{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:09:06Z","timestamp":1783098546303,"version":"3.54.6"},"reference-count":105,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Fibromyalgia is a complex disorder whose main symptoms are chronic widespread pain and fatigue and affects between 0.2 and 6.6% of the world population. Nowadays, there are no molecular biomarkers that could facilitate diagnosis. The latest efforts by researchers have focused on studying problems at the level of central nervous system sensitivity, inflammation, and oxidative disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 892 women were initially enrolled in the study. For individuals who met the inclusion criteria, a plasma proteome analysis was conducted using blood samples. Briefly, blood was collected, centrifuged, and analyzed by liquid nano-chromatography coupled to tandem mass spectrometry. After the raw data analysis, proteins with statistically significant differential abundance and a fold change over 1.2 (20% increase in fibromyalgia compared with control samples) or under 0.8 (20% decrease in fibromyalgia compared with control samples) in fibromyalgia were selected. For fecal metagenome analysis, fecal samples were collected and processed for DNA extraction. Amplicon sequencing of V3\u2013V4 regions from the 16S ribosomal RNA gene was performed using the Illumina MiSeq platform. The statistical analysis was conducted using R v4.3.2 base packages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After applying exclusion criteria, 242 women (199 patients and 43 age- and environmentally paired controls) provided plasma and feces samples, as well as properly filled health questionnaires. A total of 30 proteins and 19 taxa were differentially expressed in fibromyalgia patients, and their integration into an algorithm allows for discrimination between cases and controls. The multi-omic approach for biomarker discovery in this study proposes a multifactorial connection between gut microbiota and mitochondria-derived oxidative stress and inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Plasma and fecal multi-omics analysis suggest an intricate and multifactorial connection between gut microbiota and mitochondria-derived oxidative stress and inflammation in FM patients, with glyceraldehyde-3-phosphate dehydrogenase and <jats:italic>Streptococcus salivarius<\/jats:italic> as leading actors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>NCT05921409.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2025.1641185","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T05:33:24Z","timestamp":1759383204000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Fibromyalgia diagnosis from a multi-omics approach: a gut feeling"],"prefix":"10.3389","volume":"16","author":[{"given":"Elena","family":"Dur\u00e1n-Gonz\u00e1lez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Antol\u00edn","family":"Ram\u00edrez-Tejero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"P\u00e9rez-S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Morales-Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"G\u00f3mez-Morano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"D\u00edaz-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Mart\u00ednez-Lara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cot\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"999001","DOI":"10.3389\/fmicb.2022.999001","article-title":"Human gut microbiota in health and disease: unveiling the relationship","volume":"13","author":"Afzaal","year":"2022","journal-title":"Front. Microbiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1002\/cbf.1548","article-title":"Levels of lipid peroxidation, nitric oxide, and antioxidant vitamins in plasma of patients with fibromyalgia","volume":"27","author":"Akku\u015f","year":"2009","journal-title":"Cell Biochem. Funct"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1016\/j.bbadis.2015.03.005","article-title":"Metformin and caloric restriction induce an AMPK-dependent restoration of mitochondrial dysfunction in fibroblasts from Fibromyalgia patients","volume":"1852","author":"Alcocer-G\u00f3mez","year":"2015","journal-title":"Biochim. Biophys. Acta Mol. Basis Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1179\/135100006X116628","article-title":"Total antioxidant capacity and the severity of the pain in patients with fibromyalgia","volume":"11","author":"Altindag","year":"2006","journal-title":"Redox Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1582432","DOI":"10.1155\/2022\/1582432","article-title":"Oxidative stress in fibromyalgia: from pathology to treatment","volume":"2022","author":"Assavarittirong","year":"2022","journal-title":"Oxid. Med. Cell. Longev."