By Donna Gregory Burch
For more than a decade, Dr. Jarred Younger‘s research has been guided by one theory: Fibromyalgia is caused by an overreactive immune system. This spring, he’ll finally prove once and for all if his theory is correct, and the outcome could profoundly shift the future of fibromyalgia research.
“If our hypothesis is correct, it’s going to tell us that fibromyalgia is definitely an immune central centralization condition, and therefore the treatments need to focus on novel types of anti-inflammatories,” Younger said. “What that means is we don’t have to worry about these other [body] systems. We shouldn’t focus on neurons. We shouldn’t focus on the autonomic nervous system. We need to focus on the immune system. What that will then mean is we need to go back and revisit anti-inflammatories [that are known to cross the blood/brain barrier] that have already been created but never tried in fibromyalgia. Maybe one of those will work very well.”Beginning this month, Younger and his team at the University of Alabama at Birmingham (UAB) will inject up to 20 fibromyalgia patients and 20 healthy controls with ultra-low doses of lipopolysaccharide (LPS), a molecule that’s found on the exterior of certain infection-causing bacteria, which triggers the body’s immune system response. He anticipates the fibromyalgia patients’ immune systems will overreact to small doses of LPS while the healthy controls will show little or no reaction.
Drugs used for autoimmune conditions, like multiple sclerosis and rheumatoid arthritis, would be obvious contenders, but there are also dozens of over-the-counter botanical treatments that also might prove useful in calming an overstimulated immune system.
If Younger can finally prove fibromyalgia is the result of a malfunctioning immune system, it could lead to a big shift in the current approach to fibromyalgia treatment. The drugs approved to treat fibro – Lyrica, Cymbalta and Savella – all work to calm the central nervous system. They do not affect the immune system. That could explain why none of these drugs work very well in fibro patients.
Younger is currently recruiting fibromyalgia patients who live near Birmingham, Alabama, for the LPS study. Patients will be required to travel to UAB on two days. On the first day, participants will receive an IV drip containing an ultra-low dose of LPS in a hospital setting and will then be monitored throughout the day with regular blood draws. A few weeks later, participants will return to UAB to repeat the same process – this time with a slightly higher dose of LPS.
“The key here is we’re giving [LPS] at a lower dose than we’ve ever seen used in human research so that means we know this is ultra, ultra safe because the dose is so low,” Younger said. “We’re giving it at such a low dose that healthy individuals will not notice it at all. What I hypothesize will happen though is that in the individuals with fibromyalgia that same really low dose will be enough to have a hyper [immune system] response from them. We will be doing blood draws to look at all the immune components to see how the immune system is responding.”
If the fibromyalgia patients overreact to the LPS IV solution, “it will leave no doubt in my mind that we know what is happening in fibromyalgia, and it’ll outline a distinct set of steps we can do within a few years to hone in on an effective treatment,” Younger said.
Younger and his team expect to finish the LPS study by July and will probably announce their results in August.
If you have fibromyalgia and live in the Birmingham area, click here if you’re interested in participating in the LPS study.