DANOS NOS NERVOS AFECTA OS PULMÕES EM FIBROMIALGIA: NOVO ESTUDO

A disautonomia em pacientes com FM pode ser caracterizado por uma hiperactividade simpático implacável ao longo do dia associada a um  demente  resposta solidário com diferentes factores de stress. Os autores

O sistema nervoso autônomo (SNA) parece ser o assunto da semana para Saúde Rising. Este estudo combina o sistema nervoso autônomo com o funcionamento do pulmão – uma questão que não tem sido falado na fibromialgia que eu estou ciente.

As pessoas não costumam amarrar fibromialgia ou síndrome de fadiga crônica com problemas pulmonares, mas eles surgir – particularmente na ME / CFS – às vezes. Algumas pessoas experimentam “fome de ar” ou dificuldade em respirar ou dificuldade em tomar respirações profundas. Alguns estudos sugerem que a ventilação – o movimento de ar para dentro e para fora do pulmão – pode ser reduzida durante o exercício de alguma paciente ME / CFS. Staci Stevens, um fisiologista do exercício, se perguntou se as pequenas e altamente ativos músculos envolvidos na respiração podem ser afetados nesta doença.

 

problemas pulmonares pode não ser o principal sintoma associado com FM, mas problemas com os pulmões poderia estar dizendo se fossem uma manifestação de outro problema associado ao sistema nervoso autônomo.

Os autores chegaram ao coração da matéria neste trabalho rapidamente. Eles relataram que o sistema nervoso simpático (SNS) na fibromialgia) é hiperativo em repouso, mas, em seguida, dobras ou falhas quando colocado sob estresse; ou seja, você está conectado e cansado em “repouso” (algum descanso!) e, em seguida, as coisas tendem a ir derem errado quando você sistema é colocado sob estresse. (O mesmo padrão está presente na síndrome de fadiga crónica (ME / SFC))

Como eles se conectam dos pulmões para fibromialgia? Eles usaram diabetes. Diabetes não é mencionado muito em conexão com fibromialgia, mas os autores apontou para um problema semelhante ANS em diabetes, que conduz a problemas com enchimento de vasos sanguíneos nos vasos muito pequenos (microvascular) de sangue nos pulmões. Na diabetes isto leva a um problema com difusão de monóxido de carbono dos pulmões.

Essa é a mesma coisa que parece estar acontecendo em FM.

O Estudo

Eles levaram 45 pacientes com FM e 45 controles e fez um monte de sistema nervoso autônomo e do volume pulmonar e testes de transferência de gás, incluindo algo chamado fator de transferência que mede a capacidade do pulmão para difundir o monóxido de carbono fora dele. Eles também tinham-los a tomar uma 31 questão questionário autônomo chamado de pontuação composta Autonomic Sintoma ou COMPASS.

Resultados

FM pacientes têm microcirculação funcional e anormalidades morfológicas e o padrão anormal da hiperemia reactiva é devido a uma maior tónus simpático levando ao aumento da vasoconstrição. Os autores

Eles observaram que os pacientes com fibromialgia pontuação no questionário autônomo (COMPASS) foram altamente correlacionados com os do Fibromyalgia Impact Questionnaire (FIQ). Que sugeriu que o problema do sistema nervoso autônomo pode estar contribuindo para muitos sintomas em FM.

Os pulmões pacientes com FM não parecia tão bom. O volume total do pulmão era fina, mas a cada medida de pulmão funcionando (factor de transferência de monóxido de carbono, a capacidade de difusão de monóxido de carbono, o volume de membrana capilar alveolar e volume de sangue capilar pulmonar) foram significativamente reduzidos nos pacientes com fibromialgia.

Outras análises encontrado que a redução na capacidade de difusão do pulmão foi, provavelmente, devido a uma redução significativa no volume pulmonar capilar pulmonar; isto é, o volume microvascular dos pulmões doentes FM tinha diminuído.

Ambos os vasos menores e mais comum do sangue encontrados, nossos capilares são responsáveis ​​pelo fornecimento de sangue para a maioria dos nossos tecidos. Eles são tão pequenos que um glóbulo vermelho pode apenas mal caber através deles. Como eles são entregar células vermelhas do sangue são também permitir que as pequenas moléculas, tais como oxigénio, CO2, açúcares e aminoácidos para se difundem em e fora deles. Essa parte de difusão, aparentemente, não está funcionando muito bem.