},{"key":"B6","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1007\/978-981-19-7376-5_16","article-title":"Link between inflammatory mechanisms and fibromyalgia","volume":"1411","author":"Bains","year":"2023","journal-title":"Adv. Exp. Med. Biol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.maturitas.2017.06.025","article-title":"Estrogen\u2013gut microbiome axis: physiological and clinical implications","volume":"103","author":"Baker","year":"2017","journal-title":"Maturitas"},{"key":"B8","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1089\/neu.2020.7229","article-title":"Proteoglycan 4 reduces neuroinflammation and protects the blood-brain barrier after traumatic brain injury","volume":"38","author":"Bennett","year":"2021","journal-title":"J. Neurotrauma"},{"key":"B9","doi-asserted-by":"publisher","first-page":"131","DOI":"10.2174\/1573397111666150619095007","article-title":"Fibromyalgia: the prototypical central sensitivity syndrome","volume":"11","author":"Boomershine","year":"2015","journal-title":"Curr. Rheumatol. Rev"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/antiox9100964","article-title":"The impact of mitochondrial deficiencies in neuromuscular diseases","volume":"9","author":"Cant\u00f3-Santos","year":"2020","journal-title":"Antioxidants"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1089\/ars.2013.5346","article-title":"Could mitochondrial dysfunction be a differentiating marker between chronic fatigue syndrome and fibromyalgia?","volume":"19","author":"Castro-Marrero","year":"2013","journal-title":"Antioxid. Redox Signal"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41392-023-01547-9","article-title":"dynamics in health and disease: mechanisms and potential targets","volume":"8","author":"Chen","year":"2023","journal-title":"Signal Transduct. Target. Ther."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1001\/jama.2014.3266","article-title":"Fibromyalgia: a clinical review","volume":"311","author":"Clauw","year":"2014","journal-title":"JAMA"},{"key":"B14","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/j.ebiom.2019.07.031","article-title":"Gut microbiome and serum metabolome analyses identify molecular biomarkers and altered glutamate metabolism in fibromyalgia","volume":"46","author":"Clos-Garcia","year":"2019","journal-title":"EBioMedicine"},{"key":"B15","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1136\/jmedgenet-2015-103392","article-title":"Mutation in cytochrome b gene of mitochondrial DNA in a family with fibromyalgia is associated with NLRP3-inflammasome activation","volume":"53","author":"Cordero","year":"2016","journal-title":"J. Med. Genet"},{"key":"B16","doi-asserted-by":"publisher","first-page":"R17","DOI":"10.1186\/ar2918","article-title":"Mitochondrial dysfunction and mitophagy activation in blood mononuclear cells of fibromyalgia patients: implications in the pathogenesis of the disease","volume":"12","author":"Cordero","year":"2010","journal-title":"Arthritis Res. Ther"},{"key":"B17","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1089\/ars.2012.4892","article-title":"Is inflammation a mitochondrial dysfunction-dependent event in fibromyalgia?","volume":"18","author":"Cordero","year":"2013","journal-title":"Antioxid. Redox Signal"},{"key":"B18","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1007\/s00296-019-04251-6","article-title":"Role of inflammation in the pathogenesis and treatment of fibromyalgia","volume":"39","author":"Coskun Benlidayi","year":"2019","journal-title":"Rheumatol. Int"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1177\/0961203311411962","article-title":"Fibromyalgia in primary antiphospholipid (Hughes) syndrome","volume":"20","author":"Costa","year":"2011","journal-title":"Lupus"},{"key":"B20","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1038\/nrn1035","article-title":"Neurobiology of butyrylcholinesterase","volume":"4","author":"Darvesh","year":"2003","journal-title":"Nat. Rev. Neurosci"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.1016\/j.neuroscience.2010.08.005","article-title":"Effects of the probiotic Bifidobacterium infantis in the maternal separation model of depression","volume":"170","author":"Desbonnet","year":"2010","journal-title":"Neuroscience"},{"key":"B22","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1186\/s12891-020-03201-9","article-title":"Determining the association between fibromyalgia, the gut microbiome and its biomarkers: a systematic review","volume":"21","author":"Erdrich","year":"2020","journal-title":"BMC