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Plasma and platelet serotonin levels in familial Mediterranean fever
A M Onat1, L Ozçakar, M A Oztürk
1Gaziantep University Hospitals, Department of Rheumatology, Gaziantep, Turkey. mesutonat@yahoo.com
Objective:
Familial Mediterranean fever (FMF) is the most common auto-inflammatory syndrome with exaggerated acute phase and inflammatory response. After revealing the MEFV gene mutation with the finally disturbed end product pyrin, some of the mechanisms were explained. However it is still unknown what triggers or ends these periodical attacks. Moreover, the treatment of up to 30% of the patients, that are resistant to colchicine is still a problem. In this study we investigated the role of serotonin in colchicine-resistant FMF patients.
Methods:
Twenty-four FMF patients (male/female: 15/9) and 32 age- and sex-matched healthy controls (male/female: 17/15) were included into the study. Patients were subdivided into two groups. Thirteen had FMF attacks despite regular colchicine (colchicine-resistant group), other 11 had disease under control with colchicine for at least 6-months. Sampling was done both during the attack and ten days after its cessation. Plasma and platelet serotonin levels and acute phase reactants were studied in patients and controls.
Results:
Colchicine-resistant patients had plasma serotonin (5-HT) levels of 7.85 +/- 1.0 nmol/l during acute attacks which significantly reduced to the levels of 6.3 +/- 0.6 nmol/l (p < 0.001), after 10 days of acute attacks and these levels were significantly lower than those of attack-free patients' and controls' (10.7 +/- 0.2 nmol/l and 10.1 +/- 0.3 nmol/l, respectively). Platelet 5-HT level was 6.4 +/- 0.3 nmol/10(9) platelets during acute attack, and this level was increased to 9.8 +/- 0.5 nmol/10(9) platelets on the 2(nd) sampling, 10 days after the cessation of the acute attack (p < 0.001). They were both significantly higher than those of attack-free FMF patients (5.9 +/- 0.1 nmol/10(9) platelets) and healthy controls (5.7 +/- 0.3 nmol/10(9) platelets). There was a negative correlation between plasma and platelet 5-HT levels (r=-0.77, p < 0.001).
Conclusion:
Changes in plasma and platelet 5-HT levels may be related to the disturbances in 5-HT transport mechanisms or may also be attributed to the potential role of serotonin in the inflammatory cascade. Last but not least, serotonin may have a role in the pathogenesis of FMF.
Insights
Serotonin (5-HT) levels differ in colchicine-resistant Familial Mediterranean Fever (FMF) patients during attacks. These findings suggest serotonin may play a role in FMF pathogenesis and inflammatory responses.
Area of Science:
- Immunology
- Genetics
- Biochemistry
Background:
- Familial Mediterranean Fever (FMF) is a common auto-inflammatory syndrome characterized by exaggerated inflammatory responses.
- While MEFV gene mutations are identified, triggers and termination mechanisms of FMF attacks remain unclear.
- Colchicine resistance affects up to 30% of FMF patients, necessitating alternative therapeutic targets.
Purpose of the Study:
- To investigate the role of serotonin (5-HT) in colchicine-resistant FMF patients.
- To compare plasma and platelet serotonin levels between FMF patients and healthy controls.
- To explore potential links between serotonin and FMF pathogenesis.
Main Methods:
- Study included 24 FMF patients (13 colchicine-resistant, 11 colchicine-controlled) and 32 healthy controls.
- Blood samples were collected during FMF attacks and 10 days post-attack cessation.
- Plasma and platelet serotonin (5-HT) levels and acute phase reactants were measured.
Main Results:
- Colchicine-resistant FMF patients exhibited significantly lower plasma 5-HT during attacks compared to post-attack and controls.
- Platelet 5-HT levels were significantly higher in colchicine-resistant FMF patients during attacks compared to post-attack and controls.
- A negative correlation was observed between plasma and platelet 5-HT levels (r=-0.77, p < 0.001).
Conclusions:
- Altered plasma and platelet serotonin levels in FMF patients may indicate dysregulated 5-HT transport mechanisms.
- Serotonin might be involved in the inflammatory cascade of FMF.
- These findings suggest a potential role for serotonin in the pathogenesis of Familial Mediterranean Fever.
