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Diagnosis and treatment of fibromyalgia (FM) remains a challenge owing to the lack of reliable biomarkers. Our objective was to develop a rapid biomarker-based method for diagnosing FM by using vibrational spectroscopy to differentiate patients with FM from those with rheumatoid arthritis (RA), osteoarthritis (OA), or systemic lupus erythematosus (SLE) and to identify metabolites associated with these differences. Blood samples were collected from patients with a diagnosis of FM (n = 50), RA (n = 29), OA (n = 19), or SLE (n = 23). Bloodspot samples were prepared, and spectra collected with portable FT-IR and FT-Raman microspectroscopy and subjected to metabolomics analysis by ultra-HPLC (uHPLC), coupled to a photodiode array (PDA) and tandem MS/MS. Unique IR and Raman spectral signatures were identified by pattern recognition analysis and clustered all study participants into classes (FM, RA, and SLE) with no misclassifications (p < 0.05, and interclass distances > 2.5). Furthermore, the spectra correlated (r = 0.95 and 0.83 for IR and Raman, respectively) with FM pain severity measured with fibromyalgia impact questionnaire revised version (FIQR) assessments. Protein backbones and pyridine-carboxylic acids dominated this discrimination and might serve as biomarkers for syndromes such as FM. uHPLC-PDA-MS/MS provided insights into metabolites significantly differing among the disease groups, not only in molecular m/z+ and m/z- values but also in UV-visible chromatograms. We conclude that vibrational spectroscopy may provide a reliable diagnostic test for differentiating FM from other disorders and for establishing serologic biomarkers of FM-associated pain.

Fibromyalgia (FM) is a chronic central sensitivity syndrome characterized by augmented pain processing at diffuse body sites and presents as a multimorbid clinical condition. Long COVID (LC) is a heterogenous clinical syndrome that affects 10–20% of individuals following COVID-19 infection. FM and LC share similarities with regard to the pain and other clinical symptoms experienced, thereby posing a challenge for accurate diagnosis. This research explores the feasibility of using surface-enhanced Raman spectroscopy (SERS) combined with soft independent modelling of class analogies (SIMCAs) to develop classification models differentiating LC and FM. Venous blood samples were collected using two supports, dried bloodspot cards (DBS, n = 48 FM and n = 46 LC) and volumetric absorptive micro-sampling tips (VAMS, n = 39 FM and n = 39 LC). A semi-permeable membrane (10 kDa) was used to extract low molecular fraction (LMF) from the blood samples, and Raman spectra were acquired using SERS with gold nanoparticles (AuNPs). Soft independent modelling of class analogy (SIMCA) models developed with spectral data of blood samples collected in VAMS tips showed superior performance with a validation performance of 100% accuracy, sensitivity, and specificity, achieving an excellent classification accuracy of 0.86 area under the curve (AUC). Amide groups, aromatic and acidic amino acids were responsible for the discrimination patterns among FM and LC syndromes, emphasizing the findings from our previous studies. Overall, our results demonstrate the ability of AuNP SERS to identify unique metabolites that can be potentially used as spectral biomarkers to differentiate FM and LC. [ABSTRACT FROM AUTHOR]

BACKGROUND: The purpose of this study was to test the hypothesis that a health and wellness coaching (HWC)-based intervention for fibromyalgia (FM) would result in sustained improvements in health and quality of life, and reductions in health care utilization. METHODS: Nine female subjects meeting American College of Rheumatology criteria for a diagnosis of primary FM were studied. The HWC protocol had two components, which were delivered telephonically over a twelve-month period. First, each patient met individually with a coach during the 12 month study at the patients preference of schedule and frequency (Range:22-32 × 45-min sessions). Coaches were health professionals trained in health and wellness coaching tasks, knowledge, and skills. Second, each patient participated in bimonthly (first six months) and monthly (second six months) group classes on self-coaching strategies during the 12 month study. Prior to the intervention, and after 6 months and 12 months of coaching, the Revised Fibromyalgia Impact Questionnaire (FIQR) was used to measure health and quality of life, and the Brief Pain Inventory-Short Form (BPI) was used to measure pain intensity and interference with function. Total and rheumatology-related health encounters were documented using electronic medical records. Data were analyzed using repeated measures ANOVA. RESULTS: All nine patients finished the HWC protocol. FIQR scores improved by 35 % (P = 0.001). BPI scores decreased by 32 % overall (P = 0.006), 31 % for severity (P = 0.02), and 44 % for interference (P = 0.006). Health care utilization declined by 86 % (P = 0.006) for total and 78 % (P

Hydroxyphenyl-pyranoanthocyanins are vibrantly colored, anthocyanin-derived polyphenols found in some wines and aged juices. Upon heating (90 °C), solutions of 10-catechyl-pyranoanthocyanins (a type of hydroxyphenyl-pyranoanthocyanins) formed a unique, color producing degradation compound. This compound was produced in the greatest quantities at pH 1 and pH 3 where its formation contributed to retention of color intensity despite extensive heating conditions (up to 34 hours). We elucidated the structure of this colored compound and investigated if other hydroxyphenyl-pyranoanthocyanins produced similar colored thermal degradation products. Analysis of the isolated 10-catechyl-pyranoanthocyanin degradation compound by uHPLC-PDA, high resolution MS/MS (QTOF), FTIR, 1D and 2D NMR (1H, COSY, HMBC, HSQC), spectrophotometry, and color analysis revealed that it was a 4-carboxy-3-deoxyanthocyanidin with a catechol substitution, named 4-carboxy-3-deoxycyanidin. It produced an exact mass of 315.0502 consistent with a chemical formula of C16H11O7+. NMR allowed for structural assignments, and key FTIR discriminating bands supported the presence of aromatic rings and the carboxylic acid moiety. The color of 4-carboxy-3-deoxycyanidin transitioned from yellow (λvis-max = 479 nm) at pH 1 to magenta (λvis-max = 545 nm) at pH 9.2, analogous with a flavylium system. Similarly, unique, colored degradation compounds formed from three other hydroxyphenyl-pyranoanthocyanins (10-p-hydroxyphenyl-, 10-guaiacyl-, and 10-syringyl-pyranoanthocyanins) each with a m/z 398 units lower than their parent pyranoanthocyanin. These findings revealed the formation of a unique class of pyranoanthocyanin derived flavylium compounds: 4-carboxy-3-deoxyanthocyanidins. [ABSTRACT FROM AUTHOR]