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Lower serum activity of prolyl endopeptidase in fibromyalgia is related to severity of depressive symptoms and pressure hyperalgesia

Published online by Cambridge University Press:  01 July 1998

M. MAES ,
I. LIBBRECHT ,
F. VAN HUNSEL ,
A.-H. LIN ,
S. BONACCORSO ,
F. GOOSSENS ,
I. De MEESTER ,
L. De CLERCK ,
M. BIONDI  and
S. SCHARPE
...Show all authors
M. MAES
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
I. LIBBRECHT
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
F. VAN HUNSEL
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
A.-H. LIN
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
S. BONACCORSO
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
F. GOOSSENS
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
I. De MEESTER
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
L. De CLERCK
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
M. BIONDI
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
S. SCHARPE
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
A. JANCA
Affiliation:
Clinical Research Center for Mental Health, Department of Medical Biochemistry and Department of Immunology and Rheumatology, University of Antwerp, Belgium; Department of Psychiatry, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry, University of Rome, La Sapienza, Rome, Italy; and Division of Mental Health, WHO, Geneva, Switzerland
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Abstract

Background. The aims of the present study were to examine serum activities of peptidases, i.e. prolyl endopeptidase (PEP) and dipeptidyl peptidase IV (DPP IV), in patients with fibromyalgia and to examine the effects of subchronic treatment with sertraline on these variables.

Method. Serum PEP and DPP IV activity were measured in 28 normal volunteers and 21 fibromyalgia patients, classified according to the American College of Rheumatology criteria. Tenderness at tender points was evaluated by means of dolorimetry. Fibromyalgia patients had repeated measurements of serum PEP and DPP IV both before and after repeated administration of sertraline or placebo for 12 weeks.

Results. Patients with fibromyalgia had significantly lower serum PEP activity than normal volunteers. There were significantly negative correlations between serum PEP activity and severity of pressure hyperalgesia and the non-somatic, cognitive symptoms of the Hamilton Depression Rating Scale. Fibromyalgia patients with severe pressure hyperalgesia had significantly lower PEP activity than normal controls and fibromyalgia patients with less severe hyperalgesia. Fibromyalgia patients with severe non-somatic depressive symptoms had significantly lower serum PEP activity than normal volunteers. There were no significant changes in serum DPP IV activity in fibromyalgia. There were no significant effects of repeated administration of sertraline on serum PEP and DPP IV activity in patients with fibromyalgia.

Conclusions. The results show that fibromyalgia, and aberrant pain perception and depressive symptoms in fibromyalgia are related to lower serum PEP activity. It is hypothesized that lower serum PEP activity may play a role in the biophysiology of fibromyalgia through diminished inactivation of algesic and depression-related peptides.

Type
Research Article
Information
Psychological Medicine , Volume 28 , Issue 4 , July 1998 , pp. 957 - 965
Copyright
© 1998 Cambridge University Press

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