Musculoskelet. Disord"},{"key":"B23","doi-asserted-by":"publisher","first-page":"18586","DOI":"10.1074\/jbc.RA119.010950","article-title":"Gut microbial \u03b2-glucuronidases reactivate estrogens as components of the estrobolome that reactivate estrogens","volume":"294","author":"Ervin","year":"2019","journal-title":"J. Biol. Chem"},{"key":"B24","doi-asserted-by":"publisher","first-page":"3047","DOI":"10.1093\/bioinformatics\/btw354","article-title":"MultiQC: summarize analysis results for multiple tools and samples in a single report","volume":"32","author":"Ewels","year":"2016","journal-title":"Bioinformatics"},{"key":"B25","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.jpain.2023.07.020","article-title":"Autonomic small-fiber pathology in patients with fibromyalgia","volume":"25","author":"Falco","year":"2024","journal-title":"J. Pain"},{"key":"B26","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1042\/EBC20210020","article-title":"Nuclear receptors: from molecular mechanisms to therapeutics","volume":"65","author":"Frigo","year":"2021","journal-title":"Essays Biochem"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1701","DOI":"10.3390\/biomedicines11061701","article-title":"Fibromyalgia and irritable bowel syndrome interaction: a possible role for gut microbiota and gut-brain axis","volume":"11","author":"Garofalo","year":"2023","journal-title":"Biomedicines"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/jcm9113527","article-title":"Evidence of mitochondrial dysfunction in fibromyalgia: deviating muscle energy metabolism detected using microdialysis and magnetic resonance","volume":"9","author":"Gerdle","year":"2020","journal-title":"J. Clin. Med"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.55563\/clinexprheumatol\/257e99","article-title":"Fibromyalgia: one year in review 2023","volume":"41","author":"Giorgi","year":"2023","journal-title":"Clin. Exp. Rheumatol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1093\/rheumatology\/ken140","article-title":"Altered intestinal permeability in patients with primary fibromyalgia and in patients with complex regional pain syndrome","volume":"47","author":"Goebel","year":"2008","journal-title":"Rheumatology"},{"key":"B31","doi-asserted-by":"publisher","first-page":"7344","DOI":"10.1172\/JCI144201","article-title":"Passive transfer of fibromyalgia symptoms from patients to mice","volume":"131","author":"Goebel","year":"2021","journal-title":"J. Clin. Invest"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1038\/s41385-018-0062-z","article-title":"Desmoglein 2, but not desmocollin 2, protects intestinal epithelia from injury","volume":"11","author":"Gross","year":"2018","journal-title":"Mucosal Immunol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"436","DOI":"10.3390\/biomedicines10020436","article-title":"Role of microbiota-gut-brain axis in regulating dopaminergic signaling","volume":"10","author":"Hamamah","year":"2022","journal-title":"Biomedicines"},{"key":"B34","doi-asserted-by":"publisher","first-page":"12347","DOI":"10.1038\/s41598-020-69271-w","article-title":"Serum proteome profiles revealed dysregulated proteins and mechanisms associated with fibromyalgia syndrome in women","volume":"10","author":"Han","year":"2020","journal-title":"Sci. Rep"},{"key":"B35","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.yhbeh.2017.10.011","article-title":"Sex differences and estradiol involvement in hyperalgesia and allodynia in an experimental model of fibromyalgia","volume":"97","author":"Hernandez-Leon","year":"2018","journal-title":"Horm. Behav"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2236749","DOI":"10.1080\/19490976.2023.2236749","article-title":"Gut microbial beta-glucuronidase: a vital regulator in female estrogen metabolism","volume":"15","author":"Hu","year":"2023","journal-title":"Gut Microbes"},{"key":"B37","unstructured":"16S Metagenomic Sequencing Library Preparation: Preparing 16S Ribosomal RNA Gene Amplicons for the Illumina MiSeq System (Part # 15044223 Rev. B) [PDF]"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1001025","DOI":"10.3389\/fimmu.2022.1001025","article-title":"From bench to bedside: calprotectin (S100A8\/S100A9) as a biomarker in rheumatoid arthritis","volume":"13","author":"Inciarte-Mundo","year":"2022","journal-title":"Front. Immunol."