To the Editor:
I write to expand on the very interesting findings by Coury, et al1 regarding the ameliorating effects of coexisting fibromyalgia (FM) on inflammatory damage from rheumatoid arthritis (RA). I offer a possible explanation for their results.
We recently described cytokine and chemokine aberrations in 92 FM patients and 69 family members compared to 77 controls2. Although no inflammation existed in tissues affected by FM, we found elevated plasma concentrations of several proinflammatory proteins including tumor necrosis factor-α, interleukin 1ß (IL-1ß), and interferon-γ, among others. However, antiinflammatory potential was also manifested in the forms of elevated IL-13, IL-10, IL-4, and IL-1ra. This raises the possibility that FM evokes no inflammatory response because of this cytokine admixture. If so, this would obviously prove somewhat salutary for patients with RA.