Abstract
We proposed to assess the oxidant/antioxidant status, lipid peroxidation and nitric oxide (NO) in untreated fibromyalgia (FM) patients and controls. The effect of amitriptyline (A, 20 mg daily) and sertraline (S, 100 mg daily) treatment on patients’ superoxide dismutase (SOD), xanthine oxidase (XO), adenosine deaminase (ADA) enzyme activities, thiobarbituric acid reactive substances (TBARS) and NO levels was investigated. Thirty female patients with primary FM and age-matched 16 healthy female controls were included. Patients received an 8-week course of treatment with either A or S. FM patients had higher serum levels of TBARS (particularly malondialdehyde) and lower levels of nitrite compared to controls whereas enzyme activities were similar. A and S significantly improved Fibromyalgia Impact Questionnaire (FIQ) pain scores, Hamilton anxiety and depression rating scales. But neither A nor S had significant effects on measured oxidative stress parameters, except SOD activity that was significantly reduced after S treatment. Total myalgic scores negatively correlated with XO activity, and depression scales negatively correlated with levels of TBARS. Our results indicate that patients with FM are under oxidative stress. These findings represent a rationale for further research assessing the effect of free radical scavengers or antioxidant agents like vitamins and omega-3 fatty acids on peripheral and central mechanisms in FM.
Abbreviations
- FM:
-
Fibromyalgia
- NO:
-
Nitric oxide
- S:
-
Sertraline
- A:
-
Amitriptyline
- SOD:
-
Superoxide dismutase
- XO:
-
Xanthine oxidase
- ADA:
-
Adenosine deaminase
- TBARS:
-
Thiobarbituric acid reactive substances
- FIQ:
-
Fibromyalgia Impact Questionnaire
- ROS:
-
Reactive oxygen species
- CFS:
-
Chronic fatigue syndrome
- O2 :
-
Dioxygen
- NOS:
-
Nitric oxide synthase
- PPT:
-
Pain pressure threshold
- HDRS:
-
Hamilton Depression Rating Scale
- HARS:
-
Hamilton Anxiety Rating Scale
- PUFAs:
-
Polyunsaturated fatty acids
- NBT:
-
Nitroblue tetrazolium
- PDE:
-
Phosphodiesters
- MDA:
-
Malondialdehyde
- NO −2 :
-
Nitrite
- NO. :
-
Nitric oxide radical
References
Goldenberg DL (1999) Fibromyalgia syndrome a decade later. What have we learned? Arch Intern Med 159:777–785
Cofford LJ, Appleton BE (2000) The treatment of fibromyalgia: a review of clinical trials. Curr Rheum Rep 2:101–103
Akyol O, Isci N, Temel I, Ozgocmen S, Uz E, Murat M, Buyukberber S (2001) The relationships between plasma and erythrocyte antioxidant enzymes and lipid peroxidation in patients with rheumatoid arthritis. Joint Bone Spine 68:311–317
Ozgocmen S, Sogut S, Ardicoglu O, Fadillioglu E, Pekkutucu I, Akyol O (2004) Serum nitric oxide, catalase, superoxide dismutase, and malondialdehyde status in patients with ankylosing spondylitis. Rheumatol Int 24:80–83
Keenoy BM, Moorkens G, Vertommen J, Leeuw ID (2001) Antioxidant status and lipoprotein in chronic fatigue syndrome. Life Sci 68:2037–2049
Vecchiet J, Capillone F, Falasca K, Mezzetti A, Pizzigallo E, Bucciarelli T, De Laurentis S, Affaitati G, De Cesare D, Giamberardino MA (2004) Relationship between musculoskeletal symptoms and blood markers of oxidative stress in patients with chronic fatigue syndrome. Neurosci Lett 335:151–154
Esterbauer H, Schaur RJ, Zollner H (1991) Chemistry and biochemistry of 4-hydroxynonenal, malonaldehyde and related aldehydes. Free Radic Biol Med 11:81–128
Sogut S, Zoroglu S, Ozyurt H, Yilmaz HR, Ozugurlu F, Sivasli E, Yetkin O, Yanik M, Tutkun H, Savas HA, Tarakcioglu M, Akyol O (2003) Changes in nitric oxide levels and antioxidant enzyme activities may have a role in the pathophysiological mechanisms involved in autism. Clin Chim Acta 331:111–117
Kigwell BA (2000) Nitric oxide-mediated metabolic regulation during exercise: effect of training in health and cardiovascular disease. FASEB J 14:1685–1696
Akyol O, Zoroglu SS, Armutcu F, Sahin S, Gurel A (2004) Nitric oxide as a physiopathological factor in neuropsychiatric disorders. In Vivo 18:377–390
Cepinskas G, Rui T, Kvietys PR (2002) Interaction between reactive oxygen metabolites and nitric oxide in oxidant tolerance. Free Radic Biol Med 33:433–440
Larson AA, Giovengo SL, Russell IJ, Michalek JE (2000) Changes in the concentrations of amino acids in the cerebrospinal fluid that correlate with pain in patients with fibromyalgia: implications for nitric oxide pathways. Pain 87:201–211
Wolfe F, Smythe HA, Yunus MB, Bennet RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheum 33:160–172
Catal SA, Erdem HR, Okumus M, Ozgocmen S, Yorgancioglu ZR (2000) The measurement of pain pressure threshold in patients with rheumatoid arthritis. Pain Clin 12:187–191
