The gut microbiota promotes pain in fibromyalgia 2025 Khoutorsky et al

Highlights

• Transplanting gut microbiota from women with fibromyalgia into mice induces pain
• It also induces immune activation, metabolomic changes, and reduced skin innervation
• Gut microbiota promotes pain through several mechanisms

Summary

Fibromyalgia is a prevalent syndrome characterized by widespread pain in the absence of evident tissue injury or pathology, making it one of the most mysterious chronic pain conditions. The composition of the gut microbiota in individuals with fibromyalgia differs from that of healthy controls, but its functional role in the syndrome is unknown.

Here, we show that fecal microbiota transplantation from fibromyalgia patients, but not from healthy controls, into germ-free mice induces pain and numerous molecular phenotypes that parallel known changes in fibromyalgia patients, including immune activation and metabolomic profile alterations. Replacing the fibromyalgia microbiota with a healthy microbiota substantially alleviated pain in mice.

An open-label trial in women with fibromyalgia (Registry MOH_2021-11-04_010374) showed that transplantation of a healthy microbiota is associated with reduced pain and improved quality of life. We conclude that altered gut microbiota has a role in fibromyalgia pain, highlighting it as a promising target for therapeutic interventions.

Open access

 

It’s important to note that they had to use antibiotics prior to the FMT, so this might not be a viable treatment if we’re concerned about super-bacteria.

On mice:

The open-label pilot:

 

What a difference in framing and presentation from the usual. This is how it should be presented. There is far too much marketing language allowed in EBM. It would make a huge difference if it were all described neutrally, using common terms and caveats.

All the difference between running a major story on page A1 above the fold in a major newspaper, vs page A18 of the week-end edition, featuring an odd headline that twists and hides the story.

Also a correct framing of what promising means: let's get more rigorous with it over time, but no one should use this right now. Not: let's jump all the guns and use it as standard practice because it must be correct (since we want it to be), as is standard in biopsychosocialand.

 

I am not aware of any immune or metabolic changes in 'FM'.
As usual I would be more inclined to read this if they gave some actual data in the abstract.

 

Here is some data from the text.

 

God knows what any of that means.

 

I am clueless about the subject, and so....

Are Microbiome Studies Ready for Hypothesis-driven Research? (2019, NLM)

https://pmc.ncbi.nlm.nih.gov/articles/PMC6153026/#S8