Download the full January 2002 AFSA Update as a PDF
Life's Uncertainties Abound, but NOT the Need for FMS Research
Unrest and turmoil exist around
the world. Yet, the need for biomedical research on common conditions, such
as FMS, permeates the boundaries of countries and cultures. FMS is everywhere
you turn and the only way to minimize its path of destruction is through stepping
up research on the disease. This is AFSA’s mission, and it is due to your
generous donations that our research funding goals can be met. Each year brings
with it new challenges, and each year we depend upon your help.
Your FMS Legacy
Ordinarily, a legacy is something
that you are proud to leave behind for the younger members of your family
and the next generation that is yet to be born. But there is nothing to rejoice
about in the case of FMS genetic predisposition. The situation doesn’t have
to be so grim. Mold your legacy into a person of action, one who changes the
direction of FMS research. The genetic study described is just a start. AFSA
plans to build upon this project of generating replenishable DNA by getting
genetic-minded researchers to submit grant proposals that will lead the way
to a better understanding of FMS as well as more effective treatments. This
strategy is only a segment of our future funding plan. It will cost money,
but with millions of Americans fully understanding the detrimental impact
of FMS, this task is doable. Become a part of the plan for the future ...
and that of generations to come. Contribute to AFSA and change the face of
your FMS legacy today.
Cytokine Abnormalities Official! AFSA-Funded Study Appears in Rheumatology
The July 2001 issue of Rheumatology,
featured an AFSA-funded project by UCLA professor Daniel Wallace, M.D., and
his coworkers titled: “Cytokines play an aetiopathogenetic role in fibromyalgia
- a hypothesis and pilot study.” The report not only showed that cytokine
chemical abnormalities were substantial, but it also provided a basis for
how FMS may progress over time. In addition, the study lays the groundwork
and justification for investigating the use of two classes of novel pain relievers;
one of which has just been approved by the FDA for prescription sale.
Cytokines are produced by the immune
system and can cause many—if not all—of the symptoms of FMS. Wallace looked
for cytokine abnormalities in FMS patients, and he added to the scientific
intrigue by subdividing the FMS patients into “early stage” (symptoms for
less than two years) and “late stage” (symptoms for greater than two years).
Why evaluate the two groups separately? Wallace cites studies indicating that
when FMS is diagnosed and treated in the early stage, remission of symptoms
is likely to occur. But, once the symptoms have persisted for over two years,
remissions are rare. So the study intent was not just to look for cytokine
abnormalities, but to also investigate a plausible basis for why remissions
rarely occur once FMS has persisted for a number of years (i.e., the typical
Before addressing Wallace’s major
findings, it should be noted that cytokines are not easy substances to analyze.
They are released by cells throughout the body and rapidly disappear into
the blood circulation. To overcome this obstacle, Wallace not only looked
at cytokines and their receptors in the serum, but he assayed for the ability
of the patient’s blood cells to produce cytokines when stimulated by such
substances as LPS, which can resemble a bacterial invasion. Naturally, a control
group of healthy people was also included in the study for comparison.
Serum levels of Interleukin-1 receptor
antibody (IL-1Ra) were significantly higher in both patient groups compared
to controls. In other words, the level of IL-1Ra did not appear to be influenced
by the duration of FMS symptoms. Plasma levels of Interleukin-8 (IL-8) were
three times higher in patients (almost predominantly due to those in the late
stage of FMS). Interleukin-6 (IL-6) levels were not elevated in the sera of
either FMS group, but when stimulated, IL-6 was produced in substantially
higher quantities in the late stage patients, compared to those with early
stage FMS and the controls. The stimulated production of IL-1Ra was also higher
in the late stage group.
In a nutshell, there are significant
changes in cytokine production even in the early stage of FMS, but this production
generally increases as the duration of symptoms progresses. This latter finding
could explain why symptoms tend to worsen with time and why therapies are
often less effective (and remissions rare) after several years of persistent
Cytokine interactions with the
body’s pain, hormonal and stress response mechanisms are complex. The diagram
below helps explain the relationships along with the study findings. Wallace
indicates in his report that over time, the level of response to stressors
may increase the production of IL-6, but the protective dampening mechanisms
provided by IL-1Ra may be exhausted or overwhelmed. Fortunately, a drug that
acts like IL-1Ra has just been FDA approved, with many more cytokine-altering
drugs soon to be released. There is hope that these abnormalities and the
symptoms that they produce can be minimized in the near future.
Doug Pacht’s best friend’s mother,
Claire Cohen, suffered miserably with FMS and died of causes unrelated to
FMS a year ago. The fact that Doug knew a person with FMS is not at all unusual.
FMS is a highly prevalent condition; roughly 3-5% of the population has it.
The novelty of Doug’s story is that he went through a tremendous amount of
effort to help people with FMS, even though he did not have the condition
himself. After Claire passed away, Doug sought out possible ways to sponsor
research in FMS.
A resident of Florida and an avid
runner, Doug entered himself into the New York City marathon race that occurred
last November. Before the race, he did his homework to find out which charitable
organization was most active in funding research on FMS ... that’s when he
came across the AFSA Web site. He contacted AFSA about his plan to solicit
sponsorships for running the marathon race in Claire’s honor and donate all
the money to AFSA on her behalf. After all the pledges were made (totaling
$955 due to his wonderful fund-raising efforts), Doug still had to run 26
miles for people with FMS and collect the money to mail in to AFSA.
Doug’s enormous effort, made on
behalf of FMS patients everywhere, is proof that there are people who genuinely
care about your well-being!
22nd Project Funded - In Memory of Laura Skalla
- EBV Transformation for Genetic Studies on FMS
Visit our Projects Funded section for a detailed description.