New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It

New UAB Study Could Radically Change Fibromyalgia Treatment As We Know It

By Donna Gregory Burch

For more than a decade, Dr. Jarred Younger‘s research has been guided by one theory: Fibromyalgia is caused by an overreactive immune system. This spring, he’ll finally prove once and for all if his theory is correct, and the outcome could profoundly shift the future of fibromyalgia research.

Jarred Younger, PhD.
Photo courtesy Stanford School of Medicine.

Beginning this month, Younger and his team at the University of Alabama at Birmingham (UAB) will inject up to 20 fibromyalgia patients and 20 healthy controls with ultra-low doses of lipopolysaccharide (LPS), a molecule that’s found on the exterior of certain infection-causing bacteria, which triggers the body’s immune system response. He anticipates the fibromyalgia patients’ immune systems will overreact to small doses of LPS while the healthy controls will show little or no reaction.

“If our hypothesis is correct, it’s going to tell us that fibromyalgia is definitely an immune central centralization condition, and therefore the treatments need to focus on novel types of anti-inflammatories,” Younger said. “What that means is we don’t have to worry about these other [body] systems. We shouldn’t focus on neurons. We shouldn’t focus on the autonomic nervous system. We need to focus on the immune system. What that will then mean is we need to go back and revisit anti-inflammatories [that are known to cross the blood/brain barrier] that have already been created but never tried in fibromyalgia. Maybe one of those will work very well.”

Drugs used for autoimmune conditions, like multiple sclerosis and rheumatoid arthritis, would be obvious contenders, but there are also dozens of over-the-counter botanical treatments that also might prove useful in calming an overstimulated immune system.

If Younger can finally prove fibromyalgia is the result of a malfunctioning immune system, it could lead to a big shift in the current approach to fibromyalgia treatment. The drugs approved to treat fibro – Lyrica, Cymbalta and Savella – all work to calm the central nervous system. They do not affect the immune system. That could explain why none of these drugs work very well in fibro patients.

Younger is currently recruiting fibromyalgia patients who live near Birmingham, Alabama, for the LPS study. Patients will be required to travel to UAB on two days. On the first day, participants will receive an IV drip containing an ultra-low dose of LPS in a hospital setting and will then be monitored throughout the day with regular blood draws. A few weeks later, participants will return to UAB to repeat the same process – this time with a slightly higher dose of LPS.

“The key here is we’re giving [LPS] at a lower dose than we’ve ever seen used in human research so that means we know this is ultra, ultra safe because the dose is so low,” Younger said. “We’re giving it at such a low dose that healthy individuals will not notice it at all. What I hypothesize will happen though is that in the individuals with fibromyalgia that same really low dose will be enough to have a hyper [immune system] response from them. We will be doing blood draws to look at all the immune components to see how the immune system is responding.”

If the fibromyalgia patients overreact to the LPS IV solution, “it will leave no doubt in my mind that we know what is happening in fibromyalgia, and it’ll outline a distinct set of steps we can do within a few years to hone in on an effective treatment,” Younger said.

Younger and his team expect to finish the LPS study by July and will probably announce their results in August.

If you have fibromyalgia and live in the Birmingham area, click here if you’re interested in participating in the LPS study.

Donna Gregory Burch

Donna Gregory Burch was diagnosed with fibromyalgia in 2014 after several years of unexplained pain, fatigue and other symptoms. She was later diagnosed with chronic Lyme disease. Donna covers news, treatments, research and practical tips for living better with fibromyalgia and Lyme on her blog, FedUpwithFatigue.com. You can also find her on Facebook and Twitter. Donna is an award-winning journalist whose work has appeared online and in newspapers and magazines throughout Virginia, Delaware and Pennsylvania. She lives in Delaware with her husband and their many fur babies.

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Authored by: Donna Gregory Burch

There are 12 comments for this article
  1. Lauren at 5:48 pm

    I have to say, I’m hoping he’s right! After battling Fibromyalgia for years, I was shocked to find out that I was harboring Mycobacterium Avium Intracellulare Complex behind both of my breast implants (which were 21 years old.) Never has my surgeon found this type of Mycobacterium. We are all exposed to this bug in various water systems and our bodies are supposed to be able to conquer it without even knowing we have it! That is unless our immune system is compromised… For the longest I ran the occasional 99 degree temp and didn’t know why. We still don’t know how it got behind BOTH implants. Quite strange, but this study would certainly explain a lot.

