Open Access Open Badges Research article

Antipolymer antibody in Italian fibromyalgic patients

Laura Bazzichi1*, Camillo Giacomelli2, Francesca De Feo1, Tiziana Giuliano1, Alessandra Rossi2, Marica Doveri1, Chiara Tani1, Russell B Wilson3 and Stefano Bombardieri1

Author Affiliations

1 Department of Internal Medicine, Division of Rheumatology, University of Pisa, Pisa, Italy

2 Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Pisa, Italy

3 Autoimmune Technologies, L.L.C. 1010 Commons Suite 1705, New Orleans, LA 70112, USA

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Arthritis Research & Therapy 2007, 9:R86  doi:10.1186/ar2285

Published: 6 September 2007


The objectives of the present study were to evaluate the presence of antipolymer antibody (APA) seropositivity in 285 Italian patients affected by primary fibromyalgia (FM) and to verify whether APA levels correlate with disease severity and with cytokine levels.

APA levels were determined on serum samples by an indirect ELISA kit that detects IgG APA. Cytokines (IL-1, IL-6, IL-8, IL-10 and TNF╬▒) were measured by ELISA in plasma. The impact of FM on the quality of life was estimated using the Fibromyalgia Impact Questionnaire, while pain severity was evaluated using a visual analogic scale. Patients were also characterized by the presence of tiredness, stiffness, nonrestorative sleep, anxiety, depression, tension headache, irritable bowel syndrome, temporomandibular dysfunction and Raynaud's phenomena.

Using a cut-off value of 30 U, APA-positive values were detected in 60 FM patients (21.05%) and in 15 healthy control individuals (15.00%) without significant differences among their levels or the percentage of seropositivity. FM patients with moderate and severe symptoms had slightly higher APA levels with respect to patients with mild symptoms. APA-seropositive patients exhibited significant correlations between APA levels and the Fibromyalgia Impact Questionnaire estimate (P = 0.042), tiredness (P = 0.003) and IL-1 levels (P = 0.0072).

In conclusion, APA cannot be considered a marker of disease in Italian FM patients. The presence of APA, however, might permit the identification of a subset of FM patients with more severe symptoms and of patients who may respond differently to different therapeutic strategies.