title: Elevated expression of prostaglandin E2 synthetic pathway in skeletal muscle of prior polio patients.
abstract: OBJECTIVE
  The aim of this study was to investigate signs of inflammation in muscle of patients with prior polio, since the main symptoms in these patients are muscle pain, weakness and fatigue. In the context of pain and inflammation, the prostaglandin E2 pathway is of interest. Prostaglandin E2 has many biological actions and is a mediator of inflammation and pain.
  
  
  METHODS
  Skeletal muscle biopsies from 8 patients with prior polio and post-polio symptoms, presenting with pain and muscular weakness, and from 6 healthy controls were studied. Immunohistochemistry, conventional microscopy, and computerized image analysis were performed.
  
  
  RESULTS
  There was statistically significant higher expression of enzymes of the prostaglandin E2 synthetic pathway, in muscle from patients, compared with controls. Expression of prostaglandin enzymes was mainly in scattered cells and blood vessels, and may indicate an inflammatory process of the muscle, which could be secondary to systemic inflammation.
  
  
  CONCLUSIONS
  This data may indicate an inflammatory process in muscle of prior polio patients. Up-regulation of the prostaglandin E2 pathway reveals a potential background to the pain experienced by these patients, and may provide opportunities for directed pharmacological and physical therapies, which could lead to better outcomes of rehabilitation interventions.
authors.affiliation: Department of Clinical Sciences, Karolinska Institutet Danderyds Hospital, 18288 Stockholm, Sweden. eva.melin@ki.se.
authors.forename: Eva
authors.initials: E
authors.lastname: Melin
authors.forename: Eva
authors.initials: E
authors.lastname: Lindroos
authors.forename: Ingrid E
authors.initials: IE
authors.lastname: Lundberg
authors.forename: Kristian
authors.initials: K
authors.lastname: Borg
authors.forename: Marina
authors.initials: M
authors.lastname: Korotkova
mesh_terms: D000328:Adult; D015232:Dinoprostone / Q000096:biosynthesis / Q000378:metabolism*; D005221:Fatigue / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000378:metabolism; D018482:Muscle, Skeletal / Q000378:metabolism*; D063806:Myalgia / Q000378:metabolism; D011051:Poliomyelitis / Q000378:metabolism*; D016262:Postpoliomyelitis Syndrome / Q000378:metabolism; D055815:Young Adult
chemical_list: D015232:Dinoprostone