Fibromyalgia Pain May Also Result from Neurogenic Inflammation of Peripheral Nerves, Review Argues

Fibromyalgia Pain May Also Result from Neurogenic Inflammation of Peripheral Nerves, Review Argues
Scientists agree that central sensitization plays an important role in fibromyalgia (FM) pathology. A review study by Monash University researcher Geoffrey Littlejohn points out that peripheral neurogenic inflammation of the nerves also likely contributes to FM symptoms. The review, titled "Neurogenic neuroinflammation in fibromyalgia and complex regional pain syndrome," appeared in the journal Nature Reviews Rheumatology. FM is considered to originate foremost from altered signaling in the brain and spinal cord. Central sensitization is a process by which nerve cells in the brain and spine become overly sensitive, responding with pain signals to normally non-painful stimuli. In the peripheral nervous system, neurogenic inflammation is caused by the release of pro-inflammatory factors from the nerve endings of pain neurons. These factors, called neuropeptides, act on nearby blood vessels and attract immune cells that release pro-inflammatory cytokines. This sequence of events ultimately leads to the expression of more alpha-receptors, making the sympathetic nervous system overly sensitive — a well-known finding in FM patients. The release of neuropeptides and subsequent cytokines likely contributes to neurogenic flares, or the abnormal skin responses in FM patients. Such inflammatory skin reactions have also been linked to dysfunctional blood vessel endothelial cells that allow blood plasma to leave the vessels after stimulation of the skin. This skin response is also influenced by the sympathet
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