Fibromyalgia linked to intestinal bacteria for the first time

Scientists have found a correlation between a disease that involves chronic pain and alterations in the intestinal microbiome.

Fibromyalgia affects 2-4 percent of the population and has no known cure. Symptoms include fatigue, lack of sleep and cognitive difficulties, but the disease is most clearly characterized by chronic widespread pain. In an article published today in the journal Pain, a research team based in Montreal has shown, for the first time, that there are alterations in the bacteria in the gastrointestinal tract of people with fibromyalgia. Approximately 20 different species of bacteria were found in larger or smaller amounts in the microbiomes of the participants suffering from the disease than in the healthy control group.

Greater presence or absence of certain species of bacteria. 

“We use a variety of techniques, including Artificial Intelligence, to confirm that the changes we saw in the microbiomes of fibromyalgia patients were not caused by factors such as diet, medications, physical activity, age, etc. , which is known to affect the microbiome, ”says Dr. Amir Minerbi of the Alan Edwards Pain Management Unit at the McGill University Health Center (MUHC), and first author of the article. The team also included researchers from McGill University and the University of Montreal, as well as others from the MUHC Research Institute.

Dr. Minerbi adds: “We discovered that fibromyalgia and fibromyalgia symptoms (pain, fatigue and cognitive difficulties) contribute more than any of the other factors to the variations we see in the microbiomes of people with the disease. We also saw that the severity of a patient’s symptoms was directly correlated with a greater presence or a more pronounced absence of certain bacteria, something that had never been reported before. ”

Are bacteria simply the disease markers?

At this point, it is not clear whether the changes in intestinal bacteria observed in fibromyalgia patients are simply markers of the disease or if they play a role in causing it. Because the disease involves a set of symptoms, and not simply pain, the next step in the investigation will be to investigate if there are similar changes in the intestinal microbiome in other conditions that involve chronic pain, such as low back pain, headaches and neuropathic pain. . .

Researchers are also interested in exploring whether bacteria play a causal role in the development of pain and fibromyalgia. And if their presence could, eventually, help find a cure, as well as speed up the diagnostic process.

Confirm a diagnosis and the next steps to find a cure

Fibromyalgia is a disease that has been difficult to diagnose. Patients can wait up to 4 to 5 years to get a final diagnosis. But this may be about to change.

“We classified large amounts of data, identifying 19 species that increased or decreased in individuals with fibromyalgia,” says Emmanuel Gonzalez, of the Canadian Center for Computational Genomics and the Department of Human Genetics at McGill University. “By using machine learning, our computer was able to make a diagnosis of fibromyalgia, based only on the composition of the microbiome, with an accuracy of 87 percent. As we move forward in this first discovery with more research, we hope to improve this accuracy, potentially creating a radical change in diagnosis. ”

“People with fibromyalgia suffer not only from the symptoms of their disease, but also from the difficulty of family, friends and medical teams to understand their symptoms,” says Yoram Shir, lead author of the article and director of Alan Edwards’ Pain. Management Unit at the MUHC and an Associate Researcher of the BRIi Program of the RI-MUHC. “As pain doctors, we are frustrated by our inability to help, and this frustration is a good fuel for research. This is the first evidence, at least in humans, that the microbiome could have an effect on diffuse pain, and we really need new ways to see chronic pain. ”

How the investigation was conducted

The research was based on a cohort of 156 individuals in the Montreal area, 77 of whom suffer from fibromyalgia. Participants in the study were interviewed and were given samples of feces, blood, saliva and urine, which were then compared with those of healthy control subjects, some of whom lived in the same house as fibromyalgia patients or were their parents, descendants or siblings.

The next steps of the researchers will be to see if they get similar results in another cohort, perhaps in a different part of the world, and do animal studies to find out if changes in bacteria play a role in the development of the disease.

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