La Dysautonomie chez les patients FM peut être caractérisé par une hyperactivité sympathique sans relâche tout au long de la journée associée à une réponse sympathique se dérégler à différents facteurs de stress. Les auteurs
Le système nerveux autonome (SNA) semble être le sujet de la semaine pour la santé en hausse. Cette étude combine le système nerveux autonome avec poumon fonctionnement – une question qui n’a pas été parlée dans la fibromyalgie que je connais.
Personnes ne lient généralement fibromyalgie ou syndrome de fatigue chronique avec les problèmes pulmonaires, mais ils des cultures – surtout dans ME / CFS – parfois. Certaines personnes ressentent « faim d’air » ou difficulté à respirer ou difficulté à prendre des respirations profondes. Certaines études suggèrent que la ventilation – le mouvement de l’air dans et hors des poumons – peut-être être réduite au cours de l’exercice de certains ME / CFS patient. Staci Stevens, un physiologiste de l’exercice, a demandé si les muscles petits et très actifs impliqués dans la respiration pourraient être touchés dans cette maladie.
Problèmes de poumon ne peuvent être le symptôme majeur associé à la FM, mais des problèmes avec les poumons pourrait être dire s’il s’agissait d’une manifestation d’un autre problème associé au système nerveux.
Les auteurs a obtenu rapidement au cœur de la question dans le présent document. Ils ont rapporté que système nerveux sympathique (SNS) dans la fibromyalgie) est hyperactif au repos mais alors plis ou tombe en panne lorsque mis sous tension ; soit vous êtes câblé et fatigué au « repos » (peu de repos !) et puis les choses ont tendance à se détraquer quand votre système est mis sous tension. (Le même modèle est présent dans le syndrome de fatigue chronique (ME / CFS))
Comment ils se connectent les poumons à la fibromyalgie ? Ils ont utilisé le diabète. Diabète n’est pas mentionné beaucoup dans le cadre de la fibromyalgie, mais les auteurs ont signalé un problème similaire de ANS dans le diabète, ce qui conduit à des problèmes de vaisseaux sanguins remplissant les très petits vaisseaux sanguins (microvasculaires) dans les poumons. Dans le diabète, cela conduit à un problème avec la diffusion de monoxyde de carbone dans les poumons.
C’est la même chose qui semble se produire au FM.
L’étude
Ils ont pris 45 patients de FM et 45 témoins et a fait un tas de système nerveux et du volume pulmonaire et gaz transfert tests y compris ce qu’on appelle le facteur de transfert qui mesure la capacité des poumons à diffuser le monoxyde de carbone hors de lui. Ils ont également eu leur prendre un questionnaire autonome 31 question appelé le Score Composite de symptôme autonome ou d’un compas.
Résultats
FM patients ont microcirculation fonctionnelle et des anomalies morphologiques et le modèle anormal d’hyperémie réactive est en raison de la plus grande tonus sympathique menant à une vasoconstriction accrue. Les auteurs
Ils ont noté que les scores patients fibromyalgie questionnaire sur le système nerveux autonome (COMPASS) étaient fortement corrélés avec ceux sur le Fibromyalgia Impact Questionnaire (FIQ). Qui a suggéré que le problème de système nerveux pourrait contribuer à de nombreux symptômes sur la bande FM.
Les poumons de patients FM n’a pas l’air si bons. Volume pulmonaire totale était beau, mais toutes les mesures du poumon fonctionne (facteur de transfert du monoxyde de carbone, la capacité de diffusion du monoxyde de carbone, volume de la membrane capillaire alvéolaire et du volume sanguin capillaire pulmonaire) ont été significativement réduits chez les patients atteints de fibromyalgie.
De nouvelles analyses trouvent que la réduction du poumon diffusant capacité était probablement dû à une réduction significative du volume pulmonaire capillaire pulmonaire ; c’est-à-dire le volume microvasculaire des poumons malades FM avait diminué.
Les deux les plus petits et le plus communs les vaisseaux sanguins trouvés, nos capillaires sont responsables de la prestation de sang à la plupart de nos tissus. Elles sont si petites qu’un globule rouge peut s’adapter à peine à travers eux. Car qu’ils sont des globules rouges, qu’ils sont également permettre de petites molécules telles que l’oxygène, CO2, sucres et acides aminés pour diffuser dans et hors d’eux. Cette partie de la diffusion ne fonctionne apparemment pas très bien.
