Antipolymer antibody reactivity in a subset of patients with fibromyalgia correlates with severity

Objective. To determine the prevalence of antipolymer antibodies (BPA) in p atients with fibromyalgia (FM) and autoimmune disease control groups and to determine if the presence of these antibodies correlates with severity in patients with FM. Methods, Sera from patients with FM (n = 47), osteoarthritis (OA) (n = 16), and rheumatoid arthritis (RA) (n = 13) were analyzed. Patients with implan ts of any kind and patients with concurrent autoimmune conditions were excl uded from study. Banked sera from autoimmune disease controls including pol y/dermatomyosis (n = 15), RA (n = 30), systemic lupus erythmatosus (SLE) (n = 30), and systemic sclerosis (SSc) (n = 30) were also analyzed. To determ ine if seroreactivity correlates with severity. banked sera from patients w ith FM assessed as severe (n = 28) or mild (n = 37) and from controls (n = 21)wen assayed. Results. Following analysis, the prevalence of seroreactivity was found to br higher in patients with FM (22/47, 47%) compared to patients with OA (3/ 16, 19%: p < 0.1) or RA(1/13, 8%; p < 0.05) and the autoimmune disease cont rol sera from poly/dermatomyosis (15, 13%; p < 0.05). and patients with RA( 3/30, 10%: p < 0.01), SLE (1/30, 3% p < 0.01), and SSc (1/30, 3% : p < 0.01 ). The prevalence of APA seroreactivity was also significantly higher in pa tients with severe FM (17/28, 61%) compared to patients with mild FM (11/37 , 30%; p < 0.05) and controls (4/21, 19%: p < 0.01). In addition, both mean threshold and mean tolerance dolorimetry scores were significantly lower i n the seropositive patients with mild FM (1.33 +/- 0.21, 1.95 +/- 0.25, res pectively) compared to the seronegative patients (1.83 +/- 0.08, 2.53 +/- 0 .11; p < 0.05 for both comparisons, respectively). Conclusion. These results reveal that an immunological response, production of anti-polymer antibodies. is associated with a subset of patients with F M. The results also suggest that the APA assay may be an objective marker i n the diagnosis and assessment of FM and may provide additional avenues of investigation into the pathophysiological processes involved in RM.