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Effects of non-pharmacological interventions on inflammatory biomarker expression in patients with fibromyalgia: a systematic review
Sanada K, Diez MA, Valero MS, Perez-Yus MC, Demarzo MMP, Garcia-Toro M, Garcia-Campayo J
Arthritis Research & Therapy 2015 Sep 26;17(272):Epub
systematic review

INTRODUCTION: Fibromyalgia (FM) is a prevalent disorder. However, few studies have evaluated the effect of treatment interventions on biomarker expression. The aim of this review was to explore the efficacy of non-pharmacological interventions on inflammatory biomarker expression, specifically cytokines, neuropeptides and c-reactive protein (CRP), in FM patients. METHOD: A literature search using PubMed, Embase, PsycINFO and the Cochrane Library was performed from January 1990 to March 2015. Randomized controlled trials (RCTs) and non-RCTs published in English, French or Spanish were eligible. RESULTS: Twelve articles with a total of 536 participants were included. After exercise, multidisciplinary, or dietary interventions in FM patients, interleukin (IL) expression appeared reduced, specifically serum IL-8 and IL-6 (spontaneous, lipopolysaccharide (LPS)-induced, or serum). Furthermore, the changes to insulin-like growth factor 1 (IGF-1) levels might indicate a beneficial role for fatigue in obese FM patients. In contrast, evidence of changes in neuropeptide and CRP levels seemed inconsistent. CONCLUSION: Despite minimal evidence, our findings indicate that exercise interventions might act as an anti-inflammatory treatment in FM patients and ameliorate inflammatory status, especially for pro-inflammatory cytokines. Additional RCTs focused on the changes to inflammatory biomarker expression after non-pharmacological interventions in FM patients are needed.

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