Les auteurs ont suggéré que les dommages aux nerfs autonomes cardiaques causait des problèmes avec « la régulation du tonus microvasculaire » et la distribution de remplissage pulmonaire. Ils ont proposé que les récepteurs sur les cellules qui causent les patients FM dilater les vaisseaux sanguins ont été tellement être hyperstimulés au fil du temps qu’ils ne sont pas répondre aux signaux à se dilater plus. Que les feuilles des vaisseaux sanguins resserrée, altère les débits sanguins et même (je crois) pourrait réduire le volume sanguin.
Les auteurs ont coché un certain nombre de résultats suggérant que la circulation des problèmes serait que sans surprise en FM réduit la production de monoxyde d’azote empêche les vaisseaux sanguins d’ouvrir suffisamment pour déplacer les vaisseaux sanguins chez les patients FM d’ouvrir suffisamment pour déplacer le sang correctement et causant la rigidité de la paroi artérielle.
Ils ont également noté que les taux élevés de phénomènes de Raynaud, trouvés chez les participants de la FM dans cette étude (1/3). Raynaud se produit lorsque des spasmes dans les artères restreignent sang flux généralement aux mains ou des pieds, provoquant les doigts ou les orteils habituellement à blanchir, puis bleu et alors que le sang retourne, provoque leur tingle ou brûler. Ceci est souvent causée par l’exposition à une température réduite. Chez certaines personnes, être exposé à des températures de 60 degrés peut provoquer de Reynaud.
Le fait que les patients FM avec des phénomènes de Raynaud avaient tendance à avoir des pires résultats de test de poumon était logique compte tenu de l’hyperactivité du système nerveux sympathique similaires trouvée dans le phénomène de Raynaud. Que, hyperactivité locale, ce qui affecte les artères pas les petits vaisseaux sanguins trouvés dans les poumons, est si extrême qu’il provoque les vaisseaux sanguins deviennent vasoconstricted ou à la baisse assez que le sang ne peut traverser.
Phénomène de Raynaud apparaît alors comme une autre manifestation d’une dysrégulation système nerveux sur la bande FM.
Les auteurs n’ont pas passer du temps sur la signification clinique de leurs conclusions et il n’est pas clair dans le livre de ce qu’ils sont. Diffusion de dioxyde de carbone réduit se trouve dans de nombreuses maladies pulmonaires (fibrose, alvéolite, vascularite, bronchopneumopathie chronique obstructive, emphysème, hypertension pulmonaire) ainsi que de l’anémie (faible sanguine). Il n’est pas clair s’ils contribueraient à l’essoufflement ou respiration problèmes parfois trouvés en moi / CFS ou FM ou si elles reflètent un problème qui est présent, mais qui n’est pas provoquant de nombreux symptômes.
Ce n’est pas la première fois que les éventuels problèmes microcirculatoires ont surgi sur la bande FM, cependant. Les auteurs d’une étude de l’exercice 2014 a proposé que les problèmes microcirculatoires pourraient contribuer aux basses conclusions VO2 max qu’ils ont trouvé chez des patients FM. Ils ont fait valoir que la prochaine étude théorique sur la bande FM devrait examiner les flux de sang dans les petits vaisseaux sanguins alimentant les muscles.
- Voir donnant un coup de main : A très différente de la fibromyalgie pour plus d’informations sur une machine qui est censé augmenter la microcirculation en FM
Lésions nerveuses proposée
Ces auteurs ont proposé que les dommages aux nerfs cardiaques autonomes étaient surtout susceptible d’expliquer le fonctionnement du poumon émoussé. Ceci, bien sûr, n’est pas la première fois que les dommages aux nerfs autonomes a été proposé ou trouvé dans FM autonome, nerfs sont parmi les fibres nerveuses petits que beaucoup d’études ont trouvé endommagés dans la peau des patients FM.
L’an dernier qu’un dommage a été étendu aux fibres nerveuses dans les yeux. Sommers retrouvé récemment une telle tendance inhabituelle des lésions nerveuses dans FM qu’elle maintenant l’appelle « pathologie de petites fibres » pour le distinguer de la neuropathie plus typique de petites fibres trouvée dans d’autres troubles. Caro et hivers ont trouvé dommage aux grandes fibres nerveuses en FM ainsi.
Il y a un an, un chercheur a suggéré que les chercheurs profondes regardent nerfs plus ils sont susceptibles de trouver. Sa prédiction semble venir vrai. De la peau jusqu’aux yeux pour éventuellement les poumons des problèmes nerveux sont surgissent dans la fibromyalgie.
Ce pourrait être la cause de ces problèmes nerveux ? Si les conclusions de la peau d’un groupe espagnol résistent puis une infusion d’inflammation, problèmes mitochondriales et le stress oxydatif pourrait remplir le projet de loi.
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