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A comparative study on antibodies to nucleoli and 5-hydroxytryptamine in patients with fibromyalgia syndrome and tryptophan-induced eosinophilia-myalgia syndrome

  • Clinical Pharmacology
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Abstract

Eosinophilia myalgia syndrome (EMS) has been related to intake of “contaminated” L-tryptophan, and an alteration in tryptophan 5-hydroxytryptamine (5-HT, serotonin) metabolism has been reported in EMS patients. Recently we found that a defined autoantibody pattern consisting of antibodies to nucleoli, gangliosides, and phospholipids is closely related to the fibromyalgia syndrome (FS) which clinically resembles the EMS. We were therefore interested to see whether these antibodies can also be detected in patients with EMS. Studied were 27 patients with acute EMS (13 of whom were also examined 2 years after acute onset), 100 patients with FS, and 40 patients with progressive systemic sclerosis (PSS). As controls, sera from 100 blood donors were analyzed. Antibodies to nucleoli were demonstrated by immunofluorescence test on cell cultures in 52% of patients with acute EMS, 62% of patients with chronic EMS, and 37% of FS patients. Western blotting with a nuclear extract from HeLa cells revealed in both diseases the same epitopes at 63, 57, and 53 kDa. Antibodies to 5-HT, gangliosides (Gm1), and phospholipids were determined by enzyme-linked immunosorbent assay. Among patients with FS 73% had antibodies to 5-HT, in contrast to only 19% of patients with acute EMS. However, 77% of the 13 EMS patients analyzed 2 years later had become anti-5-HT antibody positive during that time. Also the incidence of antibodies to Gm1 increased from 37% at acute onset to 69% in patients with chronic EMS (30%). The various antibodies were detected in only 18% of healthy controls. Serum 5-HT levels were decreased in patients with acute EMS compared to those with chronic EMS or FS. In patients with PSS they were significantly increased. It is concluded that EMS may have been developed in patients with FS who may have reacted in an allergic manner to a more immunogenic (“contaminated”) L-tryptophan.

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Abbreviations

5-HT:

5-hydroxytryptamine

ANA:

antinuclear antibodies

BHK:

baby hamster kidney

EMS:

eosinophilia myalgia syndrome

FS:

fibromyalgia syndrome

IFL:

immunofluorescence test

PSS:

progressive systemic sclerosis

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  1. Medizinische Klinik, Universität Tübingen, D-72076, Tübingen, Germany

    R. Klein & P. A. Berg

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  1. R. Klein
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Correspondence to: P.A. Berg

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Klein, R., Berg, P.A. A comparative study on antibodies to nucleoli and 5-hydroxytryptamine in patients with fibromyalgia syndrome and tryptophan-induced eosinophilia-myalgia syndrome. Clin Investig 72, 541–549 (1994). https://doi.org/10.1007/BF00207485

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  • DOI: https://doi.org/10.1007/BF00207485

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