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Smoking is associated with reduced leptin and neuropeptide Y levels and higher pain experience in patients with fibromyalgia.

Bokarewa MI, Erlandsson MC, Bjersing J, Dehlin M, Mannerkorpi K - Mediators Inflamm. (2014)

Bottom Line: Pain was characterized by a visual analogue scale, tender point (TP) counts, pressure pain threshold, and neuroendocrine markers NpY and substance P (sP).Current smokers (n = 18) had lower levels of leptin compared to ex-smokers (n = 25, P = 0.002), while the expected NpY increase was absent in FM patients.In smokers, this was transcribed in higher VAS-pain (P = 0.04) and TP count (P = 0.03), lower pain threshold (P = 0.01), since NpY levels were directly related to the pain threshold (rho = 0.414) and inversely related to TP counts (rho = -0.375).

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Göteborg, P.O. Box 480, 405 30 Göteborg, Sweden.

ABSTRACT
Smoking deregulates neuroendocrine responses to pain supporting production of neuropeptide Y (NpY) by direct stimulation of nicotinic receptors or by inhibiting adipokine leptin. Present study addressed the effect of cigarette smoking on adipokines and pain parameters, in 62 women with fibromyalgia (FM) pain syndrome with unknown etiology. Pain was characterized by a visual analogue scale, tender point (TP) counts, pressure pain threshold, and neuroendocrine markers NpY and substance P (sP). Levels of IGF-1, leptin, resistin, visfatin, and adiponectin were measured in blood and cerebrospinal fluid. Current smokers (n = 18) had lower levels of leptin compared to ex-smokers (n = 25, P = 0.002), while the expected NpY increase was absent in FM patients. In smokers, this was transcribed in higher VAS-pain (P = 0.04) and TP count (P = 0.03), lower pain threshold (P = 0.01), since NpY levels were directly related to the pain threshold (rho = 0.414) and inversely related to TP counts (rho = -0.375). This study shows that patients with FM have no increase of NpY levels in response to smoking despite the low levels of leptin. Deregulation of the balance between leptin and neuropeptide Y may be one of the essential mechanisms of chronic pain in FM.

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Related in: MedlinePlus

Clinical measurements of pain in patients with fibromyalgia. By smoking habits, the patients were assigned as smokers (SM, n = 18), ex-smokers (Ex-SM, n = 25), and nonsmokers (non-SM, n = 19). (a) Pain distribution was evaluated in 18 standard tender points (TP). (b) Pain intensity was measured by a visual analogue scale (VAS, 0–100 mm). (c) Pressure pain threshold was measured using an algometer. Plots indicate median, interquartile range, and P values. The comparison between the groups was done by Kruskal-Wallis with Dunn's post hoc test. Scatterplots show correlation of serum levels of neuropeptide Y (NpY) with TP number (d) and with pressure pain threshold values (e). The Spearman's correlation test was applied.
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fig1: Clinical measurements of pain in patients with fibromyalgia. By smoking habits, the patients were assigned as smokers (SM, n = 18), ex-smokers (Ex-SM, n = 25), and nonsmokers (non-SM, n = 19). (a) Pain distribution was evaluated in 18 standard tender points (TP). (b) Pain intensity was measured by a visual analogue scale (VAS, 0–100 mm). (c) Pressure pain threshold was measured using an algometer. Plots indicate median, interquartile range, and P values. The comparison between the groups was done by Kruskal-Wallis with Dunn's post hoc test. Scatterplots show correlation of serum levels of neuropeptide Y (NpY) with TP number (d) and with pressure pain threshold values (e). The Spearman's correlation test was applied.

Mentions: Stress-related analgesia and reduced pain perception are described in smokers being more pronounced in women [48]. These properties of smoking are used by patients with FM as a pain coping strategy [17]. In the present study, we observed a gradually increasing prevalence of smokers in parallel with increasing TP counts (Figure 1).


