Begrijp hersenontsteking bij patiënten met fibromyalgie

Fibromyalgie (FM) is een veel voorkomende en complexe chronische pijnstoornis die wijdverspreide pijn en een gevoeligheid voor aanraking veroorzaakt die kan optreden op specifieke tender- of activeringspunten of door het hele lichaam.

De symptomen van fibromyalgie zijn wijdverspreid en bestrijken de volledige intensiteit. Symptomen zoals vermoeidheid, slaapstoornissen, cognitieve problemen en stijfheid zijn het meest gemeld. Bijkomende symptomen zijn depressie, angst, migraine, spanningshoofdpijn, bekkenpijn, prikkelbare of overactieve blaas, prikkelbare darmsyndroom (IBS), TMJ en gastro-intestinale reflux. Stress verhoogt de intensiteit van de symptomen en kan de oorzaak zijn van een cyclus van pijn die onmogelijk te beheersen is.

Degenen die lijden aan fibromyalgie hebben over het algemeen een grotere reactie op externe stimulatie. Er kan een grotere autonome reactie zijn op milde dagelijkse gewaarwordingen, zoals geluiden, licht en geuren.

Het laatste onderzoek heeft de neiging om aan te geven dat deze aandoening van overgevoeligheid iets te maken heeft met veranderingen in de hersenen .

Er is toenemend bewijs dat als gevolg van verschillende stressvolle chronische aandoeningen, pijnpaden in de hersenen zijn veranderd. Een persoon die met fibro leeft, zal vaak chronische hoofdpijn, viscerale pijn en andere pijnlijke aandoeningen ervaren.

Stressvolle gebeurtenissen in het leven en fysieke of emotionele trauma’s veroorzaken de recrudescentie van ontstekingsreacties en deze reacties worden doorgegeven aan de hersenen. Als deze stressvolle omstandigheden lange tijd aanhouden, produceren ze veranderingen in de hersenen die het hypersensitiviteitssyndroom veroorzaken.

Recentelijk is er een veel grotere interesse in het observeren van hersencellen die een rol spelen bij ontsteking en overgevoeligheid. Een van die cellen waarvan bekend is dat ze een centrale rol spelen bij ontstekingsreacties in de hersenen is  microglia .

 

Mechanismen van ontsteking en neuronale betrokkenheid

Ontsteking is een verdedigingsmechanisme. Zodra het lichaam wordt geconfronteerd met een infectieus agens, puin of ander vreemd materiaal, treedt er een ontsteking op en worden er chemicaliën vrijgegeven uit de witte bloedcellen van het lichaam om uw lichaam tegen vreemde stoffen te beschermen. De bloedstroom neemt toe naar het gebied van verwonding of infectie. Dit beschermingsproces kan de zenuwen stimuleren en pijn veroorzaken.  Macrofagen  zijn cellen die het lichaam vrijmaken van gebruikte cellen en ander afval. Samen met dendritische cellen, spelen een belangrijke rol bij het verzenden van een reactie inflammatoire.

Het hersencentrum initieert acties om de lichaamstemperatuur te verhogen en microbiële groei te voorkomen. De hersenen proberen energie te besparen door ons te dwingen te rusten, sociale interactie en fysieke activiteiten te verminderen, bijvoorbeeld. . De hersenen zijn fundamenteel voor de reactie op pijn. Maar hoe gebeurt de uitwisseling van informatie tussen het vlampunt en de hersenen? Het gebeurt via boodschappers die cytokines worden genoemd, en via de toegang van zenuwen.

 

Hersenenontsteking en fibromyalgie

Nu weten we dat de hersenen niet alleen betrokken zijn bij de beheersing van onze gedachten en emoties, maar ook automatisch omgaan met het beheren van inflammatoire reacties op trauma, stress en andere bedreigingen. Dit afweermechanisme met lokale reacties en veranderingen in het functioneren van de hersenen is geëvolueerd gedurende de miljoenen jaren van onze evolutie. Ons lichaam is onberispelijk gemaakt om adequaat te reageren op een acute dreiging.

In de afgelopen eeuw of zo zijn de omgeving en leefomstandigheden sneller veranderd dan ons lichaam kan aanpassen of evolueren. Aangepaste werkomstandigheden, een betere behandeling van vele acute stoornissen, kankers en chirurgische therapieën hebben bijgedragen aan stress en chronische ontsteking. Ons brein staat voortdurend onder stress, wat heeft geleid tot sensibilisatie van verschillende hersenstructuren. Deze continue feedback naar de hersenen produceert een sensitisatie van de microglia die ontstekingsreacties, overgevoeligheid en hyperreactie produceert. Het lijkt erop dat de meervoudige afweermechanismen van onze hersenen en ons lichaam niet op deze chronische manier functioneren, waardoor er nieuwe soorten gezondheidsproblemen ontstaan. 

 

Fibromyalgie en microgliale verbinding

De chronische stressvolle toestand maakt specifieke hersencellen hyperreactief. Het resultaat is een toename van de niveaus van ontstekingsfactoren, het gevoel van pijn en stemmingswisselingen, zoals depressie of angst.

Om deze hypothese met betrekking tot de hyperactiviteit van microglia-cellen in de hersenen bij fibromyalgie te demonstreren, werd een studie gepubliceerd in het wetenschappelijke tijdschrift Reports.

Hoewel verdacht voor een lange tijd dat microglia betrokken is bij fibromyalgie geleden, is het moeilijk om te studeren of te testen dit concept. Maar beter begrip van celbiologie, is het mogelijk geworden om soort microglia cellen geïnduceerd door mensen (maak iMG ) van andere cellen afgeleid van perifere bloedcirculatie.

In de gepubliceerde studie creëerden de wetenschappers  iMG  van 14 patiënten met fibromyalgie 10 van personen met een goede gezondheid. Ze bestudeerden de reacties van iMG-cellen op stimulatie door extracellulair ATP. De onderzoekers vonden dat de cellen van patiënten met FM vertoonden de hoogste niveaus van tumornecrosefactor (TNF), een soort van inflammatoire cytokine messenger-. 

resultaat

Dit experiment toonde de hyperreactiviteit van microglia bij personen die aan FM lijden. Dit zijn overgevoelig cellen die mogelijk verantwoordelijk zijn voor de verhoogde perceptie van pijn en neiging tot kan stoornissen van  de stemming  in FM.

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