Serial whole-body cryotherapy in fibromyalgia is effective and alters cytokine profiles

Philipp Klemm,Elena Neumann,Iris Aykara,Uwe Lange,Ulf Müller-Ladner,Johanna Becker,Gabriel Dischereit,Thomas Asendorf

doi:10.1186/s42358-020-00159-z

Philipp Klemm, Elena Neumann + Show 6 more

Open Access

https://doi.org/10.1186/s42358-020-00159-z

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Abstract

IntroductionWhole-body cryotherapy (WBC) has shown to be beneficial in the treatment of fibromyalgia (FM). There is cumulative evidence that cytokines play a crucial role in FM. It’s unknown whether clinical effects of WBC can be demonstrated at the molecular level and how long the effects last.MethodsWe compared effects of serial WBC (6 sessions (− 130 °C in 6 weeks) in FM patients and healthy controls (HC). Primary outcome was the change in pain level (visual analogue scale 0–100 mm) after 6 sessions. Secondary outcomes were a change in disease activity (revised Fibromyalgia Impact Questionnaire) and pain after 3 sessions and 3 months after discontinued therapy and in cytokine levels (interleukin (IL-)1, IL-6, tumor necrosis factor α (TNF-α) and IL-10). The patients’ opinions on the satisfaction, effectiveness and significance of WBC were evaluated.ResultsTwenty-three FM patients and 30 HC were enrolled. WBC resulted in a significant reduction in pain and disease activity after 3 and 6 sessions. No clinical benefit could be measured 3 months after discontinued treatment. Overall, probands were satisfied with WBC and considered WBC to be important and effective. FM patients had significantly different levels of IL-1, IL-6, TNF-α and IL-10 at each reading point compared to HC. Levels of IL-1, IL-6 and IL-10 were significantly altered over time in FM patients. Compared to HC FM patients showed a significantly different response of IL1, − 6 and − 10 to WBC.ConclusionSerial WBC is a fast acting and effective treatment for FM. Proven effects of WBC may be explained by changes in cytokines.

Highlights

Whole-body cryotherapy (WBC) has shown to be beneficial in the treatment of fibromyalgia (FM)
Secondary outcomes showed that disease activity is significantly reduced by WBC and that the effects on pain are significantly manifested after only 3 WBC sessions
FM patients had significantly different levels of IL-1, IL-6, tumor necrosis factor α (TNF-α) and IL-10 at each reading point compared to healthy controls (HC)

Summary

Introduction

Whole-body cryotherapy (WBC) has shown to be beneficial in the treatment of fibromyalgia (FM). Several factors seem to be of importance These include abnormal pain sensitivity and pain inhibition [7, 8], a disturbed hypothalamic-pituitary-adrenal axis [9, 10] and cytokine dysregulation [11]. Both genetic and environmental factors seem to play a role [7, 8]. There is increasing evidence of neurogen- derived inflammatory mechanisms [12] These affect (2021) 61:3 peripheral tissues as well as the spinal cord and brain and involve a variety of neuropeptides, chemokines, and cytokines. In neuropathic pain models, pharmacological blocking of the pro-inflammatory cytokines interleukin (IL-), IL-6 and tumor necrosis factor α (TNF-α) has been found to prevent or reverse allodynia and hyperalgesia [15]

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