Peripheral immune aberrations in fibromyalgia : a systematic review, meta-analysis and meta-regression
Andrés Rodríguez, Laura (Universitat Autònoma de Barcelona. Facultat de Psicologia)
Borràs, Xavier (Universitat Autònoma de Barcelona. Facultat de Psicologia)
Feliu-Soler, Albert (Universitat Autònoma de Barcelona)
Pérez-Aranda, Adrián (Universitat Autònoma de Barcelona)
Angarita-Osorio, Natalia (Universitat Autònoma de Barcelona)
Moreno-Peral, Patricia (RedIAPP (Red de Investigación en Actividades Preventivas y Promoción de la Salud))
Montero-Marín, Jesús (University of Oxford. Department of Psychiatry)
Garcia-Campayo, Javier (RedIAPP (Red de Investigación en Actividades Preventivas y Promoción de la Salud))
Carvalho, André F (University of Toronto. Department of Psychiatry)
Maes, Michael (Chulalongkorn University. Department of Psychiatry)
Luciano, Juan Vicente (Institut de Recerca Sant Joan de Déu)

Data:	2019
Descripció:	9 pàg.
Resum:	The objective was to identify immune alterations in patients with fibromyalgia syndrome (FMS) compared to healthy controls (HC) using meta-analysis and meta-regression. Six electronic databases were searched for suitable original articles investigating immune biomarkers in FMS in comparison to HC. We extracted outcomes and variables of interest, such as mean and SD of peripheral blood immune biomarkers, age or sex. A random-effects model with restricted maximum-likelihood estimator was used to compute effect sizes (standardized mean difference and 95% CI, Hedges' g) and meta-analysis, group meta-analysis and meta-regressions were conducted. Forty-three papers were included in this systematic review, of which 29 were suitable for meta-analysis. Interleukin (IL)-6 (g = 0. 36 (0. 09-0. 63); I2 = 85. 94; p = 0. 01), IL-4 (g = 0. 50 (0. 03-0. 98); I2 = 81. 87; p = 0. 04), and IL-17A (g = 0. 53 (0. 00-1. 06); I2 = 87. 15; p = 0. 05), were significantly higher in FMS compared to HC while also combinations of cytokines into relevant phenotypes were significantly upregulated including M1 macrophage (g = 0. 23 (0. 03-0. 43); I2 = 77. 62; p = 0. 02), and immune-regulatory (g = 0. 40 (0. 09-0. 72); I2 = 84. 81; p = 0. 01) phenotypes. Heterogeneity levels were very high and subgroup and meta-regression analyses showed that many covariates explained part of the heterogeneity including medication washout, sex, time of blood sampling and exclusion of patients with major depressive disorder. In conclusion, FMS is accompanied by a disbalance between upregulated pro-inflammatory (M1 and Th-17) and immune-regulatory cytokines although effect sizes are small-to-moderate. Based on our results we provide specific methodological suggestions for future research, which should assess Th-1, Th-17, chemokines, and Th-2 phenotypes while controlling for possible confounding variables specified in this study.
Ajuts:	Ministerio de Economía y Competitividad RD16/0007/0005 Ministerio de Economía y Competitividad RD16/0007/0012 Instituto de Salud Carlos III PI15/00383 Instituto de Salud Carlos III CD16/00147 Instituto de Salud Carlos III CPII19/00003 Agència de Gestió d'Ajuts Universitaris i de Recerca FI_B00754 Agència de Gestió d'Ajuts Universitaris i de Recerca FI_B00783
Nota:	This study was awarded both with the Grant PSSJD & FSJD 2016 and with the I Premio del Instituto esMindfulness 2016
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Llengua:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Matèria:	Chemokines ; Cytokines ; Fibromyalgia ; Immune biomarkers ; Meta-analysis
Publicat a:	Brain, behavior, and immunity, Vol. 87 (2020) , p. 881-889, ISSN 1090-2139

DOI: 10.1016/j.bbi.2019.12.020
PMID: 31887417
PMID: 31887417

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