Scansioni PET mostrano fibromialgia I pazienti hanno infiammazione nel cervello

I pazienti con fibromialgia spesso sentono le parole “Sei così bello. Come puoi essere ammalato? “O forse le parole insensibili” fibromialgia è tutto nella tua testa “. Ricerca continua e recente; tuttavia, convalida la realtà di questa malattia invisibile. Questa informazione consente alle persone con fibromialgia e altre malattie invisibili simili di premere su ogni dubbio e trovare la convalida per le loro complesse malattie. Ancora più importante, comprendere la recente ricerca aiuta a fornire indicazioni e identifica le scelte naturali per una sana gestione del dolore con fibromialgia.

Cos’è l’infiammazione?

L’infiammazione fa parte del processo di guarigione del corpo. Senza infiammazione, infezioni e ferite non guarirebbero. Ma l’infiammazione può anche essere potenzialmente dannosa. Esistono due tipi di infiammazione, acuta e cronica. L’infiammazione acuta arriva improvvisamente da una ferita o infezione. Presenta sintomi classici come gonfiore, arrossamento e dolore.

L’infiammazione acuta è momentanea, che dura da pochi giorni a un paio di settimane, a seconda dell’origine dell’infiammazione. L’infiammazione cronica è un’infiammazione a lungo termine che dura per mesi e anni. Succede lentamente e prepara le basi per le malattie croniche. Le malattie cardiache, le malattie autoimmuni, le malattie neurologiche, il diabete, il cancro, l’Alzheimer, l’artrite e molte altre condizioni sono legate all’infiammazione cronica.

I gruppi di ricerca trovano un’infiammazione diffusa nel cervello dei pazienti con fibromialgia

Gli studi di imaging PET rivelano un’elevata attivazione gliale, correlazione con i livelli di affaticamento. Uno studio ha documentato per la prima volta un’infiammazione diffusa nel cervello di pazienti con la condizione mal compresa chiamata fibromialgia.

Uno studio condotto dai ricercatori del Massachusetts General Hospital (MGH) – che ha collaborato con un gruppo del Karolinska Institutet in Svezia – ha documentato per la prima volta un’infiammazione diffusa nel cervello di pazienti con una condizione mal compresa chiamata fibromialgia. Il loro rapporto è stato pubblicato online sulla rivista  Brain, Behavior and Immunity .

“Non abbiamo buone opzioni terapeutiche per la fibromialgia, quindi identificare un potenziale target terapeutico potrebbe portare allo sviluppo di terapie innovative e più efficaci”, afferma Marco Loggia, PhD, del Centro Martinos per l’imaging biomedico basato su MGH, autore senior del rapporto. “E trovare cambiamenti neurochimici oggettivi nel cervello dei pazienti con fibromialgia dovrebbe aiutare a ridurre il persistente stigma che molti pazienti affrontano, spesso viene loro detto che i loro sintomi sono immaginari e non c’è niente di veramente sbagliato in loro”.

L’attuale studio fornisce evidenze di legame TSPO elevato, misurato con PET CPBR28, in pazienti con fibromialgia (FM) rispetto ai controlli sani (HC). Questo marker di attivazione gliale è stato aumentato in diverse regioni del cervello implicate nella patologia FM da precedenti studi di neuroimaging. Segnaliamo anche associazioni positive tra il segnale PET TSPO in diverse di queste regioni e le valutazioni soggettive della fatica, uno dei sintomi più comuni riportati dai pazienti FM (Clauw, 2014, Wolfe et al., 2011). Le nostre osservazioni supportano un ruolo per l’attivazione neuroimmune / gliale nella patologia FM.

Questi risultati si conformano a un corpo di dati clinici che suggeriscono una possibile associazione tra neuroinfiammazione e FM. Diversi studi su pazienti con FM hanno dimostrato livelli elevati di CSF di molecole implicate nella segnalazione neurogena, come la fractalkine e IL-8. 

Fibromialgia e Neuroinfiammazione

L’infiammazione è diventata un argomento sempre più importante nella fibromialgia. È chiaro che la “sensibilizzazione centrale” – un aumento della sensibilità al dolore ingegnerizzato dal sistema nervoso centrale è presente nella fibromialgia (e in altri disturbi del dolore cronico). I fattori nervosi pro-infiammatori sono prodotti da un processo infiammatorio, quei fattori nervosi mandano i nervi che producono il dolore in una vertigine e potrebbero essere la causa di quella sensibilizzazione centrale.

La neuroinfiammazione è quindi una possibilità importante in FM, ma misurarla non è stata facile. Solo di recente sono state sviluppate tecniche di imaging cerebrale che potrebbero essere in grado di misurare la neuroinfiammazione presente in FM. Questo studio ha cercato di affrontare la questione della neuroinfiammazione in un modo diverso. Negli ultimi tempi c’è stato un maggiore interesse nelle varie cellule del cervello che svolgono un ruolo nell’infiammazione e nell’ipersensibilità.

