Research: Distinguishing ME/CFS & FM

Posted on 02/23/2023 by wames

Distinguishing ME/CFS and FM through gene expression

 

Canadian researchers have measured the activity (expression) of genes in people with ME/CFS and Fibromyalgia. 3 of the 11 miRNA were over-expressed in ME/CFS and under-expressed in FM. These three miRNAs could be used as potential biomarkers to distinguish ME/CFS from FM.

microRNA is the name of a family of molecules that helps cells control the kinds and amounts of proteins they make. That is, cells use microRNA to help control gene expression. Molecules of microRNA are found in cells and in the bloodstream. OSUCCC

Research abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and fibromyalgia (FM) are two chronic complex diseases with overlapping symptoms affecting multiple systems and organs over time. Due to the absence of validated biomarkers and similarity in symptoms, both disorders are misdiagnosed, and the comorbidity of the two is often unrecognized.

Our study aimed to investigate the expression profiles of 11 circulating miRNAs previously associated with ME/CFS pathogenesis in FM patients and individuals with a comorbid diagnosis of FM associated with ME/CFS (ME/CFS + FM), and matched sedentary healthy controls.

Whether these 11 circulating miRNAs expression can differentiate between the two disorders was also examined. Our results highlight differential circulating miRNAs expression signatures between ME/CFS, FM and ME/CFS + FM, which also correlate to symptom severity between ME/CFS and ME/CFS + FM groups.

We provided a prediction model, by using a machine-learning approach based on 11 circulating miRNAs levels, which can be used to discriminate between patients suffering from ME/CFS, FM and ME/CFS + FM.

These 11 miRNAs are proposed as potential biomarkers for discriminating ME/CFS from FM. The results of this study demonstrate that ME/CFS and FM are two distinct illnesses, and we highlight the comorbidity between the two conditions.

Proper diagnosis of patients suffering from ME/CFS, FM or ME/CFS + FM is crucial to elucidate the pathophysiology of both diseases, determine preventive measures, and establish more effective treatments.

Circulating microRNA expression signatures accurately discriminate myalgic encephalomyelitis from fibromyalgia and comorbid conditions, by Evguenia Nepotchatykh, Iurie Caraus, Wesam Elremaly, Corinne Leveau, Mohamed Elbakry, Christian Godbout, Bita Rostami-Afshari, Diana Petre, Nasrin Khatami, Anita Franco & Alain Moreau in Scientific Reports vol 13, Article number: 1896 (2023) [doi.org/10.1038/s41598-023-28955-9]

 

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The World ME Alliance & the WHO discuss disability health equity

Posted on 02/22/2023 by wames

The WMEA engages with the WHO over disability health equity

 

Following the World ME Alliance’s letter to the World Health Organization (WHO) highlighting critical gaps in their “Global report on health equity for persons with disabilities”, we have met with officials to discuss our recommendations.

This was a positive discussion on the importance of including those with energy limiting disabilities in global health responses. We discussed the range and severity of disability experienced by people with ME and other energy limiting disabilities, and the impact this can have on access to healthcare.

The WHO is now working to produce a Guide for Action, to help countries implement the recommendations set out in the “Global report on health equity for persons with disabilities”.

The World ME Alliance will continue to meet with WHO officials as this guide is developed, to ensure people with ME and other energy limiting disabilities are considered throughout.

We extend our thanks to Darryll Barrett (WHO Technical Lead for Disability), Dr Tarun Dua (Head of the Brian Health Unit), Dr Nicoline Schiess and Kaloyan Kamenov for a productive meeting, and look forward to ongoing work together.

This meeting was attended by the co-chairs of the World ME Alliance, Sonya Chowdhury and Oved Amitay, along with Sian Leary, our Head of Advocacy and Communications.

WAMES is an active member of the WMEA along with 20 other organisations around the globe

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Research: Different risk factors distinguish ME/CFS from severe fatigue

Posted on 02/16/2023 by wames

Severe Fatigue is not the same as ME/CFS

 

US researchers led by Prof Komaroff found that severe fatigue was much more common than ME/CFS in a large group of nurses and the triggers were different. There was an increased risk of ME/CFS in people with a history of mononucleosis (or glandular fever).

