Antipolymer antibody reactivity in a subset of patients with fibromyalgia (FM) correlates with severity

OBJECTIVE: To determine the prevalence of antipolymer
antibodies (APA) in patients with fibromyalgia (FM) and
autoimmune disease control groups and to determine if the
presence of these antibodies correlates with severity in
patients with FM.

METHODS: Sera from patients with FM (n =
47), osteoarthritis (OA) (n = 16), and rheumatoid arthritis
(RA) (n = 13) were analyzed. Patients with implants of any
kind and patients with concurrent autoimmune conditions were
excluded from study. Banked sera from autoimmune disease
controls including poly/dermatomyosis (n = 15), RA (n = 30),
systemic lupus erythmatosus (SLE) (n = 30), and systemic
sclerosis (SSc) (n = 30) were also analyzed. To determine if
seroreactivity correlates with severity, banked sera from
patients with FM assessed as severe (n = 28) or mild (n = 37)
and from controls (n = 21) were assayed.

RESULTS: Following
analysis, the prevalence of seroreactivity was found to be
higher in patients with FM (22/47, 47%) compared to patients
with OA (3/16, 19%; p<0.1) or RA (1/13, 8%; p<0.05) and the
autoimmune disease control sera from poly/dermatomyosis (2/15,
13%; p<0.05), and patients with RA (3/30, 10%; p<0.01), SLE
(1/30, 3%; p<0.01), and SSc (1/30, 3%; p<0.01). The prevalence
of APA seroreactivity was also significantly higher in
patients with severe FM (17/28, 61%) compared to patients with
mild FM (11/37, 30%; p<0.05) and controls (4/21, 19%; p<0.01).
In addition, both mean threshold and mean tolerance
dolorimetry scores were significantly lower in the
seropositive patients with mild FM (1.33+/-0.21, 1.95+/-0.25,
respectively) compared to the seronegative patients
(1.83+/-0.08, 2.53+/-0.11; p<0.05 for both comparisons,

CONCLUSION: These results reveal that an
immunological response, production of anti- polymer
antibodies, is associated with a subset of patients with FM.
The results also suggest that the APA assay may be an
objective marker in the diagnosis and assessment of FM and may
provide additional avenues of investigation into the
pathophysiological processes involved in FM.

Wilson RB, Gluck OS, Tesser JR, Rice JC, Meyer A, Bridges AJ

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