21. AGNP-Symposium in Nuremberg 1999

Mit der URL http://www.thieme.de/pharmaco/agnp-abstracts1999/index.html
sind die Abstracts eines Symposiums in Nürnberg abrufbar, unter denen mehrere Beiträge zur Fibromyalgie enthalten sind. Da kein thematischer Index enthalten ist, kopiere ich die Abstracts hier rein.
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Relationship of Substance P, 5-Hydroxyindole Acetic Acid and Tryptophan in Serum of Fibromyalgia Patients
Schwarz M K1, Späth M2, Bondy B1, Müller-Bardorff H1, Ackenheil M1

1Psychiatric Hospital, 2Friedrich-Baur-Institute, University of Munich, D

The serotonergic system has repeatedly been discussed to be involved in the pathophysiology of fibromyalgia (FM), which is a syndrome of widespread pain and sleep disturbance. Elevated levels of Substance P (SP), a mediator of nociception, have been described in FM.

In this study the possible relationship between SP and serotonin (5-HT) together with its precursor tryptophan (TRP) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) was evaluated in 51 serum samples of fibromyalgia patients. These parameters were compared with clinical data such as pain intensity or sleep quality.

A strong negative correlation between SP and 5-HIAA (p = .000) as well as between SP and TRP (p = .0009) could be demonstrated. High serum concentrations of 5-HIAA and TRP showed a significant relation to low pain scores (5-HIAA: p = .030; TRP: p = .014).

Moreover, 5-HIAA was strongly related to good quality of sleep (p = .000). while SP was related to sleep disturbance (p = .005).

These data are valid to support the hypothesis of a systemic involvement of 5-HT and SP in fibromyalgia.
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Relationship of the 5-HTR2c Cys23Ser Mutation with Biochemical and Clinical Variables in Fibromyalgia
Schwarz M J1, Späth M2, Müller-Bardorff H1, Ackenheil M1, Bondy B1

1Psychiatric Hospital, 2Friedrich-Baur-Institute, University of Munich, D

A dysfunction of the serotonergic system in the pathoaetiology of fibromyalgia (FM) has repeatedly been discussed. To elucidate the role of the cys23er mutation of the gene for the serotonin 2c receptor (5-HTR2c) in FM, we evaluated the relationship between this mutation and biochemical and clinical variables.

65 FM patients meeting the 1990 ACR criteria were analysed for the 5-HTR2c mutation. Additionally we measured serum levels of tryptophan (TRP), serotonin (5-HT), 5-hydroxyindolacetic acid (5-HIAA) and Substance P. Psychopathological variables were evaluated by the Symptom Check List 90-R (SCL-90-R).

Comparison of patients homocygous for the wildtype (cc allels) with those having the mutant of the 5-HTR2c gene (cs or ss) show that the wildtype is associated with lower levels of SP (p = .009), higher levels of 5-HIAA (p = .025), lower pain perception (p = .050), higher values in the subscale «Interpersonal Sensitivity and Hostility» (p = .007) and in tendency higher values in the subscale «Aggression» (p = .074) as well as in the total SCL-90-R score (p = .079). These preliminary results indicate a strong relationship between the genetic, biochemical and psychological data.
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The T102C Polymorphism of the 5-HT2A-Receptor Gene in Fibromyalgia
Schwarz M J1, Späth M&emsp18;2, Offenbächer M&emsp18;3, Glatzeder K&emsp18;3, Stratz T&emsp18;4, Ackenheil M1, Bondy B1

1Psychiatric Hospital, 2Friedrich-Baur-Institute, 3Department of Physical Medicine and Rehabilitation, University of Munich, Munich; 4Clinic of Rheumatology, Bad Säckingen, D

Based on a possible involvement of serotonergic dysfunctions in the pathophysiology of fibromyalgia (FM) and on reports of a possible genetically driven vulnerability for this disorder we investigated the silent T102C polymorphism of the 5-HT2A-receptor gene in 168 FM patients and 115 healthy controls. Our results showed a significantly different genotype distribution in FM patients with a decrease in T/T and an increase in C/C homozygotes as compared to the control population (Fisher's Exact Test, two-sided, p = 0.021). However, the increase in allele-C102 frequency reached only weak significance (p = 0.05). Correlation of genotypes to clinical parameters revealed no influences on age of onset, duration of disease or psychopathological symptoms, measured with the Beck-Depression-Inventory and the SCL-90-R. In contrast to that the pain score, being a self reported information on pain severity, was significantly higher in patients of the T/T genotype (p = 0.019). This suggests that the T102-allele might be involved in the complex circuits of nociception. However, the T102C polymorphism is not directly involved in the aetiology of FM but might be in linkage dysequilibrium with the true functional variant, which has to be unravelled.

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