Effect of Balneotherapy on Serum Prolidase Enzyme Activity in Patients with Fibromyalgia: A Prospective Cross-Sectional Study

Abstract

Objectives: The aim of this study was to compare the serum prolidase enzyme levels between patients with fibromyalgia syndrome (FMS) and healthy control subjects, and to investigate the possible effect of balneotherapy (BT) on prolidase enzyme levels in FMS patients. Materials and Methods: Included in the study were 45 patients who had been diagnosed with FMS according to American College of Rheumatology (ACR) criteria (2010), and 40 healthy volunteers. The socio-demographic data of the partipances in each group was recorded, and the Visual Analog Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ) was applied to patients with FMS. The FMS group took part in 20-minute BT sessions once a day for 21 days. To measure prolidase enzyme activity, venous blood samples were taken twice from the FMS group – before and after BT – and once from the control group. Results: The FMS group and the control group were similar in terms of age and body mass index (BMI). A comparison of the serum prolidase values of the two groups revealed a statistically significant difference (p <0.05). The serum prolidase values of the FMS group before and after BT were compared, and the difference was found to be statistically significant (p <0.05). Conclusion: The serum prolidase enzyme activity was found to be higher in patients with FM than in healthy subjects. However, serum prolidase enzyme activity decreased in patients with FMS after BT. These results can be of guidance for further clinical studies of the etiopathogenesis and treatment of FMS.

Keywords

• Prolidase
• balneotherapy
• fibromyalgia

Balneoterapinin Fibromiyaljili Hastalarda Serum Prolidaz Enzim Aktivitesine Etkisi: Prospektif Kesitsel Çalışma

Abstract

Amaç: Bu çalışmanın amacı fibromiyalji sendromlu (FMS) hastalar ile sağlıklı kontrol arasında serum prolidaz enzim düzeyini karşılaştırmak ve balneoterapinin (BT) FMS hastalarında prolidaz enzim düzeyi üzerine olası etkisini araştırmaktır. Gereç ve Yöntem: Çalışmaya American College of Rheumatology (ACR) kriterlerine (2010) göre FMS tanısı almış 45 hasta ve 40 sağlıklı gönüllü dahil edildi. Her iki gruptaki katılımcıların sosyo-demografik verileri kaydedildi ve FMS'li hastalara Görsel Analog Skala (VAS) ve Fibromiyalji Etki Anketi (FIQ) uygulandı. FMS’li hasta grubu 21 gün boyunca günde bir kez olmak üzere 20 dakikalık BT seanslarına katıldı. Prolidaz enzim aktivitesini ölçmek için venöz kan örnekleri kontrol grubundan 1 kez, FMS grubundan BT'den önce ve sonra olmak üzere iki kez alındı. Bulgular: FMS grubu ve kontrol grubu yaş ve vücut kitle indeksi (VKİ) açısından benzerdi. Gruplar serum prolidaz düzeyleri açısında karşılaştırıldığında gruplar arasında istatistiksel olarak anlamlı bir fark vardı (p <0.05). FMS grubunun serum prolidaz değerleri BT öncesi ve sonrası karşılaştırıldığında aralarındaki fark istatistiksel olarak anlamlı bulundu (p <0.05). Sonuç: Serum prolidaz enzim aktivitesi FMS hastalarında sağlıklı kontrollere göre daha yüksek bulundu. Bununla birlikte FMS’li hastalarda BT sonrası serum prolidaz enzim aktivitesi azaldı. Bu sonuçlar, FMS etiyopatogenezi ve tedavisi ile ilgili yapılacak olan klinik çalışmalar için yol gösterici olabilir.

