Efeito de esteróides gonadais na fibromialgia experimental (ensaio pré clinico) e terapia hormonal para mulheres com fibromialgia (revisão sistemática)

• Ano de defesa: 2022
• Autor(a) principal: Guilherme, Camilla Aguiar Dalan
• Orientador(a): Santana, Josimari Melo de
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Programa de Pós-Graduação: Pós-Graduação em Ciências da Saúde
• Palavras-chave em Português: Ciências da saúde; Fibromialgia; Modelo animal; Hiperalgesia; Mulheres
• Palavras-chave em Inglês: Fibromyalgia; Animal model; Hyperalgesia; Women
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: http://ri.ufs.br/jspui/handle/riufs/16807

Introduction: Fibromyalgia (FM) is pathology that causes widespread pain and other associated symptoms, damaging the quality of life of the patient, as in more cases are adult women with hormonal changes due to menopause (35 to 60 years old). In this scene, we Search to understand the hormonal relationship with FM symptoms. Objectives: 1-Evaluate the behavioral changes derived from hormonal administration (prophylactic) in Wistar females rats submitted to the fibromyalgia model; 2- Evaluate the effects of hormonal treatment on quality of life for women with fibromyalgia. Method: 1- Experimental study with Wistar females rats (n = 42) submitted to experimental model of diffuse chronic muscle hyperalgesia (DCMH), together with bilateral surgical removal of ovaries and controlled hormonal replacement. The animals were divided into seven groups: i) CTRL- - received neutral saline + no hormonal changes (n = 6); ii) CTRL+ - received acidic saline solution + no hormonal changes (n = 6); iii) OVX - ovariectomized animals + acid saline solution (n = 6); all groups forward, the animals were ovariectomized and with induction of the DCMH model, changing only the prophylaxis protocol. iv) Vehicle - received the vehicles used in the hormonal dilution (n = 6); v) P4 - replacement of progesterone (n = 6); vi) E2 - estrogen replacement (n = 6); vii) P4 + E2 - received progesterone and estrogen (n = 6). Thermal latency (hot plate), cutaneous sensory threshold (electronic von Frey) and distance covered (activity monitor) at the beginning and at the end of experiment were evaluated. 2- Systematic search of studies in seven databases (PubMed, Medline, Embase, Cochrane, SPORTDiscus, Psycinfo and Pedro) performed by two independent researchers using the descriptors “Fibromyalgia”, “Hormone replacement therapy”, “Hormone”, “Drug therapy” and “Treatment outcome”. Updated July 2022. In investigation of indicators of improvement in the patients' quality of life. To assess the risk of bias in these studies, the Revman® software was used. Results: 1) There was a decrease in the cutaneous sensory threshold in the groups that received acid saline independent of the administered prophylaxis. In the groups with hormonal alteration, they presented a decrease in the distance walked and an increase in the thermal threshold when compared to baseline. 2- At the end of the systematic searches and exclusion by duplicates, analysis by titles and selection according to the inclusion criteria, four articles were included in the systematic review. Differences in the type of hormones administered (growth hormone - GH, melatonin and estradiol), via administration (oral, transdermal or subcutaneous) and duration of the follow-up period (from 6 weeks to 12 months). Conclusion: In the experimental study, indicated that the hormone replacement proposed together with the DCMH model influences locomotor activity behavior and thermal sensory threshold, not being enough to increase the cutaneous sensory threshold. While in the systematic review, hormone replacement with melatonin and GH may indicate low risk of bias and results in improving quality of life, such as decreasing pain. Therefore, further experimental studies are recommended to better clarify the effects of hormone replacement and its long-term repercussions.