Interferon Therapy For Fibromyalgia

Fibromyalgia is a chronic disorder with an unknown cause. Sufferers have higher pain sensitivity than the norm and experience persistent fatigue, pain, and tenderness that spreads all over the body and trouble sleeping. There is no known cure for fibromyalgia and all medications are targeted only at treating or managing the symptoms and their severity.¹

Causes and risk factors

The cause of fibromyalgia is still unknown. It is associated with other diseases, especially those causing pain diseases and conditions. These diseases include rheumatoid arthritis, lupus, chronic back pain, depression, anxiety, and irritable bowel syndrome. Physical trauma, such as an acute illness or injury, and psychological stress may help trigger the development of the disorder.

Although everyone could be subject to this condition, its onset is mostly in midlife and affects more women than men. Research suggests a genetic predisposition, as the disease appears more frequently in families, but more research needs to be done to confirm the link. Brain imaging found that patients with fibromyalgia have altered signalling in the neural circuits involved in pain perception which may explain the associated symptoms.        

Key Symptoms

Patients with fibromyalgia may experience the following:

• High sensitivity to pain
• Persistent fatigue
• Muscles tenderness
• Widespread pain throughout the body often is felt in the arms, legs, head, chest, abdomen, back, and buttocks
• Brain fog and memory problems
• Headaches and migraines
• Digestive and bladder problems
• Anxiety and depression
• Sleep problems

Diagnosis 

Currently, there are no specific laboratory or imaging tests for fibromyalgia, but diagnostic methods are standardised by the American College of Rheumatology (ACR). Following this guidance, fibromyalgia is characterised by widespread pain in all four quadrants of the body for at least three months with specific eleven of the eighteen designated tender points being particularly sensitive to touch.^2,3

In 2010 the American College of Rheumatology (ACR) added other allied symptoms such as sleep problems, problems with thinking clearly, and fatigue. Because pain and fatigue can be signs of various conditions, doctors need to rule out other possibilities before diagnosing fibromyalgia.

To diagnose fibromyalgia doctors will:

• Talk to you about symptoms and medical history. This includes the location, intensity, and duration of your pain, along with fatigue and any sleep, memory, and thinking problems⁴
• Examine your body, mainly pain points and joints, to rule out any other causes such as rheumatoid arthritis⁴

Treatment options for fibromyalgia

Since the cause of fibromyalgia is still unknown, there is no cure for it. Therapies are oriented towards managing symptoms and improving the lives of patients. Options involve:

• Medication: Doctors can prescribe various medications to help manage pain and improve sleep. Three FDA-approved drugs for fibromyalgia are pregabalin, duloxetine, and milnacipran.
• Non-drug therapies: These approaches have proven effective for many patients with fibromyalgia. They include:
  • Exercise: Aerobic exercise can significantly improve symptoms.
  • Self-management: Learning to manage stress, pacing activities, and getting enough rest can be beneficial.
  • Cognitive-behavioral therapy (CBT): This therapy helps develop coping mechanisms for pain and improve emotional well-being.
• Alternative therapies: Some patients may experience symptom relief through alternative approaches like:
  • Massage therapy
  • Acupuncture
  • Yoga

Interferon-alpha and its role in fibromyalgia treatment

Scientists Alick Isaacs and Jean Lindenmann first identified interferons in 1957. The name "interferon" reflects its key function to interfere with the growth of viruses, as they are signalling proteins belonging to a group called cytokines produced by your body to fight infection. They  activate immune system responses before invaders like viruses and other diseases, such as cancer. In 1986, a major milestone was reached when the first interferon made in a lab received approval from the Food and Drug Administration (FDA) for medical use.⁵

In June 2021, a systematic review and meta-analysis published in Rheumatology investigated whether people with fibromyalgia have a different cytokine profile compared to healthy people. Researchers analysed data from twenty-nine studies involving over 2,400 participants. Compared to healthy controls, people with fibromyalgia had higher levels of certain cytokines and consistently elevated levels of a chemokine called eotaxin than healthy controls. The study suggested that people with fibromyalgia experience cytokine production abnormalities which consequently leads to an uncontrolled response to invading molecules, and therefore the body experiences a more intense reaction to infections.⁶

Due to this abnormal cytokine response, a proposed treatment is interferon-alpha stimulation. Interferon-alpha is a molecule responsible for the modulation of the immune response, implying that, inducing its activity could help regain cytokine segregation control and alleviate fibromyalgia symptoms.⁵ A clinical trial published in the Journal of Interferon and Cytokines Research investigated whether low doses of interferon-alpha delivered under the tongue (sublingually) could improve symptoms in patients with fibromyalgia syndrome (FMS).⁷ Researchers involved 112 FMS patients and divided them into four groups (28 people each) with similar characteristics. Each group received either a placebo or one of three different doses of interferon-alpha (15 IU, 50 IU, or 150 IU) under the tongue daily. Patients stopped using pain medication or sleep medication for two weeks before starting the treatment. The researchers monitored the patients for six weeks, evaluating their symptoms at regular intervals.

The key finding of the study was that the patients in the group receiving the 50 IU dose of interferon-alpha reported significant improvement in morning stiffness and physical function. No major side effects were linked to the interferon-alpha treatment. The study concluded that a specific dose of low-dose interferon-alpha might improve morning stiffness and physical function in fibromyalgia patients. Although interferon-alpha could be a promising treatment for fibromyalgia, more research needs to be done to understand the exact role these molecules play in this condition to manufacture better treatment options.

Summary

Fibromyalgia is a condition where sufferers chronically experience physical and mental harm. A theory explaining its origin relies on the dysregulation of the body’s response to invasive molecules, more specifically, abnormalities in cytokine production. Research has demonstrated that interferon-alpha treatments can restore cytokine segregation and partially ameliorate the consequences of fibromyalgia. These results highlight a potential cause for this disease, which with more evidence, could potentially lead to a cure and better understanding of fibromyalgia.