scholarly journals Metabolic features of chronic fatigue syndrome

2016 ◽  
Vol 113 (37) ◽  
pp. E5472-E5480 ◽  
Author(s):  
Robert K. Naviaux ◽  
Jane C. Naviaux ◽  
Kefeng Li ◽  
A. Taylor Bright ◽  
William A. Alaynick ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Metabolic Response ◽  
Characteristic Curve ◽  
Chronic Fatigue ◽  
The United States ◽  
Receiver Operator Characteristic Curve ◽  
Institute Of Medicine ◽  
Fatigue Syndrome ◽  
Evolutionarily Conserved ◽  
Branch Chain Amino

More than 2 million people in the United States have myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We performed targeted, broad-spectrum metabolomics to gain insights into the biology of CFS. We studied a total of 84 subjects using these methods. Forty-five subjects (n = 22 men and 23 women) met diagnostic criteria for ME/CFS by Institute of Medicine, Canadian, and Fukuda criteria. Thirty-nine subjects (n = 18 men and 21 women) were age- and sex-matched normal controls. Males with CFS were 53 (±2.8) y old (mean ± SEM; range, 21–67 y). Females were 52 (±2.5) y old (range, 20–67 y). The Karnofsky performance scores were 62 (±3.2) for males and 54 (±3.3) for females. We targeted 612 metabolites in plasma from 63 biochemical pathways by hydrophilic interaction liquid chromatography, electrospray ionization, and tandem mass spectrometry in a single-injection method. Patients with CFS showed abnormalities in 20 metabolic pathways. Eighty percent of the diagnostic metabolites were decreased, consistent with a hypometabolic syndrome. Pathway abnormalities included sphingolipid, phospholipid, purine, cholesterol, microbiome, pyrroline-5-carboxylate, riboflavin, branch chain amino acid, peroxisomal, and mitochondrial metabolism. Area under the receiver operator characteristic curve analysis showed diagnostic accuracies of 94% [95% confidence interval (CI), 84–100%] in males using eight metabolites and 96% (95% CI, 86–100%) in females using 13 metabolites. Our data show that despite the heterogeneity of factors leading to CFS, the cellular metabolic response in patients was homogeneous, statistically robust, and chemically similar to the evolutionarily conserved persistence response to environmental stress known as dauer.

scholarly journals A Rose By Any Other Name?

2016 ◽  
Vol 10 (4) ◽  
Author(s):  
Richard Marlin PhD
Keyword(s):  
United States ◽  
Chronic Fatigue Syndrome ◽  
Diagnostic Criteria ◽  
Functional Impairment ◽  
Chronic Fatigue ◽  
The United States ◽  
Myalgic Encephalomyelitis ◽  
Expert Committee ◽  
Institute Of Medicine ◽  
Fatigue Syndrome

In February of this year, an expert committee of the United States Institute of Medicine (IOM) released a lengthy report in which its members reviewed diagnostic criteria and proposed a new label for chronic fatigue syndrome, also historically referred to as myalgic encephalomyelitis.1 The committee’s proposed new label for this illness is Systemic Exertion Intolerance Disease. The report refers to the fact that a sizeable population is diagnosed with this illness, which causes considerable suffering and functional impairment. Many patients also feel stigmatized because of the label chronic fatigue syndrome.

scholarly journals Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Comprehensive Review

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 91 ◽  
Author(s):  
Mateo Cortes Rivera ◽  
Claudio Mastronardi ◽  
Claudia Silva-Aldana ◽  
Mauricio Arcos-Burgos ◽  
Brett Lidbury
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Age Of Onset ◽  
Chronic Fatigue ◽  
The United States ◽  
Myalgic Encephalomyelitis ◽  
World Health ◽  
Fatigue Syndrome ◽  
Control And Prevention ◽  
The Moment ◽  
Health Organization

