General Medicine Practice Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia.
Department of of Medical Physiology, Kasr Alainy, Faculty of Medicine, Cairo University, Giza 11562, Egypt.
Egypt J Immunol. 2024 Oct;31(4):13-26.
Fibromyalgia (FM), a musculoskeletal condition characterized by widespread pain and numerous associated symptoms, is a complex disorder with uncertain etiology and pathogenesis. Most of the patients suffering from this syndrome are undiagnosed due to a lack of standard diagnostic criteria. Recent studies have shown the involvement of immune dysfunction and various pro-inflammatory cytokines in FM. Since there is so much uncertainty regarding the pathogenesis of FM, treatment modalities are very limited and ineffective. This review aimed to analyze the immunological mechanisms behind FM, attempting to deepen the understanding of its pathogenesis. Additionally, the review elucidates FM's associations with autoimmune diseases, highlighting shared pathophysiological mechanisms and overlapping symptoms. We synthesized current literature available on Google Scholar, PubMed, Springer, and Web of Science, the review explored the intricate interactions between genetic predisposition, immune dysregulation, and environmental factors in FM pathogenesis. The inclusion criteria prioritized studies focusing on the immunological aspect of FM. In conclusion, immune dysfunction has a role to play in the pathogenesis of FM, and immunomodulatory therapies have proven to be beneficial in the treatment of FM. Genetic variants, epigenetic modifications, and gut microbiome alterations are potential triggers for immune system dysfunction, contributing to the manifestation and exaggeration of FM symptoms. This review provided a comprehensive resource for researchers and clinicians, a guide for future investigations and clinical management towards improved outcomes and enhanced quality of life for individuals with FM.
纤维肌痛症(FM)是一种以广泛疼痛和多种相关症状为特征的肌肉骨骼疾病,是一种病因和发病机制尚不清楚的复杂疾病。由于缺乏标准的诊断标准,大多数患有这种综合征的患者未被诊断出来。最近的研究表明,免疫功能障碍和各种促炎细胞因子参与了 FM。由于 FM 的发病机制存在很大的不确定性,治疗方法非常有限且无效。本综述旨在分析 FM 背后的免疫学机制,试图加深对其发病机制的理解。此外,该综述还阐明了 FM 与自身免疫性疾病的关联,突出了共同的病理生理机制和重叠症状。我们综合了 Google Scholar、PubMed、Springer 和 Web of Science 上现有的文献,综述探讨了遗传易感性、免疫失调和环境因素在 FM 发病机制中的复杂相互作用。纳入标准优先考虑了关注 FM 免疫学方面的研究。总之,免疫功能障碍在 FM 的发病机制中起作用,免疫调节疗法已被证明对 FM 的治疗有效。遗传变异、表观遗传修饰和肠道微生物组改变是免疫系统功能障碍的潜在触发因素,导致 FM 症状的表现和加重。本综述为研究人员和临床医生提供了一个全面的资源,为未来的研究和临床管理提供了指导,以改善 FM 患者的预后和生活质量。