Smoking is associated with reduced leptin and neuropeptide Y levels and higher pain experience in patients with fibromyalgia.

Bokarewa MI, Erlandsson MC, Bjersing J, Dehlin M, Mannerkorpi K - Mediators Inflamm. (2014)

Clinical measurements of pain in patients with fibromyalgia. By smoking habits, the patients were assigned as smokers (SM, n = 18), ex-smokers (Ex-SM, n = 25), and nonsmokers (non-SM, n = 19). (a) Pain distribution was evaluated in 18 standard tender points (TP). (b) Pain intensity was measured by a visual analogue scale (VAS, 0–100 mm). (c) Pressure pain threshold was measured using an algometer. Plots indicate median, interquartile range, and P values. The comparison between the groups was done by Kruskal-Wallis with Dunn's post hoc test. Scatterplots show correlation of serum levels of neuropeptide Y (NpY) with TP number (d) and with pressure pain threshold values (e). The Spearman's correlation test was applied.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4150510&req=5

fig1: Clinical measurements of pain in patients with fibromyalgia. By smoking habits, the patients were assigned as smokers (SM, n = 18), ex-smokers (Ex-SM, n = 25), and nonsmokers (non-SM, n = 19). (a) Pain distribution was evaluated in 18 standard tender points (TP). (b) Pain intensity was measured by a visual analogue scale (VAS, 0–100 mm). (c) Pressure pain threshold was measured using an algometer. Plots indicate median, interquartile range, and P values. The comparison between the groups was done by Kruskal-Wallis with Dunn's post hoc test. Scatterplots show correlation of serum levels of neuropeptide Y (NpY) with TP number (d) and with pressure pain threshold values (e). The Spearman's correlation test was applied.
Mentions: Stress-related analgesia and reduced pain perception are described in smokers being more pronounced in women [48]. These properties of smoking are used by patients with FM as a pain coping strategy [17]. In the present study, we observed a gradually increasing prevalence of smokers in parallel with increasing TP counts (Figure 1).

Bottom Line: Pain was characterized by a visual analogue scale, tender point (TP) counts, pressure pain threshold, and neuroendocrine markers NpY and substance P (sP).Current smokers (n = 18) had lower levels of leptin compared to ex-smokers (n = 25, P = 0.002), while the expected NpY increase was absent in FM patients.In smokers, this was transcribed in higher VAS-pain (P = 0.04) and TP count (P = 0.03), lower pain threshold (P = 0.01), since NpY levels were directly related to the pain threshold (rho = 0.414) and inversely related to TP counts (rho = -0.375).

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Göteborg, P.O. Box 480, 405 30 Göteborg, Sweden.

ABSTRACT
Smoking deregulates neuroendocrine responses to pain supporting production of neuropeptide Y (NpY) by direct stimulation of nicotinic receptors or by inhibiting adipokine leptin. Present study addressed the effect of cigarette smoking on adipokines and pain parameters, in 62 women with fibromyalgia (FM) pain syndrome with unknown etiology. Pain was characterized by a visual analogue scale, tender point (TP) counts, pressure pain threshold, and neuroendocrine markers NpY and substance P (sP). Levels of IGF-1, leptin, resistin, visfatin, and adiponectin were measured in blood and cerebrospinal fluid. Current smokers (n = 18) had lower levels of leptin compared to ex-smokers (n = 25, P = 0.002), while the expected NpY increase was absent in FM patients. In smokers, this was transcribed in higher VAS-pain (P = 0.04) and TP count (P = 0.03), lower pain threshold (P = 0.01), since NpY levels were directly related to the pain threshold (rho = 0.414) and inversely related to TP counts (rho = -0.375). This study shows that patients with FM have no increase of NpY levels in response to smoking despite the low levels of leptin. Deregulation of the balance between leptin and neuropeptide Y may be one of the essential mechanisms of chronic pain in FM.

Show MeSH
Related in: MedlinePlus