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Is there any Relationship Between Eosinophilia Myalgia Syndrome (Ems) and Fibromyalgia Syndrome (Fms)? an Analysis Of Clinical and Immunological Data

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Tryptophan, Serotonin, and Melatonin

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 467))

Abstract

The eosinophilia-myalgia syndrome (EMS) caused by intake of contaminated L-tryptophan resembles in its clinical presentation the fibromyalgia syndrome (FMS). We, therefore, analysed clinical and immunological parameters in 16 patients with chronic EMS and 100 patients with FMS in order to see whether there may be a relationship between both disorders. From 12 FMS patients and 12 controls also peripheral blood mononuclear cells (PBMC) were obtained. Myalgia and arthralgia was observed in chronic EMS in the same incidence as in patients with FMS (81%). Also antibodies to serotonin, gangliosides and phospholipids were present in both groups. In vitro stimulation of PBMC with different L-tryptophan preparations revealed in six of the 12 FMS patients but only two of the control individuals a production of type 2 cytokines (IL-5, IL-10). We, therefore, conclude that EMS may have developed in patients suffering primarily from FMS as an allergic reaction towards a more immunogenic L-tryptophan preparation.

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References

  • AlberatiGiani D. and Cesura A.M., 1998, Expression of the kynurenine enzymes in macrophages and microglial cells: regulation by immune modulators, Amino Acids 14:251–255.

    Article  CAS  Google Scholar 

  • Belongia E.A., Hedberg C.W., Gleich G.J., White K.E., Mayeno A.M., Loegering D.A., Dunnette S.L., Pirie PL., MacDonald K.L., and Osterholm MT., 1990, An investigation of the cause of the eosinophilia-myalgia syndrome associated with tryptophan use. N. Engl. J. Med. 323:357–365.

    Article  PubMed  CAS  Google Scholar 

  • Berg P.A. and Becker E.W., 1995, The lymphocyte transformation test-a debated method for the evaluation of drug allergic hepatic injury, Journal of Hepatology 22:115–118.

    Article  PubMed  CAS  Google Scholar 

  • Byrne G.I., Lehmann L.K., Kirschbaum J.G., Borden E.C., Lee C.M., and Brown R.R., 1986, Induction of tryptophan degradation in vitro and in vivo: a gamma interferon-stimulated activity. J. Interferon Res. 6:389–396.

    Article  PubMed  CAS  Google Scholar 

  • Clutterbuck E.J., Hirst E.M., and Sanderson C.J., 1989, Human interleukin-5 (IL-5) regulates the production of eosinophils in human bone marrow cultures: comparison and interaction with IL-1, IL-3, IL-6 and GM-CSF. Blood 73:1504–1512.

    PubMed  CAS  Google Scholar 

  • Henning K.J., Jean-Baptiste E., Singh T., Hill R.H., and Friedmann S.M., 1993, Eosinophilia-myalgia syndrome: in patients ingesting a single source of L-tryptophan, J. Rheumatol. 20:273–278.

    PubMed  CAS  Google Scholar 

  • Hertzman P.A., Falk H., Kilbourne E.M., Page S., and Shulman L.E., 1991, The eosinophilia-myalgia syndrome. The Los Angeles Alamos Conference, J. Rheumatol. 18:867–873.

    PubMed  CAS  Google Scholar 

  • Hertzmann P.A., Blevins W.L., Mayer J., Greenfield B., Ting M., and Gleich G.J., 1990, Association of the eosinophilia-myalgia syndrome with the ingestion of tryptophan, N. Engl. J. Med. 322:869–873.

    Article  Google Scholar 

  • Heyes M.P., Achim C.L., Wiley C.A., Major E.O., Saito K., and Markey S.P., 1996, Human microglia convert L-tryptophan into the neurotoxin quinolinic acid, Biochemical Journal 320:595–597.

    PubMed  CAS  Google Scholar 

  • Kerr S.J., Armati P.J., and Brew B.J., 1995, Neurocytotoxity of quinolinic acid in human brain cultures, Journal of Neurovirology 1:376–380.

    Article  Google Scholar 

  • Kerr S.J., Armati P.J., Guillemin G.J., and Brew B.J., 1998, Chronic exposure of human neurons to quinolinic acid results in neuronal changes consistent with AIDS dementia complex, AIDS 12:355–363.

    Article  PubMed  CAS  Google Scholar 

  • Klein R. and Berg P.A., 1995, High incidence of antibodies to 5-hydroxytryptamine, gangliosides and phospholipids in patients with chronic fatigue and fibromyalgia syndrome and their relatives: Evidence for a clinical entity of both disorders, European Journal of Medical Research 1:21–26.

    PubMed  CAS  Google Scholar 

  • Klein R., Bänsch M., and Berg P.A., 1992, Clinical relevance of antibodies against serotonin and gangliosides in patients with fibromyalgia syndrome, Psychoneuroendocrinology 17:593–598.

    Article  PubMed  CAS  Google Scholar 

  • Klein R. and Berg P.A., 1994, A comparative study on antibodies to nucleoli and 5—hydroxytryptamine in patients with fibromyalgia syndrome and tryptophan-induced eosinopilia-myalgia syndrome. Clin. Investig. 72:541–549.

    Article  PubMed  CAS  Google Scholar 

  • Lopez A.F., Sanderson C.J., Gamble J.R., Campbell H.D., Young I.G., and Vadas M.A., 1988, Recombinant human interleukin 5 is a selective activator of human eosinophil function, J. Exp. Med. 167:219–224.

    Article  PubMed  CAS  Google Scholar 

  • Mackowiak P.A. and LeMaistre C.F., 1987, Drug fever: a critical appraisal of convential concepts, Ann. Intern. Med. 106:728–733.