},{"key":"B39","unstructured":"Ley Org\u00e1nica 3\/2018, de 5 de diciembre, de Protecci\u00f3n de Datos Personales y garant\u00eda de los derechos digitales [Ley Org\u00e1nica, Disposici\u00f3n 16673]\n          \n          119788\n          \n          Bol. Off. Estado\n          294\n          2018"},{"key":"B40","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1128\/AEM.03133-13","article-title":"Anti-inflammatory properties of Streptococcus salivarius, a commensal bacterium of the oral cavity and digestive tract","volume":"80","author":"Kaci","year":"2014","journal-title":"Appl. Environ. Microbiol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s10549-019-05472-w","article-title":"Untapped \u201c-omics\u201d: the microbial metagenome, estrobolome, and their influence on the development of breast cancer and response to treatment","volume":"179","author":"Komorowski","year":"2020","journal-title":"Breast Cancer Res. Treat"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1097\/j.pain.0000000000002500","article-title":"Efficacy of nonpharmacological interventions for individual features of fibromyalgia: a systematic review and meta-analysis of randomised controlled trials","volume":"163","author":"Kundakci","year":"2022","journal-title":"Pain"},{"key":"B43","doi-asserted-by":"publisher","first-page":"djw029","DOI":"10.1093\/jnci\/djw029","article-title":"The intestinal microbiome and estrogen receptor-positive female breast cancer","volume":"108","author":"Kwa","year":"2016","journal-title":"J. Natl. Cancer Inst"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1038\/s41598-020-79349-0","article-title":"Salivary cortisol is associated with cognitive changes in patients with fibromyalgia","volume":"11","author":"Lin","year":"2021","journal-title":"Sci. Rep"},{"key":"B45","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/s00281-018-0672-2","article-title":"Neurogenic inflammation in fibromyalgia","volume":"40","author":"Littlejohn","year":"2018","journal-title":"Semin. Immunopathol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"109685","DOI":"10.1016\/j.intimp.2023.109685","article-title":"Gut microbiota in chronic pain: Novel insights into mechanisms and promising therapeutic strategies","volume":"115","author":"Liu","year":"2023","journal-title":"Int. Immunopharmacol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"729","DOI":"10.12968\/bjon.2006.15.13.21487","article-title":"Fibromyalgia: aetiology, diagnosis, symptoms and management","volume":"15","author":"Longley","year":"2006","journal-title":"Br. J. Nurs"},{"key":"B48","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1186\/s13059-014-0550-8","article-title":"Moderated estimation of fold change and dispersion for RNA-seq data with DESeq2","volume":"15","author":"Love","year":"2014","journal-title":"Genome Biol"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1286539","DOI":"10.3389\/fneur.2023.1286539","article-title":"Study protocol for FIBROKIT: a new tool for fibromyalgia diagnosis and patient follow-up. Front","volume":"14","author":"Lucena Del Amo","year":"2023","journal-title":"Neurol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1136\/annrheumdis-2016-209724","article-title":"EULAR revised recommendations for the management of fibromyalgia","volume":"76","author":"Macfarlane","year":"2017","journal-title":"Ann. Rheum. Dis"},{"key":"B51","doi-asserted-by":"publisher","first-page":"7344","DOI":"10.1038\/s41598-024-57350-1","article-title":"In major dysmood disorder, physiosomatic, chronic fatigue and fibromyalgia symptoms are driven by immune activation and increased immune-associated neurotoxicity","volume":"14","author":"Maes","year":"2024","journal-title":"Sci. Rep."},{"key":"B52","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/j.rbr.2016.10.004","article-title":"Prevalence of fibromyalgia: literature review update","volume":"57","author":"Marques","year":"2017","journal-title":"Rev. Bras. Reumatol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"175","DOI":"10.2147\/OARRR.S257470","article-title":"Mitochondrial imbalance as a new approach to the study of fibromyalgia","volume":"12","author":"Mart\u00ednez-Lara","year":"2020","journal-title":"Open Access Rheumatol"},{"key":"B54","doi-asserted-by":"publisher","first-page":"1136","DOI":"10.1016\/j.neubiorev.2021.10.021","article-title":"The role of the vagus nerve in fibromyalgia syndrome","volume":"131","author":"Martins","year":"2021","journal-title":"Neurosci. Biobehav. Rev"},{"key":"B55","first-page":"519","article-title":"Prevalence and impact of fi bromyalgia on function and quality of life in individuals from the general population: results from a nationwide study in Spain","volume":"26","author":"Mas","year":"2008","journal-title":"Clin. Exp. Rheumatol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1517\/14728222.2013.818657","article-title":"The role of mitochondrial dysfunctions due to oxidative and nitrosative stress in the chronic pain or chronic fatigue syndromes and fibromyalgia patients: peripheral and central