by Cort Johnson
We tend to think of fibromyalgia as a central nervous system disease but that focus has tended to obscure the growing evidence of problems in the body.
We don’t tend to think of fibromyalgia as an inflammatory disorder. It’s true that overt signs of inflammation are rarely found in people with FM but some studies suggest inflammatory factors may play a role.
Then there are the mitochondria. Mitochondrial dysfunction is thought of as a real possibility in chronic fatigue syndrome, but I’ve rarely associated it with fibromyalgia or pain. It turns out, however, that multiple studies – most of them small – suggest that mitochondrial dysfunction could indeed play a significant role in fibromyalgia. Could fibromyalgia, whatever else it is – also be a mitochondrial disorder?
A mitochondrial disorder?
Studies suggest the energy factories may be running a bit low in FM. Muscle biopsies have found patterns of mitochondrial dysfunction (abnormal mitochondria, mitochondrial defects and muscle fiber abnormalities) similar to those typically found in mitochondrial disorders. Some skin biopsies have shown patterns of neurogenic inflammation and oxidative stress – two factors that negatively impact the mitochondria. Peripheral blood cells have demonstrated CoQ10 deficiency, mitochondrial dysfunction, oxidative stress and mitochondrial degradation.
In 2013 a Spanish group proposed that mitochondrial dysfunction in FM patient was driving an inflammatory process. Now, in 2015 they have returned with a study looking at mitochondrial dysfunction, oxidative stress and inflammation using skin biopsies from people with FM.
Oxidative stress, mitochondrial dysfunction and, inflammation common events in skin of patients with Fibromyalgia. Benito Sánchez-Domínguez a,1, Pedro Bullón a,1, Lourdes Román-Malo a, Fabiola Marín-Aguilar a, Elísabet Alcocer-Gómez b, Angel M. Carrión c, José Antonio Sánchez-Alcazar b,d, Mario D. Cordero a. Mitochondrion 21 (2015) 69 – 75
Given the allodynia present, and the increasing evidence of small fiber neuropathy in FM, the skin is becoming an ever more intriguing place to look in fibromyalgia. Something, after all, is “burning away” those small unmyelinated nerve fibers in their skin. Is it inflammation? Are the mitochondria going bananas? (Could it be both?). This study won’t tell us what’s causing the SFN or allodynia in FM – it’s not going to assess either of them – but it may provide some suspects future studies can follow up on.
This small Spanish study looked at the levels of mitochondrial enzymes, mitochondrial proteins, ATP, CoQ 10 and TNF-a from a small patch of skin in the left shoulder region, as well as in the blood and saliva of 23 people with FM and 20 healthy controls.
A mitochondrial disorder
Significant reductions in mitochondrial enzyme activity (in complexes I, II, III and IV) were found in the FM patients but not the healthy controls. That in combination with reduced levels of mitochondrial proteins indicated that mitochondrial functioning was indeed significantly reduced. So were CoQ10 and ATP levels and mitochondrial DNA levels. In fact, every aspect of mitochondrial functioning tested was found to have taken a significant hit in the FM patients…