Keywords

• Prolidaz
• balneoterapi
• fibromiyalgi

References

1. Altay, M.A., Ertürk, C., Bilge, A., Yaptı, M., Levent, A., Aksoy, N. (2015). Evaluation of prolidase activity and oxidative status in patients with knee osteoarthritis: relationships with radiographic severity and clinical parameters. Rheumatol Int, 35:1725-731.
2. Altındag, O., Celik, H. (2006). Total antioxidant capacity and the severity of the pain in patients with fibromyalgia. Redox Report, 11:131-35. Altindag, O., Erel, O., Aksoy, N., Selek, S., Celik, H., Karaoglanoglu, M. (2007). Increased oxidative stress and its relation with collagen metabolism in knee osteoarthritis. Rheumatol Int, 274:339–44.
3. Baspinar, S., Kırnap, M., Baspınar, O., Dizdar, O.S., Kocer, D. (2016). Serum prolidase level in ankylosing spondylitis: low serum levels as a new potential gold standard biomarker for disease activity. Rheumatol Int, 36:1609-616.
4. Bender, T., Bariska, J., Vághy, R., Gomez, R., Kovács, I. (2007). Effect of balneotherapy on the antioxidant system--a controlled pilot study. Arch Med Res, 38:86-9.
5. Bozkurt, M., Caglayan, M., Oktayoglu, P., Em, S., Batmaz, I., Sariyildiz, M.A., Nas, K., Uçar, D., Yüksel, H., Saraç A.J. (2014). Serum prolidase enzyme activity and oxidative status in patients with fibromyalgia. Redox Rep, 19:148-53.
6. Celik, A., Birer, M.N., Kilinc, M. (2017). Serum prolidase activity in systemic sclerosis. Clin Rheumatol, 36:1827-832.
7. Cordero, M.D. (2011). Oxidative Stress in Fibromyalgia: Pathophysiology and Clinical Implications. Reumatol Clin, 7:281-93.
8. Duong, H.S., Zhang, Q.Z., Le, A.D., Kelly, A.P., Kamdar, R., Messadi, D.V. (2006). Elevated prolidaseactivityin keloids: correlation withtype I collagen turnover. Br J Dermatol, 154:820–28.

9. Gronemann, S.T., Ribel-Madsen, S., Bartels, E.M., Danneskiold-Samsoe, B., Bliddal, H. (2004). Collagen and muscle pathology in fibromyalgia patients. Rheumatology, 43:27–1.
10. Jacobsen, S., Jensen, L.T., Foldager, M., Danneskiold-Samsøe B. (1990). Primary fibromyalgia: clinical parameters in relation to serum procollagen type III aminoterminal peptide Br J Rheumatol, 2:174-77.
11. Karadag, A., Hayta, E., Celik, V.K., Bakir, S. (2019). Serum vascular endothelial growth factor and vascular endothelial growth factor receptor-1 levels in patients with fibromyalgia syndrome. Arch Rheumatol, 34:414-418.
12. Karadağ, A., Canbaş, M., Parlak, M. (2018). Balneoterapinin fibromiyalji hastalarında ağrı ve yaşam kalitesine etkisi. Mustafa Kemal Üniversitesi Tıp Dergisi, 9:114-120.
13. Karagülle, M., Kardeş, S., Karagülle, O., Dişçi, R., Avcı, A., Durak, İ., Karagülle, M.Z. (2017). Effect of spa therapy with saline balneotherapy on oxidant/antioxidant status in patients with rheumatoid arthritis: a single-blind randomized controlled trial. Int J Biometeorol, 61:169-80.
14. Korucu. R.U., Karadağ, A., Taş, A., Özmen, E., Hayta, E., Siliğ, Y. (2020). Serum Calcitonin Gene-Related Peptide and Receptor Protein Levels in Patients With Fibromyalgia Syndrome: A Cross-Sectional Study. Arch Rheumatol, 35:463-467.
15. Metyas, S., Rezk, T., Arkfeld, D., Leptich, T. (2017). The Inflammatory Fibromyalgia. Curr Rheumatol Rev, 13:98-2.
16. Myara, I., Myara, A., Mangeot, M., Fabre, M., Charpentier, C., Lemonnier, A. (1984). Plasma prolidaseactivity:A possible index of collagen catabolism in chronic liver disease. Clin Chem, 30:211–15.
17. Namiduru, E.S. (2016). Prolidase. Bratisl Lek Listy, 117:480-85.
18. Rodríguez-Carrio, J., López-Mejías, R., Alperi-López, M., López, P., Ballina-García, F.J., González-Gay, M.Á., Suárez, A. (2016). Paraoxonase 1 Activity Is Modulated by the rs662 Polymorphism and IgG Anti-High-Density Lipoprotein Antibodies in Patients With Rheumatoid Arthritis: Potential Implications for Cardiovascular Disease. Arthritis Rheumatol, 68:1367-376.
19. Sarmer, S., Ergin, S., Yavuzer, G. (2000). The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int, 20:9-2.
20. Sprott, H., Muller, A., Heine, H. (1997). Collagen crosslinks in fibromyalgia. Arthritis Rheum, 40:1450–54.
21. Topbas, M., Cakirbay, H., Gulec, H., Akgol, E., Ak, I., Can, G. (2005). The prevalence of fibromyalgia in women aged 20-64 in Turkey. Scand J Rheumatol, 34:140-4.
22. Wolańska, M., Sobolewski, K., Drozdzewicz, M. (2001). Integrins and prolidase activity in uterine leiomyoma during tumor growth. Ginekol Pol, 72: 121-26.
23. Wolfe, F., Clauw, D.J., Fitzcharles, M.A., Goldenberg, D.L., Katz, R.S., Mease, P., Russel, A.S., Russel, I.J., Winfield, J.B., Yunus, M.B. (2010). The American Collage of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research, 6:600-610.