Abstract
Fibromyalgia (FM) is a highly prevalent syndrome that impairs the quality of life of the patients; however, its diagnosis is complex and mainly centered on pain symptoms. The study of salivary biomarkers has proven highly useful for the diagnosis and prognosis of numerous diseases. The objective of this review was to gather published data on the utilization of salivary biomarkers to facilitate and complement the diagnosis of FM. Salivary biomarkers used in FM diagnosis include cortisol; calgranulin; and the enzymes α-amylase, transaldolase, and phosphoglycerate mutase. Increased serum levels of C-reactive protein, cytokines interleukin 1-β, interleukin 6, interleukin 8, interleukin 10, interleukin 17, tumor necrosis factor α, and various chemokines may serve as salivary biomarkers, given observations of their increased serum levels in patients with FM. Further research is warranted to study in depth the role and performance of biomarkers currently used in FM diagnosis/prognosis and to identify novel salivary biomarkers for this disease.
Highlights
Fibromyalgia (FM) is a multifactorial disease that involves the immune-neuroendocrine axis and is typically associated with generalized musculoskeletal pain, pain on digital palpation at “tender points”, lethargy, sleep disorders, anxiety, and/or depression
Low cortisol levels are associated with the duration of the disease, and may be the cause of chronic adaptation to stress in fibromyalgia patients [37,39,40]
These changes may have been related to pain and stress in patients with fibromyalgia [33,45,46]
Summary
Fibromyalgia (FM) is a multifactorial disease that involves the immune-neuroendocrine axis and is typically associated with generalized musculoskeletal pain, pain on digital palpation at “tender points”, lethargy, sleep disorders, anxiety, and/or depression. FM is not life-threatening and does not have physical sequelae; it can severely impair quality of life. It is currently considered a syndrome of unknown etiology, various causative factors have been proposed, including infection, physical trauma, emotional shock, stress, and even genetics [1,2]. The diagnosis of FM is complex because it has no specific biochemical, imaging, or pathological features. It is usually based on the results of anamnesis and physical examination and obtained by ruling out other diseases. Saliva is an especially useful source of clinical data because it can be readily and non-invasively collected [6,7,8]
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