Research Recommendations Following the Discovery of Pain Sensitizing IgG Autoantibodies in Fibromyalgia Syndrome

Göebel, Andreas; Andersson, David A.; Barker, Chris; Basu, Neil; Bullock, Craig; Bevan, Stuart; Bashford-Rogers, Rachael; Choy, Ernest; Clauw, David; Dulake, Debra; Dulake, Richard; Flor, Herta; Glanvill, Marcia; Helyes, Zsuzsanna; Irani, Sarosh; Laird, Jennifer M.A.; Macfarlane, Gary J.; McCullough, Hayley; Moots, Robert J.; Perrot, Serge; Shenker, Nick; Sher, Emanuele; Sommer, Claudia; Svensson, Camilla I.; Williams, Amanda C de C; Wood, Geoff; Dorris, Emma R.

doi:10.1093/pm/pnab338

Cited by 4 publications

(1 citation statement)

References 43 publications

(37 reference statements)

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“…While there is no clear inflammatory process, several candidates have been proposed as predisposing or exacerbating factors, including infection, oxidative stress, pre-existing autoimmune conditions, genetics, sleep disorders, nervous system dysfunction, changes in epidermal nerve fibres, and hormonal dysregulation [ 5 ]. While none have proven to be universal or predictive of the condition, recent guidelines recommend focusing on immunological markers, specifically auto-immune antibodies [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Investigating the association between the symptoms of women with Fibromyalgia, Digestive function, and markers of the microbiota of the Gastrointestinal Tract (The FIDGIT Study): study protocol

Erdrich

Hawrelak

Myers

et al. 2023

BMC Musculoskelet Disord

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Background Fibromyalgia a common idiopathic condition affecting around 1.4% of adults globally. Its signature symptom is chronic widespread pain, with a constellation of somatic and psychological symptoms. Fibromyalgia is associated with significant reductions in quality of life, yet to date there is no biochemical marker for its diagnosis. Previous studies have indicated a strong association with gastrointestinal dysfunction, and more recently, alterations to the gut microbiome. No studies have examined the inter-relationship between fibromyalgia, gastrointestinal dysfunction, and the microbiome. This prospective observational case-controlled study will gather data on gastrointestinal function, dietary intake, fermentation patterns of ingested carbohydrates, and symptoms commonly associated with fibromyalgia. These will be evaluated alongside human gene expression and metatranscriptomic analysis of the oral and faecal microbiome. Methods Adult women aged ≥18 years diagnosed with fibromyalgia and/or meeting ACR 2016 criteria, and healthy family or age-matched controls will be recruited from the community. From consenting participants, we will collect detailed survey information and samples of blood, urine, stool, saliva, and breath. Discussion This is the first prospective study examining interactions between digestive function, human gene expression, and the gut microbiome together with general, and fibromyalgia-specific, symptoms experienced by New Zealand women. This exploration will allow an in-depth understanding of clinically relevant factors that are associated with fibromyalgia and will guide further research and contribute to improved management of this poorly understood condition. Trial Registration The study was approved by the New Zealand Health and Disability Committee (HDEC) (ref: 20/CEN/197) and registered with the Australia and New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12620001337965. Written consent will be obtained after providing participants with detailed information about the procedures. Access to data will be restricted to the immediate research team, and all samples and survey data will be deidentified and coded before analysis.

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Section: Introductionmentioning

confidence: 99%

Investigating the association between the symptoms of women with Fibromyalgia, Digestive function, and markers of the microbiota of the Gastrointestinal Tract (The FIDGIT Study): study protocol

Erdrich

Hawrelak

Myers

et al. 2023

BMC Musculoskelet Disord

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The crosstalk of the pathophysiologic models in fibromyalgia

Ghavidel-Parsa,

Bidari

2023

Clin Rheumatol

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Small fibre pathology, small fibre symptoms and pain in fibromyalgia syndrome

Marshall,

Rapteas,

Burgess

et al. 2024

Sci Rep

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A proportion of people with fibromyalgia demonstrate small fibre pathology (SFP). However, it is unclear how SFP directly relates to pain phenomenology. Thirty-three individuals with FMS and ten healthy volunteers underwent assessment of SFP and sensory phenotyping using corneal confocal microscopy, validated questionnaires and quantitative sensory testing (QST). Corneal nerve fibre length was used to stratify participants with fibromyalgia into with SFP [SFP+] and without SFP [SFP−]. SFP was detected in 50% of the fibromyalgia cohort. Current pain score and QST parameters did not differ between SFP+ and SFP−. Mechanical pain sensitivity (MPS) demonstrated a significant gain-of-function in the SFP− cohort compared to healthy-volunteers (p = 0.014, F = 4.806, η2 = 0.22). Further stratification revealed a cohort without structural SFP but with symptoms compatible with small fibre neuropathy symptoms and a significant gain in function in MPS (p = 0.020 Chi-square). Additionally, this cohort reported higher scores for both depression (p = 0.039, H = 8.483, η2 = 0.312) and anxiety (p = 0.022, F = 3.587, η2 = 0.293). This study confirms that SFP is present in a proportion of people with fibromyalgia. We also show that in a proportion of people with fibromyalgia, small fibre neuropathy symptoms are present in the absence of structural SFP. Greater mechanical pain sensitivity, depression and anxiety are seen in these individuals.

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Research Recommendations Following the Discovery of Pain Sensitizing IgG Autoantibodies in Fibromyalgia Syndrome

Cited by 4 publications

References 43 publications

Investigating the association between the symptoms of women with Fibromyalgia, Digestive function, and markers of the microbiota of the Gastrointestinal Tract (The FIDGIT Study): study protocol

Investigating the association between the symptoms of women with Fibromyalgia, Digestive function, and markers of the microbiota of the Gastrointestinal Tract (The FIDGIT Study): study protocol

The crosstalk of the pathophysiologic models in fibromyalgia

Small fibre pathology, small fibre symptoms and pain in fibromyalgia syndrome

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