Okifuji A, Turk DC, Sinclair D, Starz TW, Marcus DA (1997) A standardized manual tender point survey. I. Development and determination of a threshold point for the identification of positive tender points in fibromyalgia syndrome. J Rheumatol 24:377–383
Ozgocmen S, Yoldas T, Kamanli A, Yildizhan H, Yigiter R, Ardicoglu O (2003) Auditory P300 event related potentials and serotonin reuptake inhibitor treatment in patients with fibromyalgia. Ann Rheum Dis 62:551–555
Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62
Hamilton M (1959) The assessment of anxiety states by rating. Br J Med Psychol 32:50–55
Sarmer S, Ergin S, Yavuzer G (2000) The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 20:9–12
Esterbauer H, Cheeseman KH (1990) Determination of aldehydic lipid peroxidation products: malonaldehyde and 4-hydroxynonenal. In: Packer L, Glazer AN (eds) Oxygen radicals in biological systems, Methods Enzymol. Academic Press, California, 186:407–421
Cortas NK, Wakid NW (1990) Determination of inorganic nitrate in serum and urine by a kinetic cadmium-reduction method. Clin Chem 36:1440–1443
Sun Y, Oberley LW, Li Y (1988) A simple method for clinical assay of superoxide dismutase. Clin Chem 34:497–500
Prajda N, Weber G (1975) Malign transformation-linked imbalance: decreased XO activity in hepatomas. FEBS Lett 59:245–249
Giusti G (1974) Adenosine deaminase. In: Bergmeyer MV (ed) Methods of enzymatic analysis, 2nd edn. Academic Press, New York, pp. 1092–1098
Eisinger J, Gandolfo C, Zakarian H, Ayavou T (1997) Reactive oxygen species, antioxidant status and fibromyalgia. J Musculoskeletal Pain 5:5–15
Lund N, Bengtsson A, Thorborg P (1986) Muscle oxygen tissue pressure in primary fibromyalgia. Scand J Rheumatol 15:165–173
Bennett RM, Clark SR, Goldberg L, Nelson D, Bonafede RP, Porter J, Specht D (1989) Aerobic fitness in patients with fibrositis. A controlled study of respiratory gas exchange and 133xenon clearance from exercising muscle. Arthritis Rheum 32:454–460
Hein G, Franke S (2002) Are advanced glycation end-product-modified proteins of pathogenetic importance in fibromyalgia? Rheumatology 41:1163–1167
Lindh MH, Johansson LG, Hedberg M, Henning GB, Grimby G (1995) Muscle fiber characteristics, capillaries and enzymes in patients with fibromyalgia and controls. Scand J Rheumatol 24:34–37
Jeschonneck M, Graohmann G, Hein G, Sprott H (2000) Abnormal microcirculation and temperature in skin above tender points in patients with fibromyalgia. Rheumatology 39:917–921
Fulle S, Mecocci P, Fano G, Vecchiet I, Vecchini A, Racciotti D, Cherubini A, Pizzigallo E, Vecchiet L, Senin U, Beal MF (2000) Specific oxidative alterations in vastus lateralis muscle of patients with the diagnosis of chronic fatigue syndrome. Free Radic Biol Med 29:1252–1259
Sackner MA, Gummels EM, Adams JA (2004) Say NO to fibromyalgia and chronic fatigue syndrome: an alternative and complementary therapy to aerobic exercise. Med Hypotheses 63:118–123
Bagis S, Tamer L, Sahin G, Bilgin R, Guler H, Ercan B, Erdogan C (2005) Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder? Rheumatol Int 25:188–190
Bilici M, Efe H, Koroglu MA, Uydu HA, Bekaroglu M, Deger O (2001) Antioxidative enzyme activities and lipid peroxidation in major depression: alterations by antidepressant treatments. J Affect Disord 64:43–51
Park DC, Glass JM, Minear M, Crofford LJ (2001) Cognitive function in fibromyalgia patients. Arthritis Rheum 44:2125–2133
Delibas N, Ozcankaya R, Altuntas I (2002) Clinical importance of erythrocyte malondialdehyde levels as a marker of cognitive deterioration in patients with dementia of Alzheimer type: a repeated study in 5-year interval. Clin Biochem 32:137–141
Merchant RE, Carmack CA, Wise CM (2000) Nutritional supplementation with Chlorella pyrenoidosa for patients with fibromyalgia syndrome: a pilot study. Phytother Res 14:167–173
Ozgocmen S, Catal SA, Ardicoglu O, Kamanli A (2000) Effect of omega-3 fatty acids in the management of fibromyalgia syndrome. Int J Clin Pharmacol Ther 38:362–363
Hostmark AT, Lystad E, Vellar OD, Hovi K, Berg JE (1993) Reduced plasma fibrinogen, serum peroxides, lipids, and apolipoproteins after a 3-week vegetarian diet. Plant Foods Hum Nutr 43:55–61
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ozgocmen, S., Ozyurt, H., Sogut, S. et al. Antioxidant status, lipid peroxidation and nitric oxide in fibromyalgia: etiologic and therapeutic concerns. Rheumatol Int 26, 598–603 (2006). https://doi.org/10.1007/s00296-005-0079-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-005-0079-y