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A Fibromyalgia Test May Be on the Way: This oft-misdiagnosed disease has a distinctive metabolic signature, a new study suggests.

Fibromyalgia is the most common cause of chronic widespread pain in the United States, affecting 2 to 8 percent of the population, but it has no diagnostic test. In addition to pain, fatigue, muscle spasms, weakness, skin tingling, bowel disturbances, and cognitive dysfunction, people with the disease face the difficulty of struggling with a condition that can take years to diagnose.

Researchers from The Ohio State University, however, believe they have made an important discovery that could finally lead to a diagnostic test. This innovative team paired medical scientists with a professor who specializes in using metabolic fingerprinting technology for food-related research. Together, they discovered "clear, reproducible metabolic patterns in the blood of dozens of patients with fibromyalgia," they reported in the Journal of Biological Chemistry in April.

Study Details. Their findings came from the use of vibrational spectroscopy (VS), a test that uses different wavelengths of light to measure vibrations and produce a distinctive molecular signature. The researchers used VS to analyze finger-prick blood samples of 121 people: 50 with fibromyalgia, 29 with rheumatoid arthritis, 19 with osteoarthritis, and 23 with lupus. First, they used samples from each group to identify the baseline molecular signature for each disease. Fibromyalgia, like the other diseases, showed a distinctive pattern of vibrations in the protein backbone and in nucleic acids. The researchers then looked for those disease signatures in blinded blood samples. Using pattern recognition, they were able to classify every patient into the correct disease category.

These findings suggest that it may be possible to use a molecular signature to develop a diagnostic test for fibromyalgia. The next step is a larger clinical trial with a more diverse population and additional controls. If the findings hold true, the researchers estimate a blood test could be ready in as few as five years.

Why Diagnosis Matters. There still exists a stigma that fibromyalgia is not a "real" disease, which can be frustrating and isolating for people living with it. A diagnosis could provide important validation to patients and help to distinguish the disease from conditions with similar symptoms. There is also hope that by identifying chemical alterations that occur in fibromyalgia, researchers will be able to target those proteins in the future to develop new therapies.

A Treatment to Avoid

Current treatments for fibromyalgia include lifestyle changes, such as better diet, sleep, cognitive therapy, and exercise--all of which have been shown to reduce symptoms. For soma patients it may also include medications such as duloxetine (Cymbalta, Eli Lilly), milnacipran (Savella, Allergan), and pregabalin (Lyrica, Pfizer). But there is one important class of drugs that people with the disease should avoid: opioids. These painkillers are often ineffective for people with fibromyalgia, and they may even worsen the disease.

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Publication:Duke Medicine Health News
Date:Jun 29, 2019
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