Discussion+-+The+Genetic+Approach+to+Fibromyalgia

Research in fibromyalgia as a syndrome with a genetic basis has proved very fruitful. This research has built on previous studies concerning nociceptor pathways; it has traced these pathways to their sources in ion channels that are themselves expressions of a personal genetic code. This means that fibromyalgia can be considered not merely a general classification of disease, but a personally tailored kind of disease the diagnosis and treatment of which in the future will require information about the personal genome.

While it has long been known how TRVP channels contribute to pain inducement, the imaging of the TRVP1 channel has allowed a more precise analysis of the mechanisms involved. Moreover, the connection between the TRPV1 channel and its coding gene has opened up many new ways of understanding the causes of fibromyalgia pain and the alleviation of its painful symptoms.

The nature of fibromyalgia as an illness impacting nociceptor pathways makes it an ideal candidate for genetic research and a **pharmacogenetics** approach to treatment. The //Proove Genetic Test for Fibromyalgia// (see the link “Broader Impact - Pharmacogenetics and Fibromyalgia) identified ten genes that can impact the metabolism of drugs used to treat fibromyalgia, and one gene that is involved in symptoms such as sensitivity to pain and anxiety. We have learned that drugs in general are not “one size, fits all.” This is particularly the case for fibromyalgia since pain receptivity varies from individual to individual on the basis of how genes are expression. Starting from information about othe personal genome, therefore, doctors will be better able to target pain pathways.

This is not to say that The Proove Test and others like it are without controversy. The Proove Test does not allow for the prediction or diagnosis of fibromyalgia itself. It only provides a window on an individual's sensitivity to certain pain-alleviating medications. The ability to match polymorphisms with specific pain pathways is still in its infancy. Moreover, the information gleaned from the mapping of the personal genome is itself subject to many legal, moral, and research-related questions. Who should have this information? What rights does the individual have over his/her own genomic information? In regards to a syndrome with worldwide prevalance, should individual genomic information by available to researchers, doctors, and private or state insurance agents?

In sum, as in so many medical areas today, while personal genomics holds out great hope for the treatment of fibromyalgia, it also raises difficult questions that answers to which will inevitably impact research and public policy in the future.

Materials and Methods Prevalence of Fibromyalgia TRPV Genes Family Portrait Broader Impact - Pharmacogenetics and Fibromyalgia Criticism of the Proove Genetic Test Works Cited