Session Information
Date: Tuesday, November 7, 2017
Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes Poster II
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose:
Whole-body cryotherapy (WBCT) has been demonstrated in several studies as being effective in the reduction of inflammatory symptoms and in providing pain relief. It is recommended for the treatment of arthritis, fibromyalgia (FMS) and ankylosing spondylitis. The mode of action of this therapy, which consists of a brief exposure to temperatures between -110 and -160°C in special cryochambers, has not been fully elucidated.
The aim of this study was to investigate the changes in the gene expression of selected genes (CCL4, TGFBR3, CD69, MAP2K3, and IL-8) going through a series of three exposures to WBCT within three days and to analyse the association with patient reported outcomes.
Methods:
Twenty six patients with fibromyalgia (24 female/2 male, age 51.8±8.9 years (mean±SD) were included in the study and underwent 3 exposures to WBCT in a cryochamber system (Zimmer MedizinSysteme GmbH, Germany) with 3 chambers (10 seconds at -10°C, 10 seconds at -60°C and for a maximum of 3 minutes at -110°C) on 3 consecutive days. During the study patients did not change their medication. Patients were asked to complete a questionnaire of 11 questions (including pain, restlessness, physical function, and headache). Blood was collected immediately prior to (baseline) and directly after the first exposure to WBCT and after the third exposure using PAXgene RNA tubes. Total RNA was extracted with the PAXgene Blood RNA kit. Gene expression levels of MAP2K3, CCL4, TGFBR3, CD69, and IL-8 were analysed by real-time PCR.
Results:
All 26 patients tolerated the application of the WBCT well. The VAS pain reduced significantly from 6.0±0.3 at baseline to 4.1±0.3 after the third cold exposure (p<0.001). In 15 patients an improvement by at least 20% of the patient reported outcomes was found.
The gene expression levels of CCL4, CD69 and TGFbR3 decreased significantly (p<0.001, p<0.01, and p<0.05, resp.) In contrast, the expression of MAP2K3 was found to be significantly up-regulated (p<0.05). No significant change was observed regarding the IL-8 expression.
Changes of the expression levels were not found to be associated with improvements of VAS pain, headache, restlessness, or physical function.
Conclusion:
The results of our study indicate that the whole-body cryotherapy may cause subtle but significant changes in gene expression levels of CCL4, CD69, MAP2K3, and TGFbR3 in immune cells of peripheral blood. The MAP2K3 expression is known to be regulated by environmental stress, which is in accordance with the observed up-regulation of MAP2K3 expression. The down-regulation of the CD69, a marker for T-cell activation and the chemokine CCL4 that is produced by T-cells, indicate that the exposure to WBCT has an effect on peripheral T-cells. This effect seems to be independent from the patients’ response.
Further studies are necessary to elucidate the molecular mechanisms associated with the therapeutic effect of the WBCT.
To cite this abstract in AMA style:
Drynda S, Mika O, Kekow J. Impact of Whole-Body Cryotherapy on Gene Expression of Peripheral Blood Cells in Patients with Fibromyalgia and Association with Patient-Reported Outcomes [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/impact-of-whole-body-cryotherapy-on-gene-expression-of-peripheral-blood-cells-in-patients-with-fibromyalgia-and-association-with-patient-reported-outcomes/. Accessed .ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-whole-body-cryotherapy-on-gene-expression-of-peripheral-blood-cells-in-patients-with-fibromyalgia-and-association-with-patient-reported-outcomes/