Research abstract:

Fatigue is a common reason that patients seek medical care. Only a fraction of these patients meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

To determine if ME/CFS is just a more extreme form of fatigue, or a qualitatively different condition, we assessed whether risk factors for ME/CFS and for Severe Fatigue were similar. An email questionnaire that inquired about symptoms of Severe Fatigue and ME/CFS was completed by 41,802 US female nurses from whom detailed medical and lifestyle information had been collected since 1989.

  • 102 met criteria for ME/CFS
  • 522 had Severe Fatigue
  • 41,178 individuals were without significant chronic fatigue.

We used Cox proportional hazards regression to estimate the Hazard Ratio (HR) of Severe Fatigue and of ME/CFS with each of several potential risk factors, according to the level of exposure to each risk factor.

The risk of Severe Fatigue was significantly increased among

  • participants who were older,
  • had a higher BMI in adulthood,
  • used hormone therapy,
  • had increased alcohol intake
  • and decreased caffeine intake.

In contrast, these risk factor associations were not seen in people with ME/CFS. A self-reported past history of acute infectious mononucleosis was associated with a non-significantly increased Hazard Ratio of later ME/CFS (HR 1.77, 0.87–3.61) and, to a lesser extent, of Severe Fatigue (HR 1.28, 0.98–1.66).

The different contribution of various risk factors to Severe Fatigue and ME/CFS suggests that ME/CFS has a qualitatively different underlying biology from the more common state of Severe Fatigue.

Different risk factors distinguish myalgic encephalomyelitis/ chronic fatigue syndrome from severe fatigue, by Natalia Palacios, Samantha Molsberry, Kathryn C Fitzgerald & Anthony L Komaroff in Scientific Reports vol 13, no.: 2469 (2023)

Image by freepik.com

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Are you good at maths and budgets?

Posted on 02/16/2023 by wames

WAMES is looking for a Treasurer

 

Liz is retiring, for a second time! She helpfully stepped up when Simon left last year, but now she really needs to call it a day.

The Treasurer is critical to our work of raising awareness of ME and influencing service improvement, and is a key member of the WAMES team. No charity can operate without one!

If you can easily balance your personal finances and enjoy planning and budgeting, then please consider doing the same for WAMES. Any additional knowledge and skills you might need can be picked up along the way.

The role of the treasurer is to:

  • ensure that proper financial records and procedures are maintained so we know how much money we have received and how much we are spending
  • give the management committee an understanding of WAMES’ financial affairs and advise on budgets, funding needs etc.

Arrange an informal chat with our Volunteering Support Officer: sharon@wames.org.uk                          Download details

Please note:

  • Training can be arranged & expenses will be paid
  • Most tasks can be carried out from home
  • ‘Role share’ is possible
  • You will get to know the team virtually
  • You don’t have to be knowledgeable about ME
  • The post will give useful experience to add to your CV
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Research: Impact of misdiagnosis in studies of ME/CFS

Posted on 02/16/2023 by wames

Researchers need to increase study sizes and apply strict diagnostic criteria

 

Polish researchers report that the difficulties with diagnosing ME/CFS and ensuring all research participants have the same condition, can lead to inaccurate research results.

Misdiagnosis can skew results significantly in studies with fewer than 500 participants. If research uses only participants with self-reported ME/CFS and does not check the diagnosis against accepted diagnostic criteria, then the study size needs to increase to improve accuracy.

It is also difficult to determine if results apply to all patients if only a group are studied women, young, old etc. And it is important to check that healthy controls in a study are in fact healthy.

Research studies should therefore have a large number of participants over 500 or 1,000, which could be achieved through multi-centre studies OR care is taken through applying diagnostic criteria and laboratory tests to ensure the group has the same diagnosis.

 

Research abstract:

Misdiagnosis of myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) can occur when different case definitions are used by clinicians (relative misdiagnosis) or when failing the genuine diagnosis of another disease (misdiagnosis in a strict sense). This problem translates to a recurrent difficulty in reproducing research findings.

To tackle this problem, we simulated data from case-control studies under misdiagnosis in a strict sense. We then estimated the power to detect a genuine association between a potential causal factor and ME/CFS. A minimum power of 80% was obtained for studies with more than 500 individuals per study group. When the simulation study was extended to the situation where the potential causal factor could not be determined perfectly (e.g., seropositive/seronegative in serological association studies), the minimum power of 80% could only be achieved in studies with more than 1000 individuals per group.

