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More evidence for immune-system test to diagnose Fibromyalgia

Monday 4 November 2013

 

From About.com's Adrienne Dellwo:

 

Test tubes
 

More Evidence for Immune-System Test to Diagnose Fibromyalgia

By Pat Anson, Editor
October 26th, 2013

Research Brief

According to research just presented at the American College of Rheumatology annual meeting, a diagnostic laboratory test for fibromyalgia may come from an immune system profile.

Currently, fibromyalgia is diagnosed based on symptoms, a clinical exam, and tests to exclude diseases with similar symptoms. Every year, a few studies come out that, with continued research and validation, could lead to an objective lab test.

It's not often, however, that we hear of immune-system components such as cytokines and chemokines when it comes to this condition. They've had far more attention in research on chronic fatigue syndrome and autoimmune diseases.

However, this study appears to confirm findings released in December 2012. The new research involved about 100 people with fibromyalgia, 90 controls, 25 with lupus and 25 with rheumatoid arthritis, and looked at cytokine/chemokine profiles in each group. Once again, researchers found a unique profile in fibromyalgia.

Cytokines are specialized cells in the immune system that communicate messages to other cells in order to coordinate an attack on invading pathogens, such as virus or bacteria. Chemokines are a type of cytokine that attracts immune activity to such pathogens.

In lupus and rheumatoid arthritis, along with chronic fatigue syndrome, these cells abound, demonstrating the chronic immune response that's a central feature of those illnesses. These three conditions share many symptoms with fibromyalgia and it's often difficult for doctors to tell them apart.

In fibromyalgia, according to this study and its predecessor, cytokine and chemokine levels are especially low, even when compared to healthy people. That suggests the immune dysfunction of fibromyalgia is significantly different from the other conditions. That's important, especially since it's further evidence that fibromyalgia is not autoimmune.

Also important, among participants, researchers say the test was able to:

  • Identify people with fibromyalgia with a small degree of error;
  • Separate those with fibromyalgia from those with lupus or rheumatoid arthritis.

(To see the abstract, go to page 367 of the PDF for the annual meeting.)

If these studies are correct, this could be great news. Who among us wouldn't be grateful for a lab test to validate everything we go through?

The Big "But"

Here's where I give you a warning. The company behind both of these studies, EpicGenetics, has had a test for sale since the first study. I wrote about that back in March. As I did then, I still believe it's probably not a good idea to rush out and buy it.

Yes, I said "buy." It's a mail-order test, not one you can get at the doctor's office, and it'll cost you about $750. Some of us would gladly pay that much for validation, I have no doubt.

BUT, it must be noted that the medical community at large has not accepted this test as a valid means of diagnosing fibromyalgia. Two studies, performed by the manufacturer, with data released less than a year apart, is not enough.

So you could pay a lot of money for a test, get a positive result, and triumphantly show it to your fibro-skeptical doctor only to have him say, "That's not a valid test." Cue crushing disappointment.

It could be that this test will eventually be the gold standard for diagnosing fibromyalgia. I hope it is, because the company seems aggressive about getting it out there, and we need something a few decades ago. But, for now, it's too early to say.

Meanwhile, rest assured that we get 2 or 3 studies every year that show promise at leading to better diagnostics for us. It'll happen, when the science is there. That reminds me of a great mock protest sign I've seen that said:

"What do we want?"

"Evidence-based change!"

"When do we want it?"

"After peer review!"

What would a widely accepted diagnostics test mean for you? Have you ever paid for a mail-order lab test? Did your doctor consider it valid? Leave your comments here!

 

The above, with comments, originally appeared here.

 


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