Is Fibromyalgia an Autoimmune Disease? Research suggests “YES!”
Goebel A, Krock E, Gentry C, Israel MR, Jurczak A, Urbina CM, Sandor K, Vastani N, Maurer M, Cuhadar U, Sensi S, Nomura Y, Menezes J, Baharpoor A, Brieskorn L, Sandström A, Tour J, Kadetoff D, Haglund L, Kosek E, Bevan S, Svensson CI, Andersson DA. Passive transfer of fibromyalgia symptoms from patients to mice. J Clin Invest. 2021 Jul 1;131(13):e144201. doi: 10.1172/JCI144201. PMID: 34196305; PMCID: PMC8245181.
This is the first research study to suggest that fibromyalgia may be autoimmune! The investigators removed immunoglobulin G antibodies (IgG) from humans with fibromyalgia. They then injected this IgG into mice, and it produced classic fibromyalgia problems in the mice:
– The mice ended up with higher pain levels. In the study, they withdrew paws at lower pressures than normal (using a pain measuring device, a dolorimeter). This meant that the mice felt pain at levels not felt as pain by normal mice.
– Increased cold sensitivity. They removed their paws from a cold metal plate earlier than normal)
– Became less active
– Became weaker (reduced paw grip strength)
– Skin biopsies showed few nerve fibers (like small fiber neuropathy)
– Some IgG from fibromyalgia humans attached to pain nerves in the mice. This provides a clue that there may be specific antibodies that target pain nerves, causing fibromyalgia problems.
– Some IgG from fibromyalgia humans attached to nerves along the spinal cords in the humans. This suggests that there may be antibodies that target nerves in humans, leading to fibromyalgia pain
– However, the IgG from fibromyalgia humans did not produce systemic inflammation. Nor did it produce inflammation-causing cytokines (immune system molecules that allow white blood cells to talk to each other)
– But IgG from “healthy” humans did none of the above!
My initial reactions to this study about fibromyalgia and autoimmune disease:
- Fascinating study!
- It also reminds me of one of my favorite sayings, “The more you know, the more you know you don’t know.”
- Now, if you had asked me 2 years ago if fibromyalgia is due to autoimmunity, I would have said, “No. It is due to overactive pain nerves.” Now, I must question our previous thoughts on fibromyalgia.
- Also, this may be why current treatments for fibromyalgia (exercise and nerve pain medicines) are so crappy. Perhaps we should be using some sort of immune system treatment that can remove these IgG antibodies.
The more you know, the more you know you don’t know.Donald Thomas, MD
What we already know about fibromyalgia and autoimmune disease
– Fibromyalgia is a condition that causes pain in multiple body parts. Fatigue, trouble sleeping, and numerous other problems often accompany this pain.
- Previously, very few doctors or scientists thought that fibromyalgia was due to autoimmunity.
– However, 10% – 30% of autoimmune disease patients (like lupus, Sjogren’s disease, and rheumatoid arthritis) also have fibromyalgia.
– Most fibromyalgia patients respond poorly to the current standard of medical care treatments (exercise, depression therapies, nerve pain medicines, and sleep management).
- Exercising regularly (as in “The Lupus Secrets“) is currently the most effective treatment for fibromyalgia pain.
What this study adds to our knowledge about fibromyalgia and autoimmunity
- We must consider whether fibromyalgia is an autoimmune disease, not simply a “centralized pain syndrome.”
- This is added proof that fibromyalgia is real. Those people (including many healthcare providers, unfortunately) who do not “believe” in fibromyalgia should change their minds and become empathetic and compassionate towards those who suffer from it.
- We may be able to cause fibromyalgia problems by transferring fibromyalgia-causing antibodies from one organism to another.
- Although IgG from fibromyalgia patients may bind to pain nerves and cause fibromyalgia pain, it does this without causing inflammation.
- ………………….. This means that anti-inflammatory, immune treatments may not help. We may need to try immune therapies to remove these causative IgG antibodies. This could explain why anti-inflammatory, immune medicines (like prednisone, methotrexate, and mycophenolate) do not help the fibromyalgia symptoms in patients with autoimmune disorders.
- Click on the link in this sentence to see a nice review article about chronic pain and how it may be due to autoimmunity.
How the study on autoimmunity and fibromyalgia was done (in brief)
- Sweden and the United Kingdom
- Healthy people, fibromyalgia patients, and female mice
- The researchers removed pure IgG from the patients and injected it into the abdominal cavity of female mice.
- They performed numerous tests for pain, cold sensitivity, muscle strength, and activity in the mice.
- In addition, the scientists did not know which mice received IgG from healthy people or fibromyalgia patients (i.e., they were “blinded”).
- They performed skin biopsies on the mice. They studied the skin biopsy pieces under a microscope to count the number of small nerve fibers.
- Immunofluorescence studies of the IgG were done to see if any of it was sticking to the nerves in the mice.
What should be studied in the future about fibromyalgia and autoimmune mechanisms
- Researchers should repeat this study. It would be best to do this in people of different races to see if it is present in diverse groups.
- We should identify the IgG antibodies that bind to the pain nerves and cause fibromyalgia symptoms
- If repeat studies show the above, we should search for treatments that can remove those IgG antibodies. Then, we should test to see if they are safe and reduce or stop fibromyalgia pain. Wouldn’t that be a wonderful thing?!?