CBN. For the first time, researchers have evidence that fibromyalgia can be reliably detected in blood samples; the work they hope will pave the way for a simple and rapid diagnosis.
In a study published in the Journal of Biological Chemistry, researchers at the Ohio State University reported on the success in identifying biomarkers of fibromyalgia and in differentiating another group of related diseases.
The discovery could be a major turning point in the care of patients with a disease that is often misdiagnosed or not diagnosed, leaving them without adequate care and information to control their chronic pain and fatigue, said lead researcher Kevin Hackshaw, associate professor at the Ohio State College of Medicine and rheumatologist at Wexner University Medical Center.
The identification of biomarkers of the disease, a “metabolic fingerprint” like the one discovered in the new study, could also open up the possibility of targeted treatments, he said.
To diagnose fibromyalgia, doctors now rely on information reported by the patient about a multitude of symptoms and on a physical assessment of a patient’s pain, focusing on specific tender points, he said. But there is no blood test; There is no clear and easy-to-use tool to provide a quick response.
“We found clear and reproducible metabolic patterns in the blood of dozens of patients with fibromyalgia. This brings us much closer to a blood test than ever, “Hackshaw said.
Although fibromyalgia is currently incurable and treatment is limited to exercise,
education and antidepressants, an accurate diagnosis has many benefits, said Hackshaw. These include ruling out other diseases, confirming patients that their symptoms are real and not imagined, and guiding doctors towards recognition of the disease and proper treatment.
“Most doctors today do not question whether fibromyalgia is real, but there are still skeptics,” Hackshaw said.
And many undiagnosed patients are prescribed opioids: strong and addictive pain killers that have not been shown to benefit people with the disease, he said.
“When you look at chronic pain clinics, about 40 percent of patients who take opioids meet the diagnostic criteria for fibromyalgia. Fibromyalgia often gets worse, and certainly does not improve, with opioids. “
Hackshaw and co-author Luis Rodriguez Saona, an expert in the advanced test method used in the study, said the next step is a larger-scale clinical trial to determine whether the success they saw in this research can be repeated.
The current study included 50 people diagnosed with fibromyalgia, 29 with rheumatoid arthritis, 19 with osteoarthritis and 23 with lupus.
“We found clear and reproducible metabolic patterns in the blood of dozens of patients with fibromyalgia. This brings us much closer to a blood test than ever. “
The researchers examined each participant’s blood samples using a technique called vibrational spectroscopy, which measures the energy level of the molecules within the sample. Scientists from Rodriguez-Saona’s laboratory detected clear patterns consisting of consistently establishing the results of blood samples from patients with fibromyalgia, and comparing them with those with other similar disorders.
First, the researchers analyzed blood samples from participants whose disease status they knew, in order to develop a reference standard for each diagnosis. Then, using two types of spectroscopy, they evaluated the rest of the samples blindly, without knowing the diagnoses of the participants, and accurately grouped each participant in the study in the category of appropriate disease based on a molecular signature.
“These initial results are remarkable. If we can help speed up the diagnosis for these patients, their treatment will be better and they are likely to have better prospects. There is nothing worse than being in a gray area where you do not know what illness you have, “said Rodríguez-Saona.
Graduate student Didem Peren Aykas uses the experimental diagnostic tool, which measures metabolic activity in the blood, distinguishing fibromyalgia from other conditions of chronic pain with an accuracy of almost 100 percent.
His laboratory focuses primarily on the use of metabolic fingerprint technology for food-related research, focuses on issues such as adulteration of milk and cooking oils and helps agricultural companies to discover which plants are the more suitable to fight diseases.
The opportunity to partner with medical experts to help solve the problem of the misdiagnosis of fibromyalgia was exciting, said Rodriguez-Saona, professor of Food Science and Technology in the state of Ohio.
Rodriguez-Saona said that for the next study he would like to examine 150 to 200 subjects per disease group to see if the findings of this research are replicable in a larger and more diverse population.
Hackshaw said his goal is to have a test ready for widespread use within five years.
Fibromyalgia is the most common cause of chronic widespread pain in the United States and disproportionately affects women. The US Centers for Disease Control and Prevention UU estimates that approximately 2 percent of the population, approximately 4 million adults, have fibromyalgia. Other organizations estimate even higher numbers.
Approximately three out of four people with fibromyalgia have not received an accurate diagnosis, according to previous research, and those who do know that they have the disease waited an average of five years between the onset of symptoms and diagnosis. Common symptoms include pain and stiffness throughout the body, fatigue, depression, anxiety, trouble sleeping, headaches and problems with thinking, memory and concentration.
Eventually, this work could lead to the identification of a particular protein or acid, or a combination of molecules, that is linked to fibromyalgia, said Rodríguez-Saona.
“We can look back at some of these fingerprints and potentially identify some of the chemicals associated with the differences we’re seeing,” he said.
In addition to identifying fibromyalgia, the researchers also found evidence that the metabolic fingerprinting technique has the potential to determine the severity of fibromyalgia in an individual patient.
“This could lead to better and more targeted treatment for patients,” Hackshaw said.
Other researchers from the state of Ohio who participated in the study were Didem Aykas, Gregory Sigurdson, Marcal Plans Pujolras, Francesca Madiai, Lianbo Yu and Monica Giusti. Tony Buffington, formerly of Ohio State and now at the University of California, Davis, was also a co-author.
The research was supported in part by the Columbus Medical Research Foundation.