  2. R. Aren at 2:33 pm

    All respect and appreciation to patients volunteering in this study — they’ll be accepting a significant degree of misery, and possibly of harm or even danger, and that is no small consideration.

    Please note: there’s a mistaken word in paragraph 3 of the article, where it says “… to tell us that fibromyalgia is definitely an immune central centralization condition…” the word CENTRALIZATION is incorrect. The word that belongs there is SENSITIZATION.

    Central Sensitization is a concept of many years’ investigation, notably by MB Yunus. Google Scholar offers a few useful cites among hundreds, possibly thousands by now, in the professional peer-reviewed literature:
    https://scholar.google.com/scholar?q=Central+Sensitization+Yunus&hl=en&as_sdt=0&as_vis=1&oi=scholart&sa=X&ved=0ahUKEwiQjqWgxMDTAhUH2GMKHWGoA9IQgQMIIDAA

    It may be a sign of underfunding that research has only progressed to its current level, ‘tho’ it’s also true that greatest accuracy in findings requires exquisitely small, exhaustively controlled steps. Results may not radically change healthcare delivery for fibromyalgia patients any time soon, but our close following of the research field sometimes gives guidance for modifying our own daily self-care.

    Here’s hoping.

  3. Emiy at 1:07 pm

    Funny, NSAIDS do nothing for my pain. The only things that work are exercise (walking or recumbant bike), Tylenol Arthritis or Hydrocodone, and 5% Lidocaine patches). I would say sex, but the next day I am in a flare and don’t get me wrong, I do enjoy sex, just pay for it the next day.

  4. Kathy Malles-overcast at 10:12 am

    What your saying makes sense. I know 2 different lady’s who had nothing wrong with them, but once they became pregnant and their hormones changed they both developed lupus in a very bad case of it. One of these lady’s once she wasn’t pregnant any longer it went away, and when she got pregnant again it came back in full force! I also so lady’s who were completely normal before getting pregnant, but once they became pregnant, and hormones changed they developed bipolar disease. So the changing of hormones does seem to set things off in the body that didn’t show before. I’ve always wondered if my changing hormones didn’t set of my really sever case of fibromyasia. I first started experiencing symptoms of fibro, when I started going through menopause, and for the first 3 years all the symptoms I was having were blamed on menopause by my Dr. even though from everything I looked up, I kept telling him. “no, there is something more going on here” he kept insisting it was menopause, and finally after 3 years he agreed it was something more. So was in just coincident that my fibro started at the same time as menopause, or did the menopause set it off???

  5. Jean Price at 2:40 pm

    With auto-immune diseases…the whole immune system is ALREADY overreactive! So, I just wonder if this protocol WILL show enough increased inflammation to draw any conclusions! (Since a very low infection or small amount of bacteria protein could perhaps be fought off by the level of hyper-immune activity already happening! The doctor seems pretty confident…and I’m sure he is a lot smarter than me…yet it just seems like an odd way to prove increased inflammation, when he believes it’s supposed to be already excessive…normally….for those with fibromyalgia!! Guess we’ll see!

    Auto-immune/inflammatory/connective tissue disease all seem to relate to hormones, too! And yet it appears very little of this area has been actually studied in reference to these diseases! When some auto immune diseases…like for instance Lupus…occur mostly in women…AND mostly between the ages of puberty and menopause…it makes sense to me to look at how hormone factors can cause diseases and symptoms, too….thoroughly researching this area first!

    Although hormones, immune function, and the whole endocrine system are so entangled AND reactive to each other, I’m guessing it would be difficult and expensive to sort out all of these factors! The various biologicals used now to treat some auto-immune diseases mostly address T-cell levels and the body’s Tumor Necrisis Factor levels, so this makes me wonder how those also affect fibromyalgia, and if someone is studying this also! Lots to research…and sadly, lots of people are suffering in the meantime!