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic disease of unknown aetiology that is recognized by the World Health Organization (WHO) and the United States Center for Disease Control and Prevention (US CDC) as a disorder of the brain. The disease predominantly affects adults, with a peak age of onset of between 20 and 45 years with a female to male ratio of 3:1. Although the clinical features of the disease have been well established within diagnostic criteria, the diagnosis of ME/CFS is still of exclusion, meaning that other medical conditions must be ruled out. The pathophysiological mechanisms are unclear but the neuro-immuno-endocrinological pattern of CFS patients gleaned from various studies indicates that these three pillars may be the key point to understand the complexity of the disease. At the moment, there are no specific pharmacological therapies to treat the disease, but several studies’ aims and therapeutic approaches have been described in order to benefit patients’ prognosis, symptomatology relief, and the recovery of pre-existing function. This review presents a pathophysiological approach to understanding the essential concepts of ME/CFS, with an emphasis on the population, clinical, and genetic concepts associated with ME/CFS.

scholarly journals Homebound versus Bedridden Status among Those with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 106
Author(s):  
Karl Conroy ◽  
Shaun Bhatia ◽  
Mohammed Islam ◽  
Leonard A. Jason
Keyword(s):  
United States ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
The United States ◽  
Myalgic Encephalomyelitis ◽  
Fatigue Syndrome ◽  
Study Participants

Persons living with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) vary widely in terms of the severity of their illness. It is estimated that of those living with ME/CFS in the United States, about 385,000 are homebound. There is a need to know more about different degrees of being homebound within this severely affected group. The current study examined an international sample of 2138 study participants with ME/CFS, of whom 549 were severely affected (operationalized as ‘Homebound’). A subsample of 89 very severely affected participants (operationalized as ‘Homebound-bedridden’) was also examined. The findings showed a significant association between severely and very severely affected participants within the post-exertional malaise (PEM) symptom domain. The implications of these findings are discussed.

scholarly journals Deficient Butyrate-Producing Capacity in the Gut Microbiome of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients is Associated with Fatigue Symptoms

2021 ◽  
Author(s):  
Cheng Guo ◽  
Xiaoyu Che ◽  
Thomas Briese ◽  
Orchid Allicock ◽  
Rachel A. Yates ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Gut Microbiome ◽  
Symptom Severity ◽  
Chronic Fatigue ◽  
The United States ◽  
Small Sample ◽  
Myalgic Encephalomyelitis ◽  
Healthy Controls ◽  
Shotgun Metagenomics ◽  
Fatigue Syndrome

Abstract Background: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, debilitating disease of unknown cause for which there is no specific therapy. Patients suffering from ME/CFS commonly experience persistent fatigue, post-exertional malaise, cognitive dysfunction, sleep disturbances, orthostatic intolerance, fever and irritable bowel syndrome (IBS). Recent evidence implicates gut microbiome dysbiosis in ME/CFS. However, most prior studies are limited by small sample size, differences in clinical criteria used to define cases, limited geographic sampling, reliance on bacterial culture or 16S rRNA gene sequencing, or insufficient consideration of confounding factors that may influence microbiome composition. In the present study, we evaluated the fecal microbiome in the largest prospective, case-control study to date (n=106 cases, n=91 healthy controls), involving subjects from geographically diverse communities across the United States. Results: Using shotgun metagenomics and qPCR and rigorous statistical analyses that controlled for important covariates, we identified decreased relative abundance and quantity of Faecalibacterium , Roseburia , and Eubacterium species and increased bacterial load in feces of subjects with ME/CFS. These bacterial taxa play an important role in the production of butyrate, a multifunctional bacterial metabolite that promotes human health by regulating energy metabolism, inflammation, and intestinal barrier function. Functional metagenomic and qPCR analyses were consistent with a deficient microbial capacity to produce butyrate along the acetyl-CoA pathway in ME/CFS. Metabolomic analyses of short-chain fatty acids (SCFAs) confirmed that fecal butyrate concentration was significantly reduced in ME/CFS. Further, we found that the degree of deficiency in butyrate-producing bacteria correlated with fatigue symptom severity among ME/CFS subjects. Finally, we provide evidence that IBS comorbidity is an important covariate to consider in studies investigating the microbiome of ME/CFS subjects, as differences in microbiota alpha diversity, some bacterial taxa, and propionate were uniquely associated with self-reported IBS diagnosis. Conclusions: Our findings indicate that there is a core deficit in the butyrate-producing capacity of the gut microbiome in ME/CFS subjects compared to healthy controls. The relationships we observed among symptom severity and these gut microbiome disturbances may be suggestive of a pathomechanistic linkage, however, additional research is warranted to establish any causal relationship. These findings provide support for clinical trials that explore the utility of dietary, probiotic and prebiotic interventions to boost colonic butyrate production in ME/CFS.

scholarly journals Systematic Review of the Epidemiological Burden of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Across Europe: Current Evidence and EUROMENE Research Recommendations for Epidemiology

2020 ◽  
Vol 9 (5) ◽  
pp. 1557 ◽  
Author(s):  
Fernando Estévez-López ◽  
Kathleen Mudie ◽  
Xia Wang-Steverding ◽  
Inger Johanne Bakken ◽  
Andrejs Ivanovs ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Grey Literature ◽  
Reporting Quality ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Current Evidence ◽  
Future Research ◽  
Institute Of Medicine ◽  
Case Definitions ◽  
Fatigue Syndrome

This review aimed at determining the prevalence and incidence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in Europe. We conducted a primary search in Scopus, PubMed and Web of Science for publications between 1994 and 15 June 2019 (PROSPERO: CRD42017078688). Additionally, we performed a backward-(reference lists) and forward-(citations) search of the works included in this review. Grey literature was addressed by contacting all members of the European Network on ME/CFS (EUROMENE). Independent reviewers searched, screened and selected studies, extracted data and evaluated the methodological and reporting quality. For prevalence, two studies in adults and one study in adolescents were included. Prevalence ranged from 0.1% to 2.2%. Two studies also included incidence estimates. In conclusion, studies on the prevalence and incidence of ME/CFS in Europe were scarce. Our findings point to the pressing need for well-designed and statistically powered epidemiological studies. To overcome the shortcomings of the current state-of-the-art, EUROMENE recommends that future research is better conducted in the community, reviewing the clinical history of potential cases, obtaining additional objective information (when needed) and using adequate ME/CFS case definitions; namely, the Centers for Disease Control & Prevention−1994, Canadian Consensus Criteria, or Institute of Medicine criteria.

scholarly journals Current Research Provides Insight into the Biological Basis and Diagnostic Potential for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 73 ◽  
Author(s):  
Sweetman ◽  
Noble ◽  
Edgar ◽  
Mackay ◽  
Helliwell ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Preclinical Study ◽  
Myalgic Encephalomyelitis ◽  
Institute Of Medicine ◽  
Case Definitions ◽  
Biological Basis ◽  
Fatigue Syndrome ◽  
Diagnostic Potential ◽  
Long Term Impact

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe fatigue illness that occurs most commonly following a viral infection, but other physiological triggers are also implicated. It has a profound long-term impact on the life of the affected person. ME/CFS is diagnosed primarily by the exclusion of other fatigue illnesses, but the availability of multiple case definitions for ME/CFS has complicated diagnosis for clinicians. There has been ongoing controversy over the nature of ME/CFS, but a recent detailed report from the Institute of Medicine (Academy of Sciences, USA) concluded that ME/CFS is a medical, not psychiatric illness. Importantly, aspects of the biological basis of the ongoing disease have been revealed over the last 2–3 years that promise new leads towards an effective clinical diagnostic test that may have a general application. Our detailed molecular studies with a preclinical study of ME/CFS patients, along with the complementary research of others, have reported an elevation of inflammatory and immune processes, ongoing neuro-inflammation, and decreases in general metabolism and mitochondrial function for energy production in ME/CFS, which contribute to the ongoing remitting/relapsing etiology of the illness. These biological changes have generated potential molecular biomarkers for use in diagnostic ME/CFS testing.

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