mechanisms as therapeutic targets?","volume":"17","author":"Meeus","year":"2013","journal-title":"Expert Opin. Ther. Targets"},{"key":"B57","doi-asserted-by":"publisher","first-page":"7403230","DOI":"10.1155\/2016\/7403230","article-title":"PPARs and mitochondrial metabolism: from NAFLD to HCC","volume":"2016","author":"Mello","year":"2016","journal-title":"PPAR Res"},{"key":"B58","doi-asserted-by":"publisher","first-page":"2589","DOI":"10.1097\/j.pain.0000000000001640","article-title":"Altered microbiome composition in individuals with fibromyalgia","volume":"160","author":"Minerbi","year":"2019","journal-title":"Pain"},{"key":"B59","doi-asserted-by":"publisher","first-page":"3949","DOI":"10.1038\/s41598-024-53874-8","article-title":"Identification of unique genomic signatures in patients with fibromyalgia and chronic pain","volume":"14","author":"Mohapatra","year":"2024","journal-title":"Sci. Rep"},{"key":"B60","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1111\/cns.12490","article-title":"Stress and the microbiota-gut-brain axis in visceral pain: relevance to irritable bowel syndrome","volume":"22","author":"Moloney","year":"2016","journal-title":"CNS Neurosci. Ther."},{"key":"B61","doi-asserted-by":"publisher","first-page":"2285","DOI":"10.1097\/j.pain.0000000000002927","article-title":"Evidence of neuroinflammation in fibromyalgia syndrome: a [18F]DPA-714 positron emission tomography study","volume":"164","author":"Mueller","year":"2023","journal-title":"Pain"},{"key":"B62","first-page":"9","article-title":"Practical issues in calculating the sample size for prevalence studies","volume":"1","author":"Naing","year":"2006","journal-title":"Arch. Orofacial Sci."},{"key":"B63","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1016\/j.jpain.2023.10.015","article-title":"Associations between brain-gut axis and psychological distress in fibromyalgia: a microbiota and magnetic resonance imaging study","volume":"25","author":"Nhu","year":"2024","journal-title":"J. Pain"},{"key":"B64","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1016\/j.jpain.2006.04.005","article-title":"Sex hormones and pain in regularly menstruating women with fibromyalgia syndrome","volume":"7","author":"Okifuji","year":"2006","journal-title":"J. Pain"},{"key":"B65","unstructured":"Oksanen\n              J.\n            \n          \n          Vegan: Ecological Diversity [R vignette]\n          \n          2025"},{"key":"B66","doi-asserted-by":"publisher","first-page":"2602","DOI":"10.1093\/rheumatology\/keab146","article-title":"Is fibromyalgia associated with a unique cytokine profile? A systematic review and meta-analysis","volume":"60","author":"O'Mahony","year":"2021","journal-title":"Rheumatology"},{"key":"B67","doi-asserted-by":"publisher","first-page":"656895","DOI":"10.3389\/fmicb.2021.656895","article-title":"GABA production by human intestinal Bacteroides spp.: prevalence, regulation, and role in acid stress tolerance","volume":"12","author":"Otaru","year":"2021","journal-title":"Front. Microbiol"},{"key":"B68","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.3390\/ijms21041366","article-title":"Activation of transposable elements in immune cells of fibromyalgia patients","volume":"21","author":"Ovejero","year":"2020","journal-title":"Int. J. Mol. Sci"},{"key":"B69","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1007\/s00296-005-0079-y","article-title":"Antioxidant status, lipid peroxidation and nitric oxide in fibromyalgia: Etiologic and therapeutic concerns","volume":"26","author":"Ozgocmen","year":"2006","journal-title":"Rheumatol. Int"},{"key":"B70","doi-asserted-by":"publisher","first-page":"16301","DOI":"10.3390\/ijms242216301","article-title":"Gut microbiome-estrobolome profile in reproductive-age women with endometriosis","volume":"24","author":"Pai","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"B71","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1016\/j.str.2017.05.003","article-title":"An atlas of \u03b2-glucuronidases in the human intestinal microbiome","volume":"25","author":"Pollet","year":"2017","journal-title":"Structure"},{"key":"B72","unstructured":"Tool for Fibromyalgia Diagnosis and Effect of Extra Virgin Olive Oil (FIBROKIT).