Date: July 24, 2013
Researchers develop reliable way to use finger-stick blood sample
to detect fibromyalgia syndrome
Researchers have developed a reliable way to use a finger-stick blood
sample to detect fibromyalgia syndrome, a complicated pain disorder
that often is difficult to diagnose. If it were someday made available
to primary care physicians, the test could knock up to five years off
of the wait for a diagnosis, researchers predict.
In a pilot study, the scientists used a high-powered and specialized
microscope to detect the presence of small molecules in blood-spot
samples from patients known to have fibromyalgia. By 'training' the
equipment to recognize that molecular pattern, the researchers then
showed that the microscope could tell the difference between
fibromyalgia and two types of arthritis that share some of the same
Though more analysis is needed to identify exactly which molecules are
related to development of the disorder itself, the researchers say
their pilot data are promising. 'We've got really good evidence of a
test that could be an important aid in the diagnosis of fibromyalgia
patients,' said Tony Buffington, professor of veterinary clinical
sciences at The Ohio State University and senior author of the study.
'We would like this to lead to an objective test for primary care
doctors to use, which could produce a diagnosis as much as five years
before it usually occurs.'
Patients with fibromyalgia are often desperate by the time they
receive treatment because of the lengthy process required to make a
diagnosis. The main symptoms, persistent pain and fatigue, mimic many
other conditions, so physicians tend to rule out other potential
causes before diagnosing fibromyalgia. Additional symptoms include
disrupted sleep and memory or thought problems. An estimated 5 million
American adults have the disorder, according to the National Institute
of Arthritis and Musculoskeletal and Skin Diseases.
'The importance of producing a faster diagnosis cannot be overstated,
because patients experience tremendous stress during the diagnostic
process. Just getting the diagnosis actually makes patients feel
better and lowers costs because of reductions in anxiety,' said Kevin
Hackshaw, associate professor of medicine, division of rheumatology
and immunology, at Ohio State's Wexner Medical Center and lead author
of the study.
The study is published in the Aug. 21, 2013, issue of the journal Analyst.
The technology used in this work is infrared microspectroscopy, which
identifies the biochemical content of a blood sample based on where
peaks of molecules appear in the infrared spectrum. The technology
offers hints at the molecules present in the samples based on how
molecular bonds vibrate when they are struck by light.
The spectroscopy works on dried blood, so just a few drops from a
finger stick produce enough blood to run this test. Researchers first
obtained blood samples from patients diagnosed with fibromyalgia (14),
rheumatoid arthritis (15) and osteoarthritis (12). These other
conditions were chosen for comparison because they produce similar
symptoms as fibromyalgia, but are easier to diagnose. The scientists
analyzed each sample with the infrared microspectroscopy to identify
the molecular patterns associated with each disease. This functioned
as a 'training' phase of the study. When the researchers then entered
blinded blood samples into the same machinery, each condition was
accurately identified based on its molecular patterns. 'It separated
them completely, with no misclassifications,' Buffington said. 'That's
very important. It never mistook a patient with fibromyalgia for a
patient with arthritis. Clearly we need more numbers, but this showed
the technique is quite effective.' The researchers also analyzed some
of the potential chemicals that could someday function as biomarkers
in the fibromyalgia blood samples, but further studies are needed to
identify the molecules responsible for the spectral patterns, he said.
Though an infrared microscope can be expensive, Buffington said the
testing could be affordable if a central lab existed to run the
samples. That the method can use dried blood samples makes this
concept feasible because dried blood can be legally sent via U.S.
mail, he noted.
Why is a veterinarian pursuing this type of research? Buffington is a
renowned expert on domestic cats, including a painful bladder disorder
they suffer called interstitial cystitis (IC). This syndrome also
occurs in humans.
It turns out that the origins of IC, like such human disorders as
irritable bowel syndrome and fibromyalgia, cannot be traced to the
specific area of the anatomy most affected by the syndrome. These
disorders are categorized as medically unexplained or functional
syndromes, and Buffington has explored the possibility that a common
link exists among these types of diseases, and that they might have
origins in the central nervous system.
Source: Ohio State University
(c) 2013 Medical News