Determining the association between fibromyalgia, the gut microbiome and its biomarkers: A systematic review

Abstract

Background: The association between fibromyalgia and irritable bowel syndrome is well-established. Alterations in the composition and diversity of the gut microbiome in irritable bowel syndrome have been reported, however, this association is poorly understood in fibromyalgia. Our aim was to summarise the research reporting on the gastrointestinal microbiome and its biomarkers in people with fibromyalgia. Methods: A systematic review of published original research reporting on the gastrointestinal microbiota and its biomarkers in adults with a diagnosis of fibromyalgia was undertaken. Results: From 4771 studies, 11 met our inclusion criteria and were separated into four main groups: papers reporting Helicobacter pylori; other gut bacterial markers; metabolomics and other biomarkers, which included intestinal permeability and small intestinal bacterial overgrowth. Conclusion: The results suggest there is a paucity of quality research in this area, with indications that the gut microbiota may play a role in fibromyalgia within the emerging field of the gut-musculoskeletal axis. Further investigations into the relationship between the gut microbiota, gut dysfunction and fibromyalgia are warranted.

A systematic review of the association between fibromyalgia and functional gastrointestinal disorders

“…However, measurements of markers of gut-derived inflammation, such as calprotectin, lipopolysaccharide (LPS), intestinal fatty acid binding protein (iFABP), monocyte chemo-attractant protein-1 (MCP-1) and co-receptor soluble cluster of differentiation (sCD) have failed to demonstrate a relationship between these markers and the severity of symptoms associated with IBS or musculoskeletal pain. 89 Recent advances have also expanded understanding of the possible role of the gut ecological environment on pain signalling and peripheral sensitisation, 90 with data suggesting a relationship between chronic pain and the intestinal microbiome exists in CRPS, 80,91 endometriosis, 92 interstitial cystitis, 93 restless leg syndrome (RLS) and migraine. 94,95 An altered microbiota in patients with fibromyalgia is further supported by pain reduction subsequent to antibiotic treatment and following Marum's dietary intervention.…”

“…58,[78][79][80] Increasingly, research reports indicate an important role of the gastrointestinal milieu in health and a wide range of conditions, from chronic kidney disease to allergies and diseases of connective tissue and in fibromyalgia. 55,[79][80][81][82] The identification of commensal gut bacteria at sub-infective levels in synovial fluid and joint cartilage in people with arthritis adds credence to what currently is a hypothetical gut microbiotamusculoskeletal interaction. [83][84][85] While we did not seek to explore FGIDs in other musculoskeletal conditions, these groups are often used in comparison with fibromyalgia.…”

Prescribing active transport as a planetary health intervention – benefits, challenges and recommendations

“…Exposure to the environmental microbiota changes the human microbiota [31][32][33], and understanding of the relationship between the human microbiome in a range of health conditions is receiving increased attention. There is evidence to suggest an association between the human microbiome and pain [34], fibromyalgia [35], rheumatic diseases [36], psoriatic diseases [37], multiple sclerosis [38], depression [39], anxiety [40], and cancer [41], while studies into faecal microbiota transplants have provided promising results with regards to psychiatric [42], neurological [43], and gastrointestinal conditions [44,45]. If the environmental microbiota contains microbes with human health-giving properties, then these are likely to improve human health.…”

The Effect of Multiprobiotics on Memory and Attention in Fibromyalgia: A Pilot Randomized Controlled Trial

“…Moreover, FMS is frequently associated with other immuno-rheumatic diseases, such as chronic fatigue syndrome [ 25 ], which appears to improve after probiotics administration [ 26 ], or rheumatoid arthritis, in which probiotics also improve symptoms [ 27 ]. However, even though the gut microbiota may play a role in FMS, according to a recent systematic review, the data are insufficient [ 28 ], and more research is required to obtain conclusive answers in relation to the effectiveness of dietary interventions [ 29 ].…”