\n          \n          2024"},{"key":"B73","doi-asserted-by":"publisher","first-page":"868","DOI":"10.3390\/neurolint15030055","article-title":"Microbiota and mitochondrial sex-dependent imbalance in fibromyalgia: a pilot descriptive study","volume":"15","author":"Ram\u00edrez-Tejero","year":"2023","journal-title":"Neurol. Int"},{"key":"B74","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.jprot.2018.07.009","article-title":"Insight into the biological pathways underlying fibromyalgia by a proteomic approach","volume":"186","author":"Ram\u00edrez-Tejero","year":"2018","journal-title":"J. Proteomics"},{"key":"B75","doi-asserted-by":"publisher","first-page":"2892","DOI":"10.1111\/bph.15476","article-title":"Complement, inflammation and thrombosis","volume":"178","author":"Rawish","year":"2021","journal-title":"Br. J. Pharmacol"},{"key":"B76","doi-asserted-by":"publisher","first-page":"e0244830","DOI":"10.1371\/journal.pone.0244830","article-title":"Reduced activity, reactivity and functionality of the sympathetic nervous system in fibromyalgia: an electrodermal study","volume":"15","author":"Reyes del Paso","year":"2020","journal-title":"PLoS ONE"},{"key":"B77","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1177\/1099800415591035","article-title":"Nitric oxide, inflammation, lipid profile, and cortisol in normal- and overweight women with fibromyalgia","volume":"18","author":"Rus","year":"2016","journal-title":"Biol. Res. Nurs"},{"key":"B78","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1097\/NNR.0000000000000480","article-title":"Influence of oxidative stress-related genes on susceptibility to fibromyalgia","volume":"70","author":"Rus","year":"2021","journal-title":"Nurs. Res"},{"key":"B79","doi-asserted-by":"publisher","first-page":"241","DOI":"10.3109\/10408368009108731","article-title":"Dopamine beta-hydroxylase in health and disease","volume":"12","author":"Rush","year":"1980","journal-title":"Crit. Rev. Clin. Lab. Sci"},{"key":"B80","doi-asserted-by":"publisher","first-page":"604179","DOI":"10.3389\/fimmu.2020.604179","article-title":"The gut-brain axis: how microbiota and host inflammasome influence brain physiology and pathology","volume":"11","author":"Rutsch","year":"2020","journal-title":"Front. Immunol"},{"key":"B81","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1093\/humupd\/dmab035","article-title":"The role of gut and genital microbiota and the estrobolome in endometriosis, infertility and chronic pelvic pain","volume":"28","author":"Salliss","year":"2022","journal-title":"Hum. Reprod. Update"},{"key":"B82","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.mito.2015.01.010","article-title":"Oxidative stress, mitochondrial dysfunction and, inflammation common events in skin of patients with Fibromyalgia","volume":"21","author":"S\u00e1nchez-Dom\u00ednguez","year":"2015","journal-title":"Mitochondrion"},{"key":"B83","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/j.jpain.2017.11.013","article-title":"Daily fluctuations of progesterone and testosterone are associated with fibromyalgia pain severity","volume":"19","author":"Schertzinger","year":"2018","journal-title":"J. Pain"},{"key":"B84","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1002\/ana.24065","article-title":"Hyperexcitable C nociceptors in fibromyalgia","volume":"75","author":"Serra","year":"2014","journal-title":"Ann. Neurol"},{"key":"B85","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1038\/mi.2013.90","article-title":"Desmoglein-1 regulates esophageal epithelial barrier function and immune responses in eosinophilic esophagitis","volume":"7","author":"Sherrill","year":"2014","journal-title":"Mucosal Immunol"},{"key":"B86","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/s1297-319x(03)00014-9","article-title":"Antiphospholipid syndrome: why and how should we make the diagnosis?","volume":"70","author":"Sibilia","year":"2003","journal-title":"Joint Bone Spin"},{"key":"B87","doi-asserted-by":"publisher","first-page":"1683","DOI":"10.3390\/biology11111683","article-title":"The gut microbiome and female health","volume":"11","author":"Siddiqui","year":"2022","journal-title":"Biology"},{"key":"B88","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.pbiomolbio.2020.12.001","article-title":"The multiple biological roles of the cholinesterases","volume":"162","author":"Silman","year":"2021","journal-title":"Prog. Biophys. Mol. Biol"},{"key":"B89","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1007\/s00296-014-3109-9","article-title":"An insight into the gastrointestinal component of fibromyalgia: clinical manifestations and potential underlying mechanisms","volume":"35","author":"Slim","year":"2015","journal-title":"Rheumatol. Int."},{"key":"B90","doi-asserted-by":"publisher","first-page":"5756","DOI":"10.3390\/ijms23105756","article-title":"The role of microbiota in the immunopathogenesis of endometrial cancer","volume":"23","author":"Sobstyl","year":"2022","journal-title":"Int. J. Mol. Sci"},{"key":"B91","doi-asserted-by":"publisher","first-page":"2606","DOI":"10.1038\/sj.onc.1210074","article-title":"GAPDH, a novel regulator of the pro-apoptotic mitochondrial membrane permeabilization","volume":"26","author":"Tarze","year":"2007","journal-title":"Oncogene"},{"key":"B92","doi-asserted-by":"publisher","first-page":"258","DOI":"10.5507\/bp.2018.051","article-title":"Intestinal dysbiosis and hormonal neuroendocrine secretion in the fibromyalgic patient","volume":"164","author":"Tomasello","year":"2018","journal-title":"Biomed. Pap"},{"key":"B93","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.3390\/diagnostics12081845","article-title":"Network analysis for better understanding the complex psycho-biological mechanisms behind fibromyalgia syndrome","volume":"12","author":"Valera-Calero","year":"2022","journal-title":"Diagnostics"},{"key":"B94","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1038\/nrrheum.2016.25","article-title":"Neuroinflammation in fibromyalgia and CRPS is multifactorial","volume":"12","author":"Vasquez","year":"2016","journal-title":"Nat. Rev. Rheumatol"},{"key":"B95","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1002\/ejp.1607","article-title":"Peripheral and central nervous system correlates in fibromyalgia","volume":"24","author":"Vecchio","year":"2020","journal-title":"Eur. J. Pain"},{"key":"B96","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s13041-024-01102-9","article-title":"S100 proteins: a new frontier in fibromyalgia research","volume":"17","author":"Vega-Ram\u00edrez","year":"2024","journal-title":"Mol. Brain"},{"key":"B97","doi-asserted-by":"publisher","first-page":"E821","DOI":"10.1097\/j.pain.0000000000002498","article-title":"Unbiased immune profiling reveals a natural killer cell-peripheral nerve axis in fibromyalgia","volume":"163","author":"Verma","year":"2022","journal-title":"Pain"},{"key":"B98","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1157\/13074369","article-title":"El Cuestionario de Salud SF-36 espa\u00f1ol: una d\u00e9cada de experiencia y nuevos desarrollos por los investigadores de la Red-IRYSS*","volume":"19","author":"Vilagut","year":"2005","journal-title":"Gac Sanit."},{"key":"B99","doi-asserted-by":"publisher","first-page":"12508","DOI":"10.1038\/s41598-020-69422-z","article-title":"Significant correlation between plasma proteome profile and pain intensity, sensitivity, and psychological distress in women with fibromyalgia","volume":"10","author":"W\u00e5hl\u00e9n","year":"2020","journal-title":"Sci. Rep"},{"key":"B100","doi-asserted-by":"publisher","first-page":"104055","DOI":"10.1016\/j.ebiom.2022.104055","article-title":"Gut dysbiosis in rheumatic diseases: a systematic review and meta-analysis of 92 observational studies","volume":"80","author":"Wang","year":"2022","journal-title":"EBioMedicine"},{"key":"B101","doi-asserted-by":"publisher","first-page":"2007","DOI":"10.3390\/cells10082007","article-title":"The interdependency and co-regulation of the vitamin D and cholesterol metabolism","volume":"10","author":"Warren","year":"2021","journal-title":"Cells"},{"key":"B102","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1016\/j.semarthrit.2016.08.012","article-title":"2016 Revisions to the 2010\/2011 fibromyalgia diagnostic criteria","volume":"46","author":"Wolfe","year":"2016","journal-title":"Semin. Arthritis Rheum"},{"key":"B103","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.3899\/jrheum.100594","article-title":"Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR preliminary diagnostic criteria for fibromyalgia","volume":"38","author":"Wolfe","year":"2011","journal-title":"J. Rheumatol"},{"key":"B104","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1002\/art.1780330203","article-title":"The American collegue of rheumathology 1990 criteria for the classification of fribomyalgia. Report of the Multicenter Criteria Committee","volume":"33","author":"Wolfe","year":"1990","journal-title":"Arthritis Rheum."},{"key":"B105","doi-asserted-by":"publisher","first-page":"nzaa153","DOI":"10.1093\/cdn\/nzaa153","article-title":"The roles of mitochondrial folate metabolism in supporting mitochondrial DNA synthesis, oxidative phosphorylation, and cellular function","volume":"4","author":"Xiu","year":"2020","journal-title":"Curr. Dev. Nutr."}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2025.1641185\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T05:33:26Z","timestamp":1759383206000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2025.1641185\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,2]]},"references-count":105,"alternative-id":["10.3389\/fmicb.2025.1641185"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2025.1641185","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,2]]},"article-number":"1641185"}}