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Altered microbiome composition in individuals with fibromyalgia

Minerbi, Amir1; Gonzalez, Emmanuel2,3; Brereton, Nicholas J.B.4; Anjarkouchian, Abraham5; Dewar, Ken3,6; Fitzcharles, Mary-Ann1,7; Chevalier, Stéphanie5,8,9; Shir, Yoram1

doi: 10.1097/j.pain.0000000000001640
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Fibromyalgia (FM) is a prevalent syndrome, characterised by chronic widespread pain, fatigue and impaired sleep, that is challenging to diagnose and difficult to treat. The microbiomes of 77 women with FM and that of 79 control participants were compared using 16S rRNA gene amplification and whole genome sequencing. When comparing FM patients to unrelated controls using differential abundance analysis, significant differences were revealed in several bacterial taxa. Variance in the composition of the microbiomes was explained by FM-related variables more than by any other innate or environmental variable and correlated with clinical indices of FM. In line with observed alteration in butyrate metabolising species, targeted serum metabolite analysis verified differences in the serum levels of butyrate and propionate in FM patients. Using machine learning algorithms, the microbiome composition alone allowed for the classification of patients and controls (ROC AUC 87.8%). To the best of our knowledge, this is the first demonstration of gut microbiome alteration in non-visceral pain. This observation paves the way for further studies, elucidating the pathophysiology of FM, developing diagnostic aids and possibly allowing for new treatment modalities to be explored.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

1Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, Quebec, Canada

2Canadian Center for Computational Genomics, McGill University and Genome Quebec Innovation Center, Montreal, Quebec, Canada

3Department of Human Genetics, McGill University, Montreal, Quebec, Canada

4Institut de recherche en biologie ve[Combining Acute Accent]ge[Combining Acute Accent]tale, University of Montreal, Montreal, QC H1X 2B2, Canada

5School of Human Nutrition, McGill University, 21111 Lakeshore Rd, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada

6McGill University and Genome Quebec Innovation Center, McGill University, Montreal, Quebec, Canada

7Division of Rheumatology, McGill University Health Centre, Quebec, Canada

8Research Institute of the McGill University Health Centre, 1001 Décarie Blvd, Montreal, QC H4A 3J1, Canada

9Department of Medicine, McGill University, 845 Sherbrooke St. W, Montreal, QC H3A 0G4, Canada

Address of corresponding author: Amir Minerbi, Montreal General Hospital, McGill University Health Centre, 1650 Cedar ave., Montreal, Quebec, H3G 1A4 Tel: 514-9348222 Fax: 514-934-8096 E-mail:mailto:mary-ann.fitzcharles@muhc.mcgill.caminerbi@gmail.com

© 2019 International Association for the Study of Pain