title: Effects of non-pharmacological interventions on inflammatory biomarker expression in patients with fibromyalgia: a systematic review.
abstract: BACKGROUND
  Fibromyalgia (FM) is a prevalent disorder. However, few studies have evaluated the effect of treatment interventions on biomarker expression. The aim of this review was to explore the efficacy of non-pharmacological interventions on inflammatory biomarker expression, specifically cytokines, neuropeptides and C-reactive protein (CRP), in FM patients.
  
  
  METHODS
  A literature search using PubMed, EMBASE, PsycINFO and the Cochrane library was performed from January 1990 to March 2015. Randomized controlled trials (RCTs) and non-RCTs published in English, French or Spanish were eligible.
  
  
  RESULTS
  Twelve articles with a total of 536 participants were included. After exercise, multidisciplinary, or dietary interventions in FM patients, interleukin (IL) expression appeared reduced, specifically serum IL-8 and IL-6 (spontaneous, lipopolysaccharide (LPS)-induced, or serum). Furthermore, the changes to insulin-like growth factor 1 (IGF-1) levels might indicate a beneficial role for fatigue in obese FM patients. In contrast, evidence of changes in neuropeptide and CRP levels seemed inconsistent.
  
  
  CONCLUSIONS
  Despite minimal evidence, our findings indicate that exercise interventions might act as an anti-inflammatory treatment in FM patients and ameliorate inflammatory status, especially for pro-inflammatory cytokines. Additional RCTs focused on the changes to inflammatory biomarker expression after non-pharmacological interventions in FM patients are needed.
authors.affiliation: Aragon Health Sciences Institute (IACS), Zaragoza, Spain.|Department of Psychiatry, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sanada
authors.affiliation: The Primary Care Prevention and Health Promotion Research Network (REDIAPP), Barcelona, Spain.|Department of Psychiatry, Miguel Servet University Hospital, University of Zaragoza, Avda Isabel La Católica I., 50009, Zaragoza, Spain.
authors.forename: Marta Alda
authors.initials: MA
authors.lastname: Díez
authors.affiliation: Aragon Health Sciences Institute (IACS), Zaragoza, Spain.
authors.forename: Montserrat Salas
authors.initials: MS
authors.lastname: Valero
authors.affiliation: Aragon Health Sciences Institute (IACS), Zaragoza, Spain.|The Primary Care Prevention and Health Promotion Research Network (REDIAPP), Barcelona, Spain.
authors.forename: María Cruz
authors.initials: MC
authors.lastname: Pérez-Yus
authors.affiliation: Department of Preventive Medicine, Federal University of Sao Paulo (UNIFESP), "Mente Aberta" - Brazilian Centre for Mindfulness and Health Promotion, Sao Paulo, Brazil.
authors.forename: Marcelo M P
authors.initials: MM
authors.lastname: Demarzo
authors.affiliation: The Primary Care Prevention and Health Promotion Research Network (REDIAPP), Barcelona, Spain.|Research Institute of Health Sciences (IUNICS), University of Balearic Islands, Palma, Spain.
authors.forename: Mauro
authors.initials: M
authors.lastname: García-Toro
authors.affiliation: The Primary Care Prevention and Health Promotion Research Network (REDIAPP), Barcelona, Spain. jgarcamp@gmail.com.|Department of Psychiatry, Miguel Servet University Hospital, University of Zaragoza, Avda Isabel La Católica I., 50009, Zaragoza, Spain. jgarcamp@gmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: García-Campayo
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000097:blood; D004035:Diet Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005356:Fibromyalgia / Q000097:blood* / Q000628:therapy*; D006801:Humans; D009479:Neuropeptides / Q000097:blood; D017063:Outcome Assessment, Health Care / Q000379:methods; D015203:Reproducibility of Results
chemical_list: D015415:Biomarkers; D016207:Cytokines; D009479:Neuropeptides; D002097:C-Reactive Protein