RSU researchers improve diagnosis of fibromyalgia

The RSU Institute of Microbiology and Virology has focused on studying autoimmune dimensions of fibromyalgia (FM) and is exploring the unique interactions between various biomarkers in fibromyalgia patients. The study aims to improve diagnostic and prognostic accuracy by promoting effective and personalized treatment approaches for fibromyalgia. A specific exercise program has been developed as a part of the pilot study that improves health status of fibromyalgia patients..

Fibromyalgia is a poorly understood disease of unknown etiology, characterized by chronic pain, fatigue, sleep disorders and cognitive difficulties (so-called “fibro fog”) that can resemble depression or anxiety. It can take up to six years to discover this diagnosis. Depending on the criteria used to diagnose this disease, the prevalence of fibromyalgia ranges from 0.4 % to 8.8 %, with an average global prevalence of 2.7 %.

“The research hypothesis predicts that distinct interactions between altered cytokine profiles, gut microbiome diversity, concurrent viral infections, autoantibodies, and immunoglobulin classes in fibromyalgia patients form a unique combination that may serve as a basis for identifying diagnostic biomarkers and developing patient-centered disease management approaches,” Dr. med. Zaiga Nora-Krūkle, project leader, describes the scientific novelty of this research.

Benefits and beneficiaries

Research shows that fibromyalgia is often confused with depression, anxiety or other chronic pain syndromes, and this can delay diagnosis and treatment of the disease by several years. The RSU project first explores the potential presence of viruses in fibromyalgia patients' exosomes, or microvesicles, and their potential role in developing fibromyalgia. Identifying biomarkers will improve diagnostic criteria for fibromyalgia. This will facilitate early detection of the disease, reducing the time required for diagnosis, and timely initiation of targeted treatment. It will also help create personalized, patient-centered fibromyalgia therapy.

Fibromyalgia patients often experience a lengthy diagnostic process (up to six years on average), that affects their quality of life and ability to work. Fibromyalgia is more common to occur in women of working age, and the impact of the disease on employment is significant. While the disease is diagnosed, work capacity may be lost.

Fibromyalgia patients have set up a mutual support network thanks to a discussion initiated by RSU. Networking events organized by RSU and an international symposium with experts from the Sheba Medical Center in Israel have promoted patient-to-patient communication, and the necessary contacts have been found to establish a fibromyalgia patients’ association. In the future this association could unite patients with fibromyalgia, providing support, advocacy and broader awareness of treatment options for the disease. Patient association and support groups are becoming increasingly important as they help raising awareness of fibromyalgia, offer emotional and informative support, and collaborate with medical institutions and policymakers to improve access to treatment.

Impact

As a part of this research, the RSU Institute of Microbiology and Virology has developed a unique exercise program tailored to fibromyalgia patients. The results of the program show that 80 % of participants experience a reduction in muscle pain, while 70 % of patients report improved physical endurance and better sleep quality. This program is considered a major therapeutic supplement to medication treatment, helping patients improve their well-being and quality of life.

Currently, samples of their blood and faeces have been taken from fibromyalgia patients enrolled in the research before and after the 8-week exercise program to determine specific laboratory markers and evaluate the effectiveness of physical activity and its impact on intestinal microflora and permeability, one of the sustaining factors for chronic inflammation. The first results show a positive trend, supported by patient-filled scales of pain, fatigue and cognitive ability. Patients report feeling heard and pleased about their involvement in the research and the opportunity to be heard.

The healthcare system still lacks specialized treatment programs for fibromyalgia patients, and treatment is often based on the assumption that symptoms are only related to mental health disorders. Therefore, RSU is also actively involved in improving diagnostic guidelines for fibromyalgia to promote physicians' understanding of the specific symptoms of fibromyalgia.

Health policymakers will need to ensure the development of appropriate treatment guidelines and their integration into the healthcare system so that patients receive adequate help in a timely manner.