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Small fibre pathology as biomarker for fibromyalgia

Presented by
Dr Dimitar Evdokimov, University of W√ľrzburg, Germany
EAN 2020
Results from a German study add further evidence to the concept of small nerve fibre impairment in fibromyalgia syndrome (FMS) as peripheral contributor to FMS pain [1]. Indications were found for systemic and local microRNA alterations in FMS, that may serve as diagnostic signatures and treatment target.

Skin biopsy, quantitative sensory testing, corneal confocal microscopy, pain-related evoked potentials, and microneurography were applied in 156 FMS patients. Blood samples and keratinocyte cultures from skin punch biopsies were collected to assess potential systemic and local microRNA signatures. MicroRNAs are small molecules that regulate gene expression and  may be promising biomarkers to identify and characterise chronic pain types.

In a subgroup of FMS patients, small fibre pathology including morphological, functional, and electrophysiological properties was found. In 98 patients (63%), skin innervation was abnormal and associated with disease severity. In blood and keratinocyte microRNA analysis, 69 and 41 deregulated microRNAs were found, respectively. Potential key pathways presenting themselves were fatty acid synthesis and factor forkhead box protein O1 (FOXO1) signalling in blood, and extracellular matrix receptor signalling in keratinocytes. miR-576-5p was validated as a microRNA that can distinguish between FMS and healthy controls (P<0.001), and between FMS and patients with depression with pain that served as disease controls (P<0.01). The authors deduced that the extent of small fibre impairment may reflect FMS severity.

  1. Evdokimov D, et al. Abstract EPR3053­, EAN 2020.


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