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Neuroendocrine immunology of fibromyalgia
Author(s) -
Di Franco Manuela,
Iannuccelli Cristina,
Valesini Guido
Publication year - 2010
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2009.05344.x
Subject(s) - fibromyalgia , neuroscience , pathogenesis , nociception , autonomic nervous system , sympathetic nervous system , central nervous system , medicine , immune system , homeostasis , peripheral nervous system , hormone , nervous system , sensitization , hypothalamic–pituitary–adrenal axis , immunology , receptor , biology , heart rate , blood pressure
The pathophysiology of fibromyalgia (FM) is not completely understood. The disease is characterized by a central sensitization with an amplification of pain perception. A combination of interactions among external stressors, behavioral constructs, neurotransmitters, hormones, immune, and sympathetic nervous systems appears to be involved. It is known that the neuroimmunoendocrine system has a role in the pathogenesis of the disease and multiple abnormalities have been demonstrated in the peripheral and central nervous systems. Bidirectional mechanisms involving peripheral nociceptive input as well as abnormal central pain processing are involved. Hypothalamic–pituitary–adrenal axis alterations have also been shown with abnormal response to stress. Recent data highlight the putative role of cytokines in the pathogenesis of FM. The autonomic nervous system is implicated in the maintenance of the physiological homeostasis and sympathetic activity appears increased in FM. Neuropeptide Y and its receptors Y1 and Y2 seem to have a complex role in pain modulation.