Fibromyalgia and microbiota: hope for a diagnostic tool and treatments

“Fibromyalgia, a syndrome that causes pain, fatigue and cognitive impairment, affects up to 4% of the population, mostly women“, specify the researchers. “This little understood disease remains untreated and difficult to diagnose.“.

The team of researchers from the Research Institute of the McGill University Health Center (RI-MUHC), McGill University and the University of Montreal were the first to demonstrate in 2019 that fibromyalgia was associated with alterations in the intestinal microbiota.

In this new study, conducted with 42 women with fibromyalgia and 42 healthy women, it provides the first data showing that, compared to healthy people, those with the syndrome have differences in the amounts and species of gut bacteria. metabolizing bile and differences in blood bile acid concentrations. Some of these differences are correlated with the severity of symptoms.

Secreted by the liver, bile acids help the body digest fats and also perform many functions in other body systems. Once metabolized in the intestine, they are transported back to the liver and the blood and become secondary bile acids.

The bile-metabolizing bacteria that are most abundant in the intestine were not identical in the two groups. In addition, in women with fibromyalgia, the serum concentration of secondary bile acids showed considerable alterations.

At least some of the differences observed in the composition of the microbiota and in the bile-metabolizing bacteria were likely attributable to fibromyalgia, and not to other individual or environmental factors.

“For example, people with fibromyalgia frequently suffer from irritable bowel syndrome and depressive disorders, but we were able to demonstrate that the alterations in bile acids associated with fibromyalgia were not correlated with these pathologies”, explains Emmanuel Gonzalez, bioinformatics expert and co-author.

The presence of six particular secondary bile acids was enough to determine with more than 90% accuracy whether a participant had fibromyalgia.

“This is an important advance, since diagnosing fibromyalgia is often a laborious process that requires ruling out other conditions that can cause similar symptoms.“, explains Dr. Amir Minerbi, co-first author.

A secondary bile acid, α-muricholica (α-MCA), was on average five times less present in participants with fibromyalgia than in healthy ones. This difference was associated with most symptoms of the syndrome, including pain, fatigue, non-restorative sleep and cognitive impairment.

Food being a factor that affects the composition of the intestinal microbiota, the scientists also conducted analyzes on nutritional habits. No correlation was observed between the foods consumed and the symptoms.

For more information on fibromyalgia, see the links below.

(1) Amir Minerbi, Emmanuel Gonzalez, Nicholas Brereton, Mary-Ann Fitzcharles, Stéphanie Chevalier, Yoram Shir.

Psychomedia with sources: Research Institute of the McGill University Health Centre, Pain.
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