Os autores sugeriram que os danos aos nervos autonômicos cardíacos estava causando problemas com a “regulação do tônus ​​microvascular” ea distribuição de enchimento pulmonar. Eles propuseram que os receptores nas nossas células que causam vasos sanguíneos pacientes FM para dilatar ter sido tão overstimulated ao longo do tempo que eles não estão respondendo aos sinais de dilatar mais. Isso deixa os vasos sanguíneos constricted, prejudica os fluxos de sangue e até mesmo (creio eu) poderia reduzir o volume de sangue.

Os autores enumerou uma série de descobertas sugerem que os problemas de circulação seria nenhuma surpresa em FM. a produção de óxido nítrico reduzida impede que os vasos sanguíneos a partir da abertura suficiente para mover os vasos sanguíneos em pacientes com FM de abrir suficientemente para mover o sangue de forma adequada e fazendo com que a rigidez da parede arterial.

Eles também observaram as altas taxas de fenômenos de Raynaud encontrados nos participantes FM neste estudo (1/3). Raynaud ocorre quando espasmos nas artérias restringir os fluxos sanguíneos normalmente nas mãos ou nos pés causando os dedos ou dos pés, geralmente, para virar branco, depois azul e, em seguida, como os retornos de sangue, faz com que eles a formigar ou queimar. Isso é muitas vezes causado por exposição a temperaturas reduzidas. Em algumas pessoas serem expostos a temperaturas abaixo de 60 graus pode causar Reynaud de.

O fato de que os pacientes com FM com fenômenos de Raynaud tendem a ter resultados de testes pior pulmonares fazia sentido dado o semelhante simpático hiperatividade do sistema nervoso encontrado em Raynaud. Que, hiperatividade local, o que afeta as artérias não os pequenos vasos sanguíneos encontrados nos pulmões, é tão extrema que faz com que os vasos sanguíneos se tornam constritos ou estreitou o suficiente para que o sangue não pode passar.

Raynaud, em seguida, parece ser uma outra manifestação de um sistema nervoso autônomo desregulado em FM.

Os autores não passaram nenhum tempo sobre o significado clínico de suas descobertas e não está claro no papel o que são. A difusão reduzida de dióxido de carbono é encontrada em muitas doenças pulmonares (fibrose, alveolite, vasculite, DPOC, enfisema, hipertensão pulmonar), bem como anemia (baixo volume sanguíneo). Não está claro se eles contribuem para a falta de ar ou problemas respiratórios às vezes encontrados em ME / CFS ou FM ou se eles refletem um problema que está presente, mas que não está causando muitos sintomas.

Esta não é a primeira vez que possíveis problemas de microcirculação surgiram em FM, no entanto. Os autores de um estudo 2.014 exercício proposto que os problemas da microcirculação podem ter contribuído para os resultados baixos VO2 max eles encontrados em pacientes com FM. Eles argumentaram que o próximo estudo exercício de FM deve examinar os fluxos de sangue nos pequenos vasos sanguíneos que alimentam os músculos.

  • Veja Dando uma Mão: uma abordagem muito diferente para a fibromialgia para obter informações sobre uma máquina que pretende aumentar a microcirculação em FM

Nerve Damage Proposto

Estes autores propuseram que os danos aos nervos autonômica cardíaca era mais provável para explicar o funcionamento do pulmão embotados. Isto, naturalmente, não é a primeira vez que os danos aos nervos autônomos tem sido proposto ou encontrado em FM. nervos autônomos estão entre as pequenas fibras nervosas que muitos estudos têm encontrado agora danificados na pele de pacientes com FM.

No ano passado, que o dano foi estendido para as fibras nervosas no olho. Recentemente Sommers encontrado um tal padrão incomum de lesão do nervo em FM que ela agora chama de “pequeno patologia fibra” para distingui-la da pequena neuropatia fibra mais típico encontrado em outras doenças. Caro e Winters descobriram danos para  grandes  fibras nervosas em FM.

Cerca de um ano atrás, um pesquisador sugeriu que os pesquisadores profundas olhar para os nervos mais que são susceptíveis de encontrar. Sua previsão parece estar se tornando realidade. Da pele para os olhos para, possivelmente, os pulmões problemas nervosos estão surgindo na fibromialgia.

O que poderia estar causando esses problemas nervosos? Se as descobertas da pele de um grupo espanhol realizar-se, em seguida, uma mistura de inflamação, problemas mitocondriais e estresse oxidativo pode encher a conta.

 

 

Cortesia: https://www.healthrising.org

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