    Article  PubMed  CAS  Google Scholar 

  • Manu P., Matthews D.A., and Lane T.J., 1993, Food intolerance in patients with chronic fatigue, International Journal of Eating Disorders 13:203–209.

    Article  PubMed  CAS  Google Scholar 

  • Mayeno A.N., Lin F., Foote C.S., Loegering D.A., Ames M.M., Hedberg C.W., and Gleich G., 1990, Characterization of “peak E”, a novel amino acid associated with eosinophilia-myalgia syndrome, Science 250:1707–1708.

    Article  PubMed  CAS  Google Scholar 

  • Mosmann T.R., Schumacher J.H., Fiorentino D.F., Leverah J, Moore K.W., and Bond M.W, 1990, Isolation of monoclonal antibodies specific for IL-4, IL-5, IL-6, and a new Th2-specific cytokine (IL-10), cytokine synthesis inhibitory factor, by using a solid solid phase radioimmunoadsorbent assay. J. Immunol. 145:2938–2945.

    PubMed  CAS  Google Scholar 

  • Ozaki Y., Edelstein M.P., and Duch D.S., 1987, The actions of interferon and antiinflammatory agents on induction of indoleamine-2,3-dioxygenase in human peripheral blood monocytes, Biochem. Biophys. Res. Commun. 144:1147–1153.

    Article  PubMed  CAS  Google Scholar 

  • Schwarcz R., Whetsell W.O., and Mangano R., 1983, Quinolinic acid: an endogenous metabolite that produces axonsparing lesions in rat brain, Science 219:316–318.

    Article  PubMed  CAS  Google Scholar 

  • Shulman L.E., 1990, The eosinophilia-myalgia syndrome associated with the ingestion of L-tryptophan, Arthritis Rheum. 33:913–917.

    Article  PubMed  CAS  Google Scholar 

  • Silver R.M., Heyes M.P., Maize J.C., Quearry B., Vionnet-Fussaet M., and Sternberg E.M., 1990, Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan, N. Engl. J. Med. 322:874–881.

    Article  PubMed  CAS  Google Scholar 

  • Silver R.M., McKinley K., Smith E.A., Quearry B., Harati Y., Sternberg E.M., and Heyes M.P, 1992a, Tryptophan metabolism via the kynurenine pathway in patients with the eosinophilia-myalgia syndrome, Arthritis and Rheum; 35:1097–1105.

    Article  CAS  Google Scholar 

  • Silver R.M., Sutherland S.E., Carreira P., and Heyes M.P, 1992b, Alterations in tryptophan metabolism in the toxic oil syndrome and in the eosinophilia-myalgia syndrome, J. Rheumatol. 19:69–73.

    PubMed  CAS  Google Scholar 

  • Slutsker L., Hoesly F.C., Miller L., Williams L.P., Watson J.C., and Fleming D.W., 1990, Eosinophilia-myalgia syndrome associated with the exposure to tryptophan from a single manufacturer, JAMA 264:213–217.

    Article  PubMed  CAS  Google Scholar 

  • Straus S.E., Dale J.K., Wright R., and Metcalfe D.D., 1988, Allergy and the chronic fatigue syndrome, J. Allergy Clin. Immunol. 81:791–795.

    Article  PubMed  CAS  Google Scholar 

  • Varga J., Uitto J., and Jimenez S.A., 1992, The cause and pathogenesis of the eosinophilia-myalgia syndrome, Ann. Intern. Med. 116:140–147.

    Article  PubMed  CAS  Google Scholar 

  • Wolfe F., Anderson J., Harkness D., Bennett R.M., Caro X.J., Goldenberg D.L., Russell I.J., and Yunus M.B., 1997, Health status and disease severity in fibromyalgia: Results of a six-center longitudinal study, Arthritis and Rheum. 40:1571–1579.

    Article  CAS  Google Scholar 

  • Wolfe F., Hawley D.J., Cathey M.A., Caro X., and Rusell I.J., 1985, Fibrositis: symptom frequency and criteria for diagnosis, J. Rheumatol. 12:1159–1163.

    PubMed  CAS  Google Scholar 

  • Yamaguchi Y., Hayashi Y., Sugama Y., Miura Y., Kasahara T., Kitamura S., Torisu M., Mita S., Tominaga A., and Takatsu K., 1988, Highly purified murine interleukin 5 (IL-5) stimulates eosinophil function and prolongs in vitro survival. Il-5 as an eosinophil chemotactic factor, J. Exp. Med. 167:1737–1742.

    Article  PubMed  CAS  Google Scholar 

  • Yamaguchi Y., Suda T., Shiozaki H., Miura Y., Hitoshi Y., Tominaga A., Takatsu K., and Kasahara T., 1990, Role of IL-5 in IL-2-induced eosinophilia: In vivo and in vitro expression of IL-5 mRNA by IL-2. The Journal of Immunology 145:873–877.

    PubMed  CAS  Google Scholar 

  • Yunus M., Masi A.T., Calabro J.J., Miller K.A., and Feigenbaum S.L., 1981, Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls, Semin. Arthritis Rheum. 11:151–171.

    Article  PubMed  CAS  Google Scholar 

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© 1999 Springer Science+Business Media New York

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Barth, H., Berg, P.A., Klein, R. (1999). Is there any Relationship Between Eosinophilia Myalgia Syndrome (Ems) and Fibromyalgia Syndrome (Fms)? an Analysis Of Clinical and Immunological Data. In: Huether, G., Kochen, W., Simat, T.J., Steinhart, H. (eds) Tryptophan, Serotonin, and Melatonin. Advances in Experimental Medicine and Biology, vol 467. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4709-9_61

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  • DOI: https://doi.org/10.1007/978-1-4615-4709-9_61

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7133-5

  • Online ISBN: 978-1-4615-4709-9

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