A comparative study on antibodies to nucleoli & 5-hydroxytryptamine in patients with fibromyalgia (FM) syndrome & tryptophan-induced eosinophilia-myalgia syndrome

Eosinophilia myalgia syndrome (EMS) has been related to intake of

“contaminated” L-tryptophan, and an alteration in tryptophan

5-hydroxytryptamine (5-HT, serotonin) metabolism has been

reported in EMS patients. Recently we found that a defined

autoantibody pattern consisting of antibodies to nucleoli,

gangliosides, and phospholipids is closely related to the

fibromyalgia syndrome (FS) which clinically resembles the EMS.

We were therefore interested to see whether these antibodies

can also be detected in patients with EMS. Studied were 27

patients with acute EMS (13 of whom were also examined 2 years

after acute onset), 100 patients with FS, and 40 patients with

progressive systemic sclerosis (PSS). As controls, sera from

100 blood donors were analyzed. Antibodies to nucleoli were

demonstrated by immunofluorescence test on cell cultures in

52% of patients with acute EMS, 62% of patients with chronic

EMS, and 37% of FS patients. Western blotting with a nuclear

extract from HeLa cells revealed in both diseases the same

epitopes at 63, 57, and 53 kDa. Antibodies to 5-HT,

gangliosides (Gm1), and phospholipids were determined by

enzyme-linked immunosorbent assay. Among patients with FS 73%

had antibodies to 5-HT, in contrast to only 19% of patients

with acute EMS. However, 77% of the 13 EMS patients analyzed 2

years later had become anti-5-HT antibody positive during that

time. Also the incidence of antibodies to Gm1 increased from

37% at acute onset to 69% in patients with chronic EMS (30%).

The various antibodies were detected in only 18% of healthy


Klein R, Berg PA

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