  6. Cynthia Manca at 11:30 am

    To Anne Nickol,
    I used to take NASIDS too but can no longer take it. I now take extra strength Tylenol. Have you tried switching?

  7. Cynthia Manca at 11:24 am

    This article made a lot of sense to me in regards to the Rx’s prescribed in this article. I have Lupus & Fibromyagia, I tried Lyrica but could not tolerate the side effects. I was on Cymbalta for many years and it did nothing for Fibromyagia, in fact, I had to come off it for some testing & had Horrible side effects for several months & still feel some dizziness. I have elected not to go back on it. While I tried to work though the pain of both these ailments, arthritis & muscular, what I’ve found helpful for me is periodic low doses of Medrol (two 4mg tabs).Although I can lose up to five pounds in the course of a week, it is usually short lived, as I will gain most back.Aside from this, I get more relief using this method than any other.My eldest sister who also had Lupus & Fribro, died of renal disease. After years suffering, in & out of hospitals,she took whatever meds given to her, I chose to do my own research & question the usual course of meds for these ailments. I congratulate your research & wish I lived close by to participate but will continue to follow your efforts.

  8. Bob Schubring at 9:30 am

    Anne Nickol’s comment has one sentence that’s of extreme value to all pain patients: “But with my pain levels, I cannot get myself to stop taking ibuprofen”.

    Anne’s ibuprofen habit is not a habit that conventionally, Americans would believe to be an addiction. Nobody ever gets high on ibuprofen. Yet when pain patients dependent on opioids to feel normal, express the same concept to describe how they feel, they are shouted down or ignored. Opioid-dependent pain patients do not stop taking their medicine because at their pain levels, they cannot get themselves to stop the medicine and start feeling additional pain.

    I totally agree with Anne. If this experiment proves that fibromyalgia is an inflammation of the muscles, nerves, and/or brain, it will be a breakthrough. And the next step will be to devise an inflammation treatment that does little or no harm to the liver and kidneys. Meanwhile we’re stuck with relieving the symptoms, and that means we have to fix the broken thinking, of an entire generation of Americans who grew up on Nancy Reagan’s anti-drug propaganda, who now live in terror of the rare form of mental illness known as addiction.

  9. Kathy Malles-overcast at 9:08 am

    please keep us updated on follow-ups of this article. I have tried getting I.V. drips of alpha lipoic acid, which is suppose to be and noninflammatory and it doesn’t seem to help

  10. Patricia at 8:37 am

    I was misdiagnosed with n autoimmune disease in 2010. The condition was labeled undifferentiated spondyloarthropy. For 4 years I took many different medications with no improvement in my pain and fatigue issues. Drugs included steroids, methotrexate, Embrel, Humira, and Simponi. I finally had to quit my job due to this debilitating disease. Thus I am skeptical that this disease is based on an overactive immune system.

  11. Rebecca Fraley at 7:36 am

    My daughter was first diagnosed with fibro. Her health issues surpassed fibro. Finally after many rheumatologist and doctors, found she has EDS.
    EDS does not have bone pain and swelling, as this had developed 3 years into being disabled. Seizures, and severe pain attacks to unconsciousness also..
    I kept searching.
    Found Lyme disease and co-infections.
    She is disabled beyond able to take care of herself due to pain.
    Anyone with any muscular, neurological disorder should check for EDS and Lyme.

  12. Anne Nickol at 7:09 am

    I used to hear that fibromyalgia was not an inflammatory disease. But I knew Ibuprofen helps with my pain, so I did not believe that was true. Now, I am reading a lot about how inflammation causes so many health problems. And Fibromyalgia has now been added to the list.

    I recently listened to a live steam report from Johns Hopkins on inflammation and its contribution to so many diseases; diabetes, heart disease, etc.

    I am hoping that when this theory is proven about fms, that other drugs will be found to help us. I limit my Ibuprofen to 4 a day, but worry about all the news lately of how NASIDS are so harmful and contribute to heart, kidney, and other health problems. But with my pain levels, I cannot get myself to stop taking Ibuprofen.

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