Question

There was an interesting report in The Guardian newspaper about some new research into fibromyalgia. This suggests that there is an immunological abnormality involving antibody production and that removing these harmful antibodies could be an effective form of treatment. This is a brief summary of what they found: The researchers in London took blood from 44 people with fibromyalgia and injected purified antibodies from each of them into different mice. The mice rapidly became more sensitive to pressure and cold, and displayed reduced grip strength in their paws. Animals injected with antibodies from healthy people were unaffected. Prof Camilla Svensson from the Karolinska Institute in Sweden, who was also involved in the study, said: “Antibodies from people with fibromyalgia living in two different countries, the UK and Sweden, gave similar results, which adds enormous strength to our findings.” The mice recovered once the antibodies had been cleared from their systems, which took a few weeks. This suggests that therapies such as plasma-exchange, which are designed to reduce antibody levels and are available for other autoimmune disorders, such as myasthenia gravis, may be effective in fibromyalgia patients. Given the important overlaps between ME and fibromyalgia, do you think this research is worth repeating in ME?

Answer

The results from this small research study suggest some form of immunological involvement, possibly autoimmune, in Fibromyalgia (FM). We already know that people with ME/CFS have evidence of abnormalities in various parts of the immune-system response, including in some cases the production of autoantibodies. These are antibodies that instead of being protective, are capable of attacking the body’s own tissues and organs. However, the occasional presence of low levels of autoantibodies in people with ME/CFS is best described as being suggestive of an autoimmune component to ME/ CFS – we cannot conclude that ME/CFS is an autoimmune disease on this basis.

It would clearly be interesting to repeat this research in people with ME/CFS and I will be discussing this with my colleagues at the ME/CFS Biobank – where we have blood samples and anonymised clinical data on people with ME/CFS – in due course. If it turns out that removing these antibodies in people with Fibromyalgia using plasma-exchange leads to symptom improvement this could also be relevant to ME/CFS. However, having been involved with a small trial that was carried out by Professor Peter Behan in Glasgow many years ago, that involved plasma exchange, there was no evidence of benefit. One very important note of caution here is that if this research was to be repeated in ME/CFS this would involve the use of animals – something that the ME Association has always been very reluctant to do.

More information

• The ME Association Research Summary – Passive transfer of fibromyalgia symptoms from patients to mice – July 2021
• We have detailed information about Fibromyalgia that can be downloaded from the Free Literature:
  • It explains the similarities and differences between FM and ME/CFS – symptoms, diagnosis, management, treatments, and research. HCPs can still be confused by the two conditions and we hope this leaflet will make the distinctions clear.