Physical Trauma and Infection as Precipitating Factors in Patients with Fibromyalgia

Jiao, Juan; Vincent, Ann; Stephen, S.; Luedtke, Connie A.; Kim, Chul Han; Oh, Terry H.

doi:10.1097/phm.0000000000000300

Cited by 27 publications

(37 citation statements)

References 21 publications

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“…These data indicate that the possible association between FQs and fibromyalgia is possibly due to the viral or bacterial infection for which they are prescribed. This is corroborated by a number of studies that have shown that fibromyalgia might be triggered by an infectious process [6]. Our data is corroborated by inclusion of azithromycin, an antibiotic generally prescribed for more severe respiratory community-acquired infections.…”

Section: Discussionsupporting

confidence: 87%

Oral fluoroquinolones and risk of fibromyalgia

Ganjizadeh-Zavareh

Sodhi

Spangehl

et al. 2018

Brit J Clinical Pharma

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The Food and Drug Administration (FDA) has recently included a black box warning on fibromyalgia-like symptoms with fluoroquinolones (FQs) but no large epidemiologic study is to date available. We undertook a case-control study using a random sample of 9 053 240 subjects obtained from the PharMetrics Plus health claims database in the United States. Cases received at least two fibromyalgia diagnoses coded by a rheumatologist matched to ten randomly selected controls. After identifying 5148 cases of fibromyalgia and 51 480 controls, the adjusted rate ratio (RR) of fibromyalgia for use of any fluoroquinolones, amoxicillin and azithromycin were 1.63 (95% CI: 1.41-1.87), 1.64 (95% CI: 1.46-1.85) and 1.68 (95% CI, 1.49-1.89), respectively. The adjusted RR for any use of FQ compared to any use of amoxicillin or azithromycin was 0.99 (95% CI: 0.83-1.18) and azithromycin is 0.97 (95%CI: 0.82-1.16), respectively. The risk of fibromyalgia with FQs is similar to that with amoxicillin and azithromycin.

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Section: Discussionsupporting

confidence: 87%

Oral fluoroquinolones and risk of fibromyalgia

Ganjizadeh-Zavareh

Sodhi

Spangehl

et al. 2018

Brit J Clinical Pharma

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“…The importance of the present study relies in that it shows, for the first time, that the activation of transposable elements, in particular some HERV sequences, is a mechanism linked to FM, potentially explaining the reasons for repeated failures in detecting exogenous infectious agents as etiologic triggers of the disease and for the flu-like symptoms patients experience [11][12][13][14]. Because of the reduced sample size and the limitation for identifying specific activated genomic loci with the method used, detection of molecular differences between FM patients suffering or not of comorbid ME/CFS was not possible.…”

Section: Discussionmentioning

confidence: 93%

“…Although separate clinical diagnostic criteria are described for FM and ME/CFS [2,3,[6][7][8][9][10], common features such as alterations of the immune system and overlapping symptoms such as flu-like symptoms are described [11,12]. As such, many authors have investigated a possible viral etiology of the disease [13,14]. However, no clear correlation between FM or ME/CFS and viral infection has yet been established.…”

Section: Introductionmentioning

confidence: 99%

Activation of Transposable Elements in Immune Cells of Fibromyalgia Patients

Ovejero¹,

Sadones²,

Sánchez-Fito³

et al. 2019

Preprint

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The development of nucleic acid sequencing technology and the unprecedented availability of metadata has evidenced that 45% of human genome constituted by transposable elements (TEs) is not only transcriptionally active but also physiologically needed. Aberrant regulation of TEs, and of human retroviral endogenous sequences (HERVs) in particular, associates with several neurologic and autoimmune diseases, including the Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) frequently comorbid with fibromyalgia (FM). However, no study has yet addressed whether abnormal expression of these sequences correlates with FM. The work presented here shows, for the first time, that in fact HERVs of the H, K and W types are overexpressed in the cells of the immune system of FM patients with or without comorbid ME/CFS. The patients with increased HERV expression (N=14) presented increased levels of interferon (INF-β and INF-γ) but unchanged levels of TNF-α. In support of our proposal that TE activation is a contributor to FM, we find that the tRNA pools are decreased in comparison to matched healthy participants (N=14). The findings reported here could explain the flu-like symptoms FM patients present with in the absence of concomitant infections. Future work towards identifying specific genomic loci differentially affected in FM and ME/CFS is granted.

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“…HLA genes have an essential role in the immune system. Thus, the emerging picture is that a combination of genetic predisposition, a precipitating event (infections, trauma, autoimmune diseases or other reasons of necrosis) (Jiao et al, 2015), and immune dysregulation due to psychological stress (Takahashi et al, 2018) may convert autotolerance or pre-existing occult autoimmunity into overt autoimmunity, but the autoreactive component remains elusive (Figure 1). Importantly, though the precipitation event may be transitory, autoimmunity is a response of the adaptive immune system and is chronic.…”

Section: Fibromyalgia: Introducing the Autoimmune Hypothesismentioning

confidence: 99%

Immune System Sex Differences May Bridge the Gap Between Sex and Gender in Fibromyalgia

2020

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The fibromyalgia syndrome (FMS) is characterized by chronic widespread pain, sleep disturbances, fatigue, and cognitive alterations. A limited efficacy of targeted treatment and a high FMS prevalence (2-5% of the adult population) sums up to high morbidity. Although, altered nociception has been explained with the central sensitization hypothesis, which may occur after neuropathy, its molecular mechanism is not understood. The marked female predominance among FMS patients is often attributed to a psychosocial predisposition of the female gender, but here we will focus on sex differences in neurobiological processes, specifically those of the immune system, as various immunological biomarkers are altered in FMS. The activation of innate immune sensors is compatible with a neuropathy or virus-induced autoimmune diseases. Considering sex differences in the immune system and the clustering of FMS with autoimmune diseases, we hypothesize that the female predominance in FMS is due to a neuropathy-induced autoimmune pathophysiology. We invite the scientific community to verify the autoimmune hypothesis for FMS.

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Physical Trauma and Infection as Precipitating Factors in Patients with Fibromyalgia

Cited by 27 publications

References 21 publications

Oral fluoroquinolones and risk of fibromyalgia

Oral fluoroquinolones and risk of fibromyalgia

Activation of Transposable Elements in Immune Cells of Fibromyalgia Patients

Immune System Sex Differences May Bridge the Gap Between Sex and Gender in Fibromyalgia

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