Fibromyalgia affects 2-4% of the population and has no known cure. Symptoms include fatigue, impaired sleep and behavioral problems, although chronic chronic pain is most evident. For the first moment a study team in Montreal has shown that there are changes in the bacteria of individuals with fibromyalgia in the gastrointestinal tract in a document released today in Pain newspaper. In the microbiomes of individuals with the illness, approximately 20 distinct species of bacteria were discovered in either higher or lower amounts than in the healthy control group.
Scientists have found a correlation between a disease involving chronic pain and intestinal microbiome alterations.
Greater presence or absence of certain bacterial species
“To confirm the modifications in microbiom in patients with fibromyalgia were not caused through a number of methods, including Artificial Intelligence, known to influence microbiom,” suggests Mr. Amir Minerbi of the Alan Edwards Pain Management Unit of the McGill University Health Center (MUHC) and formerly the McGill Health Institute (MUHC). Researchers from the university of McGill, the University of Montréal and the MUHC research institute were also involved. The team was also involved in research.
Dr. Minerbi adds that, “We have seen more than any other contributors to the microbioma variations in fibromyalgia and the symptoms of fibronomyalgia-pain, fatigue, and cognitive difficulties. The severity of symptoms of a patient has also been directly linked to a greater or more pronounced lack of some bacteria–something never previously reported.
Are bacteria just the markers of the disease?
It is not clear at this point whether the changes in the intestinal bacteria seen in patients with fibromyalgia are simply a marker of the disease or whether they play a role in causing it. Because the disease involves a cluster of symptoms and not just pain, the next step in the research will be to investigate whether there are similar changes in the intestinal microbiome in other conditions involving chronic pain, such as lower back pain, headaches and neuropathic pain.
Researchers are also interested in investigating whether bacteria play a causal role in the development of pain and fibromyalgia. And whether their presence could eventually help to find a cure, as well as speed up the diagnosis process.
Confirm a diagnosis and follow up steps to find a cure
Fibromyalgia is a disease that has proven to be hard to diagnose, and patients can wait for a final diagnosis for as long as 4 to 5 years.
“We sorted by big quantities of information, identifying 19 species that were either increased or reduced in people with fibromyalgia,” claims Emmanuel Gonzalez of the Canadian Center for Computational Genomics and McGill University’s Department of Human Genetics. “By using machine learning, our computer was able to diagnose fibromyalgia, based solely on the composition of the microbiome, with an accuracy of 87%. As we build on this first discovery with more research, we hope to improve this accuracy, potentially creating a step-change in diagnostics.
“People with fibromyalgia not only suffer from the symptoms of their disease, but also from family, friends and medical teams ‘ difficulty in understanding their symptoms,” tells Yoram Shir, senior author on the document, who is the Director of the MUHC Alan Edwards Pain Management Unit and an Associate Investigator of the RI-MUHC BRaiN Program. “As pain physicians, we are frustrated by our inability to help, and this frustration is a good source of 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 of looking at chronic pain.
How the study was carried out
The study was based on a cohort of 156 Montreal-area people, 77 of whom have fibromyalgia. Participants in the study were interviewed and gave samples of stool, blood, saliva and urine, which were then compared to those of healthy control subjects, some of whom lived in the same house as patients with fibromyalgia or were their parents, offspring or siblings.
The next steps of the scientists will be to see if comparable outcomes are obtained in another cohort, perhaps in another portion of the globe, and to do animal studies to find out if changes in bacteria play a role in the disease’s growth.
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