Possible Molecular Mediators Involved and Mechanistic Insight into Fibromyalgia and Associated Co-morbidities
Abstract
Fibromyalgia is a chronic complex syndrome of non-articulate origin characterized by musculoskeletal pain, painful tender points, sleep problems and co-morbidities including depression, migraine. The etiopathogenesis of fibromyalgia is complex, variable and remains inconclusive. The etiological factors that have been defined include stress, genetic predisposition and environmental components. As per the reports of the American College of Rheumatology (ACR) the prevalence of fibromyalgia varies from 2 to 22% among the general population with poor diagnostic features primarily pain. Fibromyalgia encompasses a spectrum of co-morbid conditions with multifarious pathogenesis. The highly prevalent manifestations of fibromyalgia include heterogeneous pain and aches. Biochemical and neurobiological elements of fibromyalgia include neurotransmitters, hypothalamic pituitary adrenal axis (HPA axis), inflammatory cytokines, monoaminergic pathway, opioid peptides, sex hormones, nerve growth factor (NGF) and local free radical insult. An imbalance in the serotonergic system is the major underlying etiological factor that has been explored most widely. Owing to complex interplay of diverse pathophysiological pathways, overlapping co-morbidities such as depression have been clinically observed. Therapeutic management of fibromyalgia involves both non pharmacological and pharmacological measures. The current review presents various dysregulations and their association with symptoms of fibromyalgia along with their underlying neurobiological aspects.
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The HPG and HPA axes are involved in fibromyalgia.
“evidence argues for the involvement in FM of the HPG and HPA axes [30].”
From Fibromyalgia pathogenesis explained by a neuroendocrine multistable model (2024) · cites this paper as [30]
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Pain Biomarkers in Fibromyalgia Syndrome: Current Understanding and Future Directions
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- Authors
- Singh, L., Kaur, A., Bhatti, M. S., & Bhatti, R.
- Affiliations
- Guru Nanak Dev University (IN)
- Corresponding author
- Bhatti, Manpreet S.
- Bhatti, Rajbir
- Venue
- Neurochemical Research
- Published
- 2019-04-19
- Volume
- 44
- Issue
- 7
- Pages
- 1517-1532
- ISSN
- 0364-3190 (ISSN-L)
- 1573-6903
- OpenAlex
- W2935820385
- Cited by
- 55
- References
- 200
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 11 · 2023: 5 · 2022: 6 · 2021: 15 · 2020: 6 · 2019: 1
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neurochemical Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- DST (EMR/2016/005878)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Keywords
- fibromyalgia, comorbidities, depression, migraine, serotonergic system, hypothalamic-pituitary-adrenal axis, inflammatory cytokines, monoaminergic pathways, opioid peptides, sex hormones, nerve growth factor, free radicals, neurotransmitters, pain, etiopathogenesis, fibromyalgia treatment
- MeSH terms
- Animals, Depression, Fibromyalgia, Humans, Hypothalamo-Hypophyseal System, Migraine Disorders, Neuropeptides, Pain, Pituitary-Adrenal System, Inflammatory Bowel Diseases, Comorbidity, Cytokines, Oxidative Stress, Hepatitis C, Chronic, Intercellular Signaling Peptides and Proteins
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