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Concentration of cytokines in patients with osteoarthritis of the knee and fibromyalgia

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      Fibromyalgia and osteoarthritis may present a relationship with the concentration of cytokines. The aim of this study was to compare the serum concentrations of IL-12p70, tumor necrosis factor, IL-10, IL-6, IL-1β, and IL-8 in patients with knee osteoarthritis and fibromyalgia.

      Materials and methods

      The study included 53 women (71.2±7.6 years old) diagnosed with knee osteoarthritis with moderate-to-severe pain (visual analog scale >4) for at least 3 months. Sixty women (54.1±8.1 years old) diagnosed with fibromyalgia according to the American College of Rheumatology criteria and with moderate-to-severe pain (visual analog scale >4) also participated in this study. For the dosage of cytokines, blood was collected in the morning: 5 mL from the cubital vein. The material was centrifuged at 4°C, separated into 100 μL aliquots and stored at −80°C until processing. Serum concentrations of the studied cytokines were assessed using the BD Cytometric Bead Array method. Data were analyzed with Student’s t-test and the Mann–Whitney U test.


      We found higher levels of IL-6, IL-10, and IL-1β in fibromyalgia patients. After adjustment of age as a covariate, there was no statistically significant difference in the concentration of any cytokine between fibromyalgia and knee osteoarthritis patients.


      Patients with knee osteoarthritis and fibromyalgia with the same duration and intensity of pain demonstrate similar concentrations of cytokines. Aging may play a role in cytokine profile, a finding not so extensively addressed in the literature and one that should be further investigated.

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      Most cited references 42

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      The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee.

      To develop criteria for the classification of fibromyalgia, we studied 558 consecutive patients: 293 patients with fibromyalgia and 265 control patients. Interviews and examinations were performed by trained, blinded assessors. Control patients for the group with primary fibromyalgia were matched for age and sex, and limited to patients with disorders that could be confused with primary fibromyalgia. Control patients for the group with secondary-concomitant fibromyalgia were matched for age, sex, and concomitant rheumatic disorders. Widespread pain (axial plus upper and lower segment plus left- and right-sided pain) was found in 97.6% of all patients with fibromyalgia and in 69.1% of all control patients. The combination of widespread pain and mild or greater tenderness in greater than or equal to 11 of 18 tender point sites yielded a sensitivity of 88.4% and a specificity of 81.1%. Primary fibromyalgia patients and secondary-concomitant fibromyalgia patients did not differ statistically in any major study variable, and the criteria performed equally well in patients with and those without concomitant rheumatic conditions. The newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites. No exclusions are made for the presence of concomitant radiographic or laboratory abnormalities. At the diagnostic or classification level, the distinction between primary fibromyalgia and secondary-concomitant fibromyalgia (as defined in the text) is abandoned.
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        Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association.

        For the purposes of classification, it should be specified whether osteoarthritis (OA) of the knee is of unknown origin (idiopathic, primary) or is related to a known medical condition or event (secondary). Clinical criteria for the classification of idiopathic OA of the knee were developed through a multicenter study group. Comparison diagnoses included rheumatoid arthritis and other painful conditions of the knee, exclusive of referred or para-articular pain. Variables from the medical history, physical examination, laboratory tests, and radiographs were used to develop sets of criteria that serve different investigative purposes. In contrast to prior criteria, these proposed criteria utilize classification trees, or algorithms.
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          Osteoarthritis, an inflammatory disease: potential implication for the selection of new therapeutic targets.


            Author and article information

            [1 ]Clinical Research Center, Institute of Physical Medicine and Rehabilitation, University of São Paulo Medical School, São Paulo, Brazil
            [2 ]Division of Physical Medicine, Center for Acupuncture, Institute of Orthopedics and Traumatology, University of São Paulo, São Paulo, Brazil
            [3 ]Department of Pathology, University of São Paulo, São Paulo, Brazil
            [4 ]Laboratory of Medical Investigation LIM-52-HCFMUSP, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
            [5 ]Tropical Laboratory of Hematology/Medical Research Laboratory-LIM 52, Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil
            [6 ]Program of Master in Health Promotion, São Paulo Adventist University Center, São Paulo, Brazil
            [7 ]Department of Legal Medicine, Medical Ethics, Social and Labor Medicine – Medicine School, University of São Paulo, São Paulo, Brazil
            Author notes
            Correspondence: Fábio Marcon Alfieri, Clinical Research Center, Institute of Physical Medicine and Rehabilitation, University of São Paulo Medical School, Rua Jandiatuba 580, 05716-150 São Paulo, Brazil, Tel +55 11 3905 8616, Email fabioalfieri@
            Clin Interv Aging
            Clin Interv Aging
            Clinical Interventions in Aging
            Dove Medical Press
            12 June 2014
            : 9
            : 939-944
            24959074 4061171 10.2147/CIA.S60330 cia-9-939
            © 2014 Imamura et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

            The full terms of the License are available at Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

            Original Research

            Health & Social care

            aging, cytokines, osteoarthritis, fibromyalgia


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