Experimental Evaluation of an Altered Tryptophan Metabolism in Fibromyalgia

Psychiatric Hospital, University of Munich, Nussbaumstr. 7, D - 80336 Munich, Germany.
Advances in Experimental Medicine and Biology (Impact Factor: 1.96). 02/2003; 527:265-75. DOI: 10.1007/978-1-4615-0135-0_30
Source: PubMed


Fibromyalgia (FM) is a prevalent syndrome with chronic pain and a hypothesised underlying disturbance of the tryptophan (TRP) metabolism. We performed a tryptophan depletion (TD) test in 17 FM patients and 17 controls. TRP, 5-hydroxyindoleacetic acid (5-HIAA), kynurenine (KYN), and Interleukin-6 (IL-6) were measured. Additionally pain perception was monitored in the FM patients. FM patients and controls exhibited a decrease of TRP and KYN during TD. 5-HIAA levels also decreased in all controls and in 11 FM patients, but showed a marked increase in 6 FM patients. IL-6 significantly increased during TD in the patients, but not in the controls. Pain perception was not affected in the FM patients. These data demonstrate an altered TRP metabolism in a subgroup of FM patients, where the TD seems to activate 5-HT metabolism and IL-6 production. Our findings may have diagnostic as well as therapeutic implications in the field of fibromyalgia.

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    • " et al . , 1976 ; Jokinen et al . , 2009 ; Chatzittofis et al . , 2013 ) . Tryptophan depletion ( a method of lowering brain serotonin , used as a model of depressive disorders ) not only worsens depres - sive symptoms ( Fields et al . , 1991 ; Booij et al . , 2005 ; van Steen - bergen et al . , 2012 ) and also can increase the sensation of pain ( Schwarz et al . , 2003 ; Supornsilpchai et al . , 2006 ; Wei et al . , 2010 ) . The system of antinociception operates primarily through sero - tonin 5 - HT1A and 5 - HT2 receptors ; the stimulation of 5 - HT3"
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    • "An increased density of 5-HT receptors on platelets in patients with FMS (Russell et al 1992b) and abnormal transport of serum tryptophan (Yunus et al 1990), which have also been reported, indicate a general disturbance of serotonergic neurotransmission. Interestingly, however, tryptophan depletion in FMS patients had no effect on their pain severity (Schwarz et al 2003). "
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