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The discussion section of the paper ends with a speculation that autoreactive IgG in the pathophysiology of FM may transform future research Experts' comments on the research Dr Charles Shepherd, Hon Medical Adviser, MEA I went to a medical meeting a couple of years ago where the background to this interesting approach to research into fibromyalgia was described The results clearly point to some form of immunological involvement, possibly autoimmune, in fibromyalgia We already know that people with ME/CFS have evidence of abnormalities in various parts of the immune system response, including in some cases the production of autoantibodies which instead of being protective are directed against the bodys own tissues However, this observation is best described as being suggestive of an autoimmune component to ME/CFS we cannot conclude that ME/CFS is an autoimmune disease from these findings It would clearly be interesting to repeat this research in people with ME/CFS and I will be discussing this with my colleagues at the ME Biobank where we have blood samples and anonymised clinical data in due course And if it turns out that removing these antibodies in people with fibromyalgia using plasma exchange leads to symptom improvement this could also be relevant to ME/CFS The one note of caution here is that the research would involve the use of animals and this is something that the MEA has always been very reluctant to do The MEA has an information leaflet covering all aspects of fibromyalgia and the overlaps with ME/CFS

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