Diagnostic and treatment approaches to fibromyalgia management: quantification of peripheral blood mononuclear cell function and evaluation of radial shockwave therapy

Abstract

Fibromyalgia (FM) is a chronic pain disorder that affects many individuals worldwide. The lack of a definitive diagnostic method and highly successful treatment approaches make it an interesting area of research. In the present study, the effectiveness of quantifying cytokine concentrations from stimulated peripheral blood mononuclear cells (PBMCs) in pre-intervention FM patients as a new diagnostic approach for FM, and the effectiveness of radial shockwave therapy (RSWT) as a FM treatment option to improve the function of PBMC cytokine release from pre- to post-interventions were investigated. Evaluating cytokine concentrations released from stimulated PBMCs allows the capacity of PBMCs to release cytokines and the function of the immune system to be assessed. This was done by isolating PBMCs from blood samples of healthy controls (HCs) and FM participants taken before and after receiving the treatment or placebo intervention, dividing the amount of cells in media from each sample into wells of a cell culture plate, and stimulating half of the cells with the mitogen phytohaemagglutinin protein (PHA-P) to release cytokines. The concentrations of interleukins 6 and 10 (IL-6 and IL-10, respectively) released from stimulated and unstimulated PBMCs were determined from the cell culture supernatants in pre-intervention FM participants and HCs. IL-6 and IL-10 concentrations released from stimulated and unstimulated PBMCs were also determined from the cell culture supernatants before and after FM participants received the treatment or placebo intervention. The effective change ratios for both IL-6 and IL-10 cytokines were also calculated by dividing the cytokine concentration released from stimulated PBMCs by the cytokine concentration released from unstimulated PBMCs for each FM participant. The effective change ratios from pre-intervention FM participants were compared to the effective change ratios from HCs. The effective change ratios from FM participants were also compared pre- and post-intervention for the treatment and placebo groups, and to effective change ratios from HCs. The correlation of IL-6 and IL-10 delta effective change ratios from the difference in effective change ratios pre- to post-intervention was also determined for each FM participant. The results indicated there were no significant differences between HCs and FM participants for the concentrations of IL-6 and IL-10 cytokines released from stimulated and unstimulated PBMCs. There were also no significant differences between HCs and FM participants for both the IL-6 and IL-10 cytokine effective change ratios.