A psiconeuroimunologia no estudo de pacientes fibromiálgicos, categorizados de acordo com o genótipo do 5-httlpr

Abstract

The fibromyalgia (FM) is a very heterogeneous entity. Patients differ in their clinical symptoms, endocrine and immune parameters. In this study we propose to evaluate endocrine and immune feature in groups of fibromyalgics patients subdivided according to the genotype of the polymorphic promoter region of the serotonin transporter, named 5-HTTLPR. The study included eighteen patients selected according to the diagnostic criteria of the American College of Rheumatology and seventeen healthy subjects of similar age. The fibromyalgia patients were allocated to L group when expressed only the long allele and S when the group contains at least one short allele. These eighteen patients and control subjects underwent assessment of the level of salivary cortisol, the percentage of leukocyte subpopulations, including monocytes, neutrophils and B and T lymphocytes and neuropsychological assessment. Patients in L group presented reduced levels of cortisol, increased of the percentage of monocytes "macrophage like" CD16 and higher expression of CD86+CD14+ monocytes. About to analysis of lymphocytes, was observed higher expression of CD80 and CD86 on CD19+ B lymphocytes, increased in the percentage of B lymphocytes CD19+CD86+ and higher expression of CD28 on CD4+ T lymphocytes. Both groups presented increase in the percentage of CD23+ neutrophils as well as higher scores for neuroticism and impulsiveness. It was found also a strong negative correlation between IMF of CD19+CD80+ B lymphocytes and Openness (OT) of the questionnaire NEO-PI-R and a strong positive correlation between neuroticism and CD14+CD86+ monocytes. Thus, we demonstrated that strategy of the subdivision 5HTTLPR genotype may be an important tool for classification of patients, differentiating them in two groups with distinct immunological and endocrine disorders, giving a character more inflammatory to the patients in L group and demonstrated associations between psychological factors and immune system