Una di queste cellule note per svolgere un ruolo centrale nelle risposte infiammatorie nel cervello è la microglia. Il cervello ha una popolazione abbastanza densa di loro. Ma prima di approfondire il ruolo della microglia nell’infiammazione cerebrale e nell’iper-reazione, cerchiamo di capire di più sull’infiammazione e la relazione tra cervello e malattie infiammatorie periferiche. Dopotutto, la FM è comunemente iniziata da una condizione di salute che colpisce gli organi periferici.

Meccanismo di infiammazione

L’infiammazione è un meccanismo difensivo. Una volta che il corpo affronta qualsiasi agente infettivo o trauma locale, viene riconosciuto e praticamente mangiato (agente infettivo, detriti, altro materiale estraneo) dalle cellule chiamate macrofagi. Anche i macrofagi svolgono un ruolo centrale nell’iniziare una risposta immunitaria, e lo fanno secernendo citochine e chemochine.

Le chemochine sono i messaggeri che attraggono altri tipi di cellule difensive nell’area, mentre le citochine sono messaggeri più complessi che inviano informazioni sullo stress e sull’attacco a varie cellule e parti del corpo. Subito dopo la reazione infiammatoria iniziale, ne consegue la malattia, con conseguente aumento della temperatura corporea, dolore e perdita di interesse in tutto ciò che sta intorno.

È un momento in cui i nostri centri cerebrali entrano in azione. Sono i centri specifici del cervello ad elevare la temperatura corporea in modo da controllare la crescita microbica (l’aumento della temperatura corporea è un meccanismo difensivo regolato). Il nostro cervello cerca di risparmiare energia obbligandoci a riposare, a ridurre l’interazione sociale, le attività fisiche.

Sappiamo che indipendentemente dalla posizione della risposta infiammatoria, il cervello svolge un ruolo centrale nel controllare le varie risposte. Solleva la domanda sul meccanismo alla base dello scambio di informazioni tra il punto di infiammazione (che può essere spesso molto lontano dal cervello) e il cervello. Ciò avviene in due modi, in primo luogo, attraverso i messaggeri chiamati citochine, e in secondo luogo, attraverso gli input dai nervi

Trattamento per ridurre la neuroinfiammazione

Abbiamo già alcune prove che i trattamenti che abbassano i livelli di infiammazione nel cervello in particolare possono ridurre i sintomi della fibromialgia. Molti di quelli che pensiamo come farmaci antinfiammatori (come l’ibuprofene o altri antinfiammatori non steroidei) non funzionano bene sull’infiammazione cerebrale, ma ci sono alcuni trattamenti che fanno. Il naltrexone a basse dosi (LDN) è il più efficiente, che è un farmaco ma principalmente prescritto da fornitori di farmaci alternativi, poiché la maggior parte dei medici di medicina occidentale non è ben nota al suo uso per il dolore.

Un farmaco anti-oppiacei è noto come Naltrexone che viene prescritto in dosi più elevate (50 mg) per trattare la dipendenza da oppiacei e alcol. La LDN riduce l’infiammazione nel sistema nervoso centrale se consumata a dosi molto basse (portata di 1-5 mg).

Ci sono recettori specifici sulle cellule immunitarie nel cervello chiamate cellule gliali, LDN agisce su di loro e dice loro di tornare in letargo e smettere di rilasciare sostanze chimiche infiammatorie. In due studi condotti presso la Stanford University è stato dimostrato che LDN riduce sensibilmente il dolore fibromialgico e riduce anche l’ipersensibilità del dolore.

Trattamento a base di erbe per trattare l’infiammazione

Curcuma:  Per centinaia di anni questa spezia gialla è stata usata come antinfiammatorio nella medicina ayurvedica. Il costituente attivo è una sostanza chimica chiamata curcumina, che la ricerca ha dimostrato di avere effetti anti-infiammatori nel cervello.

Tè verde:  una sostanza chimica chiamata EGCG (-) – epigallocatechina-3-gallato ha dimostrato di essere “fortemente difensiva contro l’infiammazione, il danno ossidativo e la morte cellulare” nel cervello. È estratto dal tè verde.

Verdure crocifere: il  sulforafano è un estratto di broccoli e protegge contro l’infiammazione cerebrale e riduce le lesioni ai neuroni.

I supplementi anti-infiammatori includono:

  • >>> acidi grassi omega-3
  • >>> curcuma >>> zenzero
  • >>> coQ10
  • >>> rhodiola rosea

Molti medici raccomandano una dieta anti-infiammatoria per condizioni infiammatorie, ma non abbiamo abbastanza ricerche su di esso. Le persone spesso iniziano con una dieta strettamente limitata, perché i trigger scatenanti di tutti non sono gli stessi, quindi si aggiungono di nuovo in un tipo di cibo alla volta, per verificare quali alimenti sono problematici.

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