Altered microbiome composition in individuals with fibromyalgia

Abstract

Fibromyalgia (FM) is a prevalent syndrome, characterised by chronic widespread pain, fatigue, and impaired sleep, that is challenging to diagnose and difficult to treat. The microbiomes of 77 women with FM and that of 79 control participants were compared using 16S rRNA gene amplification and whole-genome sequencing. When comparing FM patients with unrelated controls using differential abundance analysis, significant differences were revealed in several bacterial taxa. Variance in the composition of the microbiomes was explained by FM-related variables more than by any other innate or environmental variable and correlated with clinical indices of FM. In line with observed alteration in butyrate-metabolising species, targeted serum metabolite analysis verified differences in the serum levels of butyrate and propionate in FM patients. Using machine-learning algorithms, the microbiome composition alone allowed for the classification of patients and controls (receiver operating characteristic area under the curve 87.8%). To the best of our knowledge, this is the first demonstration of gut microbiome alteration in nonvisceral pain. This observation paves the way for further studies, elucidating the pathophysiology of FM, developing diagnostic aids and possibly allowing for new treatment modalities to be explored.

Determining the association between fibromyalgia, the gut microbiome and its biomarkers: A systematic review

“…1) shows the selection process and number of studies included and excluded at each step to arrive at the final eleven studies, conducted in 7 countries, included in this analysis. There was a high degree of heterogeneity across the studies, which were of variable quality ( (22)(23)(24)(25), and three reported other biomarkers (16,21,26). Four studies (16,(21)(22)(23) examined more than one type of biomarker and so are included in each of the appropriate sections below.…”

“…The urinary microbial metabolism data reported in two of the studies included in this review were obtained from the same cohort (24,25). Two other studies evaluated serum markers for a range of metabolites, proteins and gene expression (22,23), and three compared patients with more than one type of control (23)(24)(25). These are summarised in Table 5.…”

“…Gezici's group reported a significant reduction in pain, as evaluated by the number of tender points, following H.pylori eradication (p < 0.001)(18).A significant association between the differential abundance of several taxa and some indices of the 2016 ACR Fibromyalgia criteria (such as pain intensity, widespread pain index (WPI), dyscognition), and quality of life scores (including fatigue) was reported by Minerbi's group (all p < 0.05). Some operational taxonomic units were found to be inversely related to many of the same indicators in unrelated controls(23). Genus-level composition of the gut microbiome weakly correlated to pain indicators in Clos-Garcia's report, with the strongest correlations in micro ribonucleic acid (miRNA) data, followed by serum proteins and metabolomics(22).…”

A systematic review of the association between fibromyalgia and functional gastrointestinal disorders

“…Lubrano et al (21) also found a significant association between fibromyalgia and the severity of IBS symptoms (p = 0.002). Emerging evidence suggests that the gut bacterial community may be altered in IBS (69), constipation (70), and in fibromyalgia (71). This is supported by pain reduction subsequent to antibiotic treatment (72) and following Marum's dietary intervention in patients with fibromyalgia (31).…”

Oral Health and Fibromyalgia Syndrome: A Systemic Review

“…Fibromyalgia therefore has clear correlations at the level of TMJ and oral health. In particular, as can be seen from the results, patients with TMD and FM show an increase in symptoms [41][42][43][44][45]. Fibromyalgia is diagnosed due to the exclusion of other pathologies and subsequent palpation of the tender points, although it is the patient's overall symptomatic picture that leads to diagnosis.…”