People With Fibromyalgia May Have Impaired Mitochondrial Function

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New research found that people with fibromyalgia syndrome (FMS) had impaired bioenergetic health index (BHI), a proxy of mitochondrial function, which also had a slight correlation with pain.¹

“Symptoms associated with FMS, such as fatigue, exercise intolerance, and myalgia, are common in primary mitochondrial diseases, usually resulting from mitochondrial dysfunction due to nuclear or mitochondrial DNA mutations. An analysis of peripheral blood mononuclear cells (PBMCs) from 7 FMS patients versus 7 controls revealed morphological changes in mitochondria of FMS patients, primarily a loss of mitochondrial cristae. These findings suggest that mitochondrial dysfunction may contribute to the chronic pain and fatigue seen in FMS,” lead investigator Chiara Macchi, MD, Department of Pharmacological and Biomolecular Sciences “Rodolfo Paoletti”, Università Degli Studi di Milano, Milan, Italy, and colleagues wrote.¹

Macchi and colleagues studied mitochondrial dysfunction in peripheral blood mononuclear cells isolated from 50 patients with primary FMS and 20 apparently healthy controls. They did not find any differences in mitochondrial basal respiration between patients with primary FMS and healthy controls, but they did find that people with FMA had a lower median BHI (−22.1%, P =.03) than healthy controls.¹

The investigators also found patients with fibromyalgia severity scores (FSS) of at least 20 had a lower median BHI (−18.7%) compared to those with an FSS under 20. There were moderate negative moderate correlations between BHI and FSS (r = − 0.36) and widespread pain index (r = − 0.38).

“In our study, we observed impaired mitochondrial function in patients affected with primary fibromyalgia syndrome. Notably, the degree of impairment was more significant in patients with a more severe clinical phenotype and a more evident correlation with musculoskeletal pain was observed,” Macchi and colleagues concluded.¹ “Our findings support the possibility to use the measurement of this imbalance as a biomarker in the diagnosis and follow-up of patients with fibromyalgia syndrome. Our results underscore the need for further investigations in a larger cohort to identify potential biomarkers and treatment targets for this debilitating condition, which significantly impacts quality of life and currently lacks specific etiopathogenic treatments.”

Another recent study comparing 24 healthy controls to 17 people with FMS found some significant differences in gut microbiome diversity between these groups. The investigators found that HHV-6B was present in the PBMCS of 4 participants and the buccal swabs of 3 (23.5%) with FM compared with presence in the PBMCs of 4 control group participants (16.6%), although this difference was not statistically significant (P = 0.6975).²

Comparing cytokine levels between HHV-6B DNA-positive and negative patients with FM revealed significantly elevated levels of TNF-α (P = .03) in those that were positive. Notably, participants with FM and a body mass index (BMI) of 30 or higher had elevated of IL-1β, IL-2, TNF-α, and IL-17A/CTLA levels compared to those with the same BMI range in the control group, although these differences were also not statistically significant.²

Investigators also found that the gut microbiome in participants with FM was less diverse than in the control group, as shown on a-diversity metrics with both Shannon’s (P = 0.03), and inverse Simpson’s (P = 0.03) indices being significantly higher in control group participants (4.11 ± 0.4 and 30.74 ± 13.9, respectively) than in participants with FM (3.78 ± 0.5 and 20.98 ± 13.7, respectively.²

REFERENCES

1. Macchi C, Giachi A, Fichtner I, et al. Mitochondrial function in patients affected with fibromyalgia syndrome is impaired and correlates with disease severity. Sci Rep (2024): 14(30247). doi: 10.1038/s41598-024-81298-x

2. Ievina L, Fomins N, Gudra D, Kenina V, Vilmane A, Gravelsina S, Rasa-Dzelzkaleja S, Murovska M, Fridmanis D, Nora-Krukle Z. Human Herpesvirus-6B Infection and Alterations of Gut Microbiome in Patients with Fibromyalgia: A Pilot Study. Biomolecules. 2024; 14(10):1291. doi: 10.3390/biom14101291