title: Smoking is associated with reduced leptin and neuropeptide Y levels and higher pain experience in patients with fibromyalgia.
abstract: Smoking deregulates neuroendocrine responses to pain supporting production of neuropeptide Y (NpY) by direct stimulation of nicotinic receptors or by inhibiting adipokine leptin. Present study addressed the effect of cigarette smoking on adipokines and pain parameters, in 62 women with fibromyalgia (FM) pain syndrome with unknown etiology. Pain was characterized by a visual analogue scale, tender point (TP) counts, pressure pain threshold, and neuroendocrine markers NpY and substance P (sP). Levels of IGF-1, leptin, resistin, visfatin, and adiponectin were measured in blood and cerebrospinal fluid. Current smokers (n = 18) had lower levels of leptin compared to ex-smokers (n = 25, P = 0.002), while the expected NpY increase was absent in FM patients. In smokers, this was transcribed in higher VAS-pain (P = 0.04) and TP count (P = 0.03), lower pain threshold (P = 0.01), since NpY levels were directly related to the pain threshold (rho = 0.414) and inversely related to TP counts (rho = -0.375). This study shows that patients with FM have no increase of NpY levels in response to smoking despite the low levels of leptin. Deregulation of the balance between leptin and neuropeptide Y may be one of the essential mechanisms of chronic pain in FM.
authors.affiliation: Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Göteborg, P.O. Box 480, 405 30 Göteborg, Sweden.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Bokarewa
authors.affiliation: Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Göteborg, P.O. Box 480, 405 30 Göteborg, Sweden.
authors.forename: Malin C
authors.initials: MC
authors.lastname: Erlandsson
authors.affiliation: Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Göteborg, P.O. Box 480, 405 30 Göteborg, Sweden.
authors.forename: Jan
authors.identifier: 0000-0002-3538-1240
authors.initials: J
authors.lastname: Bjersing
authors.affiliation: Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Göteborg, P.O. Box 480, 405 30 Göteborg, Sweden.
authors.forename: Mats
authors.identifier: 0000-0001-5165-0968
authors.initials: M
authors.lastname: Dehlin
authors.affiliation: Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Göteborg, P.O. Box 480, 405 30 Göteborg, Sweden.
authors.forename: Kaisa
authors.initials: K
authors.lastname: Mannerkorpi
mesh_terms: D000328:Adult; D005260:Female; D005356:Fibromyalgia / Q000097:blood* / Q000503:physiopathology*; D006801:Humans; D020738:Leptin / Q000097:blood*; D008875:Middle Aged; D009478:Neuropeptide Y / Q000097:blood*; D010146:Pain / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology*; D012907:Smoking / Q000009:adverse effects*
chemical_list: D020738:Leptin; D009478:Neuropeptide Y