In conclusion, current ME/CFS studies have suboptimal power under the assumption of misdiagnosis. This power can be improved by increasing the overall sample size using multi-centric studies, reporting the excluded illnesses and their exclusion criteria, or focusing on a homogeneous cohort of ME/CFS patients with a specific pathological mechanism where the chance of misdiagnosis is reduced.

Impact of Misdiagnosis in Case-Control Studies of Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome, by  João Malato Luís Graça, and Nuno Sepúlveda in Diagnostics 13 (3)
[doi:10.3390/diagnostics13030531]  1 Feb 2023
(This article belongs to the Section Pathology and Molecular Diagnostics)

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Biomarker research: Differentiating ME and FM

Posted on 02/15/2023 by wames

Differentiating ME and FM

 

Canadian researchers believe they have uncovered a way to tell the difference between people with ME, FM and both ME + FM. 11 miRNAs (microRNAs) are proposed as potential biomarkers.

microRNA is the name of a family of molecules that helps cells control the kinds and amounts of proteins they make. That is, cells use microRNA to help control gene expression.

Molecules of microRNA are found in cells and in the bloodstream.

Gene expression refers to whether a particular gene is making too much, too little or the normal amount of its protein at a particular time. OSU

Circulating microRNA expression signatures accurately discriminate myalgic encephalomyelitis from fibromyalgia and comorbid conditions, by Evguenia Nepotchatykh, Iurie Caraus, Wesam Elremaly, Corinne Leveau, Mohamed Elbakry, Christian Godbout, Bita Rostami-Afshari, Diana Petre, Nasrin Khatami, Anita Franco & Alain Moreau in Scientific Reports volume 13, Article number: 1896 (2023)

Research abstract:

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and fibromyalgia (FM) are two chronic complex diseases with overlapping symptoms affecting multiple systems and organs over time. Due to the absence of validated biomarkers and similarity in symptoms, both disorders are misdiagnosed, and the comorbidity of the two is often unrecognized.

Our study aimed to investigate the expression profiles of 11 circulating miRNAs previously associated with ME/CFS pathogenesis in FM patients and individuals with a comorbid diagnosis of FM associated with ME/CFS (ME/CFS + FM), and matched sedentary healthy controls. Whether these 11 circulating miRNAs expression can differentiate between the two disorders was also examined.

Our results highlight differential circulating miRNAs expression signatures between ME/CFS, FM and ME/CFS + FM, which also correlate to symptom severity between ME/CFS and ME/CFS + FM groups. We provided a prediction model, by using a machine-learning approach based on 11 circulating miRNAs levels, which can be used to discriminate between patients suffering from ME/CFS, FM and ME/CFS + FM. These 11 miRNAs are proposed as potential biomarkers for discriminating ME/CFS from FM.

The results of this study demonstrate that ME/CFS and FM are two distinct illnesses, and we highlight the comorbidity between the two conditions. Proper diagnosis of patients suffering from ME/CFS, FM or ME/CFS + FM is crucial to elucidate the pathophysiology of both diseases, determine preventive measures, and establish more effective treatments.

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#newWAMESwebsite fundraising challenge!

Posted on 02/13/2023 by wames

WAMES needs a new website

 

The WAMES website has been showing its age for years so we are relieved to be in a position now in 2023 to be able to  upgrade it. This won’t happen overnight as it will take some time and energy to update the content and plan a new site. AND we need to raise the money to pay for it!

 

We invite you to join us in raising £1,500.

Our Volunteering Coordinator, Sharon Williams launched a couple of birthday fundraisers and so far has raised £200.

A great start – thanks Sharon!

What can you do?

Contact Sharon if you need some ideas sharon@wames.org.uk

Why £1,500?

We have contacted a number of Welsh web designers skilled in WordPress and have been gobsmacked to receive quotes varying from £400 to £10,000!

The lower the price, the fewer functions are offered and the more work the WAMES team would have to contribute. Unfortunately our skills are few, but we will still have to learn some new concepts and terminology to communicate effectively