Health Care

Blood proteins linked to severity of Chronic Fatigue Syndrome

Blood proteins linked to severity of Chronic Fatigue Syndrome”

The team found that varying concentrations of 17 immune-system signaling proteins, or cytokines, in the blood correlate with the disease's severity.

The findings by Dr. Jose Montoya and his team at Stanford University School of Medicine, described in a study published Monday in the Proceedings of the National Academy of Sciences, could also be used to improve the treatment of the disorder, which has been notably hard.

"I have seen the horrors of this disease, multiplied by hundreds of patients", says Jose Montoya, lead author on the new study.

Chronic fatigue syndrome's symptoms are so diffuse - sometimes manifesting as heart problems, sometimes as mental impairment nicknamed "brain fog", other times as indigestion, diarrhea, constipation, muscle pain, tender lymph nodes and so forth - that it often goes undiagnosed, even among patients who've visited a half-dozen or more different specialists in an effort to determine what's wrong with them.

Antivirals, anti-inflammatories and immune-modulating drugs have led to improvement in some cases, Montoya said.

Chronic fatigue syndrome (CFS), or myalgic encephalomyelitis (ME) as many sufferers prefer it called, is still one of the more mysterious ailments physicians grapple with. The study's senior author, Mark Davis, is determined the revelatory research will once and for all put an end to debate over whether the disease is real or psychologically based.

These findings suggest that the immune system plays a crucial role in development of the disease and confirms what scientists previously suspected - that inflammation is central to the symptoms of of chronic fatigue syndrome.

But, levels of 17 of the cytokines varied dramatically between the patients with mild versus severe ME/CFS symptoms.

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The scientists collected and analysed blood samples from 192 patients as well as from 392 healthy control subjects. "Past studies have shown high levels of many cytokines but it was not clear that these high levels were causing symptoms".

And it's not just a blood test that ME/CFS patients can finally look forward to now.

So why do routine lab tests that doctors order often come back negative or not informative in ME/CFS patients?

"We now do not have such a test", Lakhan said by email. "We're showing an inflammation that has not been seen before". These cytokines likely contribute to the flu-like symptoms reported by patients, which are characteristic of inflammation-driven diseases. Such a test could both establish the diagnosis and serve to monitor patients' responses to treatment.

"The beloved Dr. Montoya risked his career when the suffering of his first ME/CFS patient moved him to work on it", said Siebert. Interestingly, the drug is approved to treat certain autoimmune diseases and also non-Hodgkin lymphoma, a cancer that one study found uniquely occurs at a higher rate among older people with ME/CFS.

And in an ongoing privately-funded study, Stanford geneticist Ron Davis and a team including three Nobel laureates is taking a similar "big data" approach to investigate a group of ME/CFS patients who are all severely ill, including Davis' own adult son.

Komaroff also notes a recent increase in research funding by the National Institutes of Health, which has included a comprehensive in-house study aimed at unraveling the underlying causes of the condition.

"There is much to learn", Komaroff writes, in the journal.



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