Fibromyalgia is a common condition characterised by unrelenting pain, debilitating fatigue and problems with thinking and memory. It is estimated to affect up to 1 in 20 people in the UK, and there is currently no cure.

Alongside their chronic pain many people with fibromyalgia experience a range of sensory abnormalities. Lead author of this study, which was supported by the Liverpool Pain Relief Foundation and other funders, Mathilde Israel, Research Associate at the Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said: “People report a range of sensory abnormalities such as pins and needles, tingling, sensitivity to different fabrics or extreme sensitivity to cold like when they open the fridge or step out on a winter’s day – which can strongly impact on quality of life.”

The researchers believe that these symptoms are caused by changes in nerve cells in the body, specifically ‘mechanoreceptors’, which are specialised cells that send signals in the body to detect touch. Previous research conducted by this Liverpool-Kings team had already linked these antibodies with chronic pain, sensitivity to pressure, and reduced muscular strength in fibromyalgia, but this is the first time their role in sensory abnormalities has been studied.

Mathilde Israel said: “We all have antibodies in our blood that perform vital functions, keeping us healthy and free from illness. In some people, there are antibodies that are known to cause neurological disease, for example in the disease myasthenia gravis. “In fibromyalgia, this avenue of research is in its early stages. We wanted to explore whether sensory abnormalities could be caused by circulating antibodies in the body, already linked to chronic pain and tiredness.”

By recording electrical signals from nerves, the team showed that fibromyalgia antibodies altered ‘firing’ of mechanoreceptors, making many of these touch sensors also respond to cold temperature.

The researchers believe that these changes, caused by antibodies, are responsible for the sensory abnormalities that people with fibromyalgia experience.

Mathilde Israel added: “Our research argues against the commonly held belief that symptoms in fibromyalgia are caused by changes in the brain, providing evidence that the cause of the disease lies in the immune system. “At this stage, we cannot say exactly what the difference between the antibodies of healthy participants and fibromyalgia patients are, just that they are different. Exactly what underlies the change to antibodies also remains unknown.”

Further research into these specific antibody changes might help to devise diagnostic tests and targeted drug treatment.

Prof. Andreas Goebel, Chair of Pain Medicine at the University of Liverpool and Clinical Corresponding Author of the Brain paper commented: “this fantastic result showcases the strength of the close collaboration between clinical researchers and laboratory scientists to produce patient benefit. We invited our patients in Liverpool to round table discussions, together with both scientists and clinicians.

“In turn we later presented our laboratory results, and our patients’ comments helped us to interpret these findings. The result of this paradigm changing work is that together we have now given a ‘scientific voice’ to these often untold, but distressing sensory symptoms experienced by our patients in response to touch or cold. Healthcare professionals can now, for the first time provide an valid answer when their are being asked by their patients why they experience these abnormal, uncomfortable sensations: ‘they are caused by your immune system’.

This work was supported by the Medical Research Council (MRC), Versus Arthritis, Pain Relief Foundation Liverpool, Jules Thorn Award for Biomedical Research and Swedish Research Council.

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