物标志物的适用性较低;然而,它们的水平改变表明FM中正在进行代谢不对称,这可以作为探索性FM疼痛管理期间的基线。
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.