Inflammatory and Auto-Immune Mechanisms in the Pathogenesis of Fibromyalgia Syndrome: A Systematic Review

Fibromyalgia Syndrome (FMS) is a complex chronic pain disorder characterised by widespread pain, fatigue, and cognitive dysfunction. Research has increasingly aimed to find objective biological underpinnings to provide focused diagnosis and allow targeted treatment strategies. Evidence suggests that inflammatory processes and autoimmune mechanisms may play a role in the pathology of FMS, yet this evidence remains fragmented across many studies. This systematic review aims determine the contribution of inflammatory and immune driven mechanisms in the pathogenesis of FMS by identifying, critically appraising, and synthesizing current evidence on measurable abnormalities in adults with FMS. The systematic review will be conducted following PRISMA guidelines. MEDLINE, Embase, CINAHL, Web Of Science, Scopus, Google Scholar and the Bielefeld Academic Search Engine will be searched for original research published since the updated ACR diagnostic criteria in 2010. Eligible studies must investigate FMS using at least one objective inflammatory or immune marker in adults with an established FMS diagnosis and using a control group for comparison. This review will provide an integrated synthesis of the evidence for inflammatory and autoimmune mechanisms in FMS. By evaluating the quality and consistency of current data, it will support the available evidence for an immune-driven pathology, identify key knowledge gaps and providing a foundation for future research.