• Giuliana Guggino, Claudia Schinocca, Marianna Lo Pizzo, Diana Di Liberto, Domenico Garbo, Stefania Raimondo, Riccardo Alessandro, Filippo Brighina, Piero Ruscitti, Roberto Giacomelli, Guido Sireci, Giovanni Triolo, Roberto Casale, Piercarlo Sarzi-Puttini, and Francesco Dieli.
• Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Reumatologia, Università di Palermo, Italy. giuliana.guggino@unipa.it.
• Clin Exp Rheumatol. 2019 Jan 1; 37 Suppl 116 (1): 81-89.

ObjectivesHyperbaric oxygen therapy (HBOT) has been used as treatment for different clinical conditions, including fibromyalgia (FM). HBOT modulates brain activity, ameliorates chronic pain and modifies the ratio of immune cells. Clinical studies have provided evidence that FM is associated with immune system dysregulation. In the present study we aimed to evaluate the effect of HBOT on immune system and on the quality of life-style of FM patients.MethodsPatients with primary FM and controls were treated with HBOT. Physical, emotional and social assessment, quality of sleep, tender points, intensity score, WPI and symptom severity were evaluated before and after HBOT. Furthermore, a characterisation of CD4 T lymphocytes and their cytokine production was performed by flow cytometry. The expression of TNF-α, IFN-γ, IL-17, IL-9 and IL-22 was also assessed by RT-PCR. Finally, the serum levels of serotonin were evaluated by ELISA.ResultsOur results confirm the participation of immune system in the pathogenesis of FM and highlight the impact of HBOT treatment, with particular regard to the changes on proinflammatory cytokines production by CD4 T cells subsets.ConclusionsFM patients show a Th1 signature and the activation of this subset is modulated by HBOT.

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