Scientists have found a link between a disease involving chronic pain and changes in the gut microbiome.
Fibromyalgia affects 2-4 percent of the population and has no known cure. Symptoms include fatigue, impaired sleep and cognitive problems, but the disease is most clearly characterized by widespread chronic pain. In an article published today in the journal Pain, a Montreal-based research team has shown for the first time that there are changes in the bacteria in the digestive tract of people with fibromyalgia. About 20 different types of bacteria are found in the microbiome of participants suffering from the disease in greater or lesser proportions than in the healthy control group.
Greater presence or absence of certain types of bacteria
“We used a variety of techniques, including artificial intelligence, to confirm that the changes we saw in the microbiome of fibromyalgia patients were not caused by factors such as diet, medication, physical activity, age, etc. is that it has an effect on the microbiome, ”says Dr. Amir Minerbi, of the Alan Edwards Pain Management Unit at the McGill University Health Center (MUHC), and the first author on the paper. The team also included researchers from McGill University and Université de Montréal, as well as others from the MUHC Research Institute.
Dr Minerbi adds: ‘We have found that fibromyalgia and the symptoms of fibromyalgia – pain, fatigue and cognitive problems – contribute more than any of the other factors to the variations we see in the microbiome of those with the disease. We have also seen that the severity of a patient’s symptoms is directly correlated with a greater presence or a clearer absence of certain bacteria – something that has never been reported before. ‘
Are bacteria merely the markers of the disease?
At this stage, it is not clear whether the changes in the gut bacteria seen in patients with fibromyalgia are merely markers of the disease or that it plays a role in causing it. Since the disease involves a group of symptoms, and not just pain, the next step in the research is to investigate whether there are similar changes in the gut microbiome under other conditions that include chronic pain, such as lower back pain, headache and neuropathic pain. . .
The researchers are also interested in investigating whether bacteria play a causal role in the development of pain and fibromyalgia. Whether their presence can ultimately help with drug detection and speed up the diagnosis process.
Confirm a diagnosis and next steps towards healing
Fibromyalgia is a disease that is difficult to diagnose. Patients can wait as long as 4 to 5 years to get a final diagnosis. But that may be about to change.
“We sorted large amounts of data and identified 19 species that increased or decreased in individuals with fibromyalgia,” said Emmanuel Gonzalez, of the Canadian Center for Computational Genomics and the Department of Human Genetics at McGill University. “Using machine learning, our computer was able to make a diagnosis of fibromyalgia, based solely on the microbiome composition, with an accuracy of 87 percent. As we build on this first discovery with more research, we hope to improve this accuracy and possibly create a step change in diagnosis. “
“People with fibromyalgia suffer not only from the symptoms of their illness, but also from the problems of family, friends, and medical teams to understand their symptoms,” said Yoram Shir, the senior author at the newspaper that directs Alan Edwards Pain is. Management unit at the MUHC and a co-investigator of the BRaiN program of the RI-MUHC. “As pain practitioners, we are frustrated by our inability to help, and this frustration is a good fuel for research. This is the first proof, at least in humans, that the microbiome can have an effect on diffuse pain, and that we really need new ways of looking at chronic pain. ‘
How the research was done
The research is based on a group of 156 individuals in the Montreal area, 77 of whom suffer from fibromyalgia. Participants in the study were interviewed and given samples of faeces, blood, saliva and urine, which were then compared to those of healthy control subjects, some of whom lived in the same home as the fibromyalgia patients, or their parents, children or brothers and sisters.
The next steps of the researchers will be to see if they get similar results in another cohort, perhaps in another part of the world, and to examine animals to determine if changes in bacteria play a role in developing the disease.
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