The Journal of Clinical Investigation recently published a study titled “Passive transfer of fibromyalgia symptoms from patients to mice” (J Clin Invest. 2021:131(13):e144201. https://doi.org/10.1172/JCI144201). In this study, IgG antibodies taken from patients suffering from Fibromyalgia Syndrome (FMS) were injected into mice caused the mice to develop fibro-like symptoms.
Fibromyalgia Syndrome (FMS) is a chronic pain syndrome that results in widespread pain, hypersensitivity to pain stimuli and pressure and cold temperatures. Emotional/ psychological symptoms include depression and anxiety. To date there is no test for fibro, it is essentially a diagnosis of exclusion, meaning, once you have ruled out everything else, it will be labelled fibromyalgia! For instance Rheumatoid arthritis can be identified using a blood test for autoantibodies. A positive Rheumatoid factor can indicate you have or should be further investigated for Rheumatoid Arthritis. If there exist autoantibodies for Fibromyalgia then this would certainly be a bonus.
As noted by the authors in this study, “The etiology and pathophysiology of FMS are not completely understood and the current treatments strategies for FMS rely mainly on lifestyle changes, physical exercise , and drug therapy with antidepressants and anticonvulsants. Unfortunately, the modest efficacy of the available therapies in most patients leaves an enormous unmet clinical need.”
https://www.jci.org/articles/view/144201
It is worth noting that this one study is significant for those who suffer from fibromyalgia as being able to have a tangible way of explaining our disease. There are a lot of great websites that are breaking this study down so that the lay person is able to navigate the findings and implications of the results of this study.
In this study, the team isolated the IgG antibodies from fibromyalgia patients, diluted them and then injected those antibodies into mice. The mice then were noted to have reduced grip strength, hypersensitivity to cold, and hypersensitivity to pressure. The study also noted that after 2-3 weeks when the levels of human IgG had decreased, the resultant FMS symptoms induced in the mice also resolved.
So what is “IgG”?
Immunoglobulins, also known as antibodies, are glycoprotein molecules produced by plasma cells (white blood cells). They act as a critical part of the immune response by specifically recognizing and binding to particular antigens, such as bacteria or viruses, and aiding in their destruction.
Immunoglobulin G, or IgG, is the most common antibody. Immunoglobulins will be detected when the body is fighting an ‘intruder’. So immunoglobulins can be detected in the blood after being exposed to that ‘intruder’, for instance, one is able to know they have been exposed to measles, chicken pox, tetanus etc., because the blood tests show that specific antibody is circulating in the blood. This is one way we can determine if a patient has been vaccinated or has had an active disease, by the different antibodies found in the blood tests.
So what IF Fibromyalgia is deemed to be an autoimmune disease?
Immune system disorders cause abnormally low activity or over activity of the immune system. In cases of immune system overactivity, the body attacks and damages its own tissues (autoimmune diseases). What is interesting to note and what causes some doubts about labelling Fibro as an autoimmune disease, is the “damage” causes to the bodies own tissues! Currently there is no evidence of this tissue damage/ inflammation in fibro patients which is why this has traditionally been a diagnosis of exclusion as there is no physical evidence or blood markers/indicators that point definitively to ‘fibromyalgia’.
If Fibromyalgia is determined to exist within this family of immune disorders, research will need to be conducted to see if any of the existing treatments can ‘cross-over’.
Where does the study take us from here?
While this study brings to light some interesting observations, results and areas for further investigation… it does not provide a definitive solution or direction for treatment…only hope that we are a little bit closer to a solution. It will require replication of this study in mice subjects before moving on to research involving humans and then researching, replicating and initiating treatment options. It will likely be YEARS before there are interventions for humans based on this research (assuming this research is replicable and transfers to human subjects). This study had only a handful of participants (8), which means that larger studies will have to be conducted. It also did not isolate the specific IgG that could be isolated in order to target that specific antibody in discussion of possible treatments.
Conclusion
As a sufferer of fibromyalgia I am cautiously optimistic that a definitive test to diagnose fibro may be in the works but not so optimistic that it will result in changes to or new options for effectively treating fibromyalgia. Not in my near future anyway.
I’d be interested in your thoughts on how this research will impact YOUR life and do you think it will change the dialogue you have with your doctors to help realize real changes and acceptance of your condition? I know with my family, friends and coworkers, not having ‘proof’ of an invisible disability can sometimes cause friction. Will a definitive test change how disability claims are managed?
The Fibro Vagabond 