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Fibromyalgia is characterized by chronic symptoms (moderate to severe), including pain, fatigue, cognitive and sleep disorders. Difficult to diagnose and incurable, it affects 2 to 4% of the adult population, and in particular women. Researchers have shown significant alterations in bile-metabolizing bacteria in the intestine and bile acids in the blood in these patients. Using artificial intelligence to identify a specific biological signature could aid in the diagnosis of fibromyalgia.
In recent years, evidence for the critical role of the gut microbiota in a variety of pathologies — including metabolic, cardiovascular, neurological and psychiatric disorders — has accumulated. Researchers from the Research Institute of the McGill University Health Center (Canada) are particularly interested in the link between the intestinal flora and fibromyalgia. In 2019, they showed for the first time that the intestinal microbiota of patients with fibromyalgia showed significant alterations compared to that of controls. Moreover, its composition was correlated with the severity of the symptoms.
As part of the fibromyalgia microbiota project (carried out between 2017 and 2018), this team of scientists continued their research to better understand the association between intestinal bacteria and the syndrome. ” Our results show a strong relationship between the composition of patients’ microbiota, bile acids and the severity of fibromyalgia symptoms. », declares in a statement from the university the study’s lead author, Dr. Yoram Shir.
Biological signature of bile acids
In particular, changes in the relative abundance of certain bile acid metabolizing bacteria have been noted. As a reminder, bile acids (secreted by the liver) help digest oils and fats in the body. Once assimilated by the intestine, they circulate towards the liver and the blood and become secondary bile acids.
« The change in bile acids that we observed in patients with fibromyalgia in our study is distinct enough to be used as an effective biological signature to detect people with fibromyalgia. “, explains Dr. Amir Minerbi, co-author of the study, which compares 42 women with the disease with 42 healthy women.
Indeed, the researchers observed alterations in the concentration of several bacterial species known to metabolize bile acids in women with fibromyalgia, compared to controls. They were accompanied by alterations in the concentration of secondary bile acids in the blood, in particular alpha-muricholic acid (aMCA): on average five times less present in patients with fibromyalgia than in healthy participants. The presence of the acid was negatively correlated with most symptoms of the disease, including pain, fatigue, non-restorative sleep and cognitive impairment.
A link between bile acid levels and symptoms
The research team collected stool samples for microbiota bacteria analysis, as well as blood samples for bile acid analysis. To see if there was a link between the changes observed and the severity of the symptoms, the participants were asked to evaluate several parameters: pain, fatigue, quality of sleep, cognitive problems, muscle stiffness, symptoms of anxiety and depression, etc The new study establishes the first significant association of blood bile acid levels with chronic pain.
The researchers also relied on artificial intelligence to more easily diagnose the disease. They found that the specific presence of six secondary bile acids predicted whether a person had fibromyalgia, with over 90% accuracy. ” Statistical learning algorithms could accurately detect people with the disease using the concentration of these serum bile acids “, write the authors in Pain.
Although the study is awaiting re-reading and the sample of patients interviewed remains small, the researchers believe that their results provided an accurate biological signature of fibromyalgia and that artificial intelligence may be able to improve the diagnosis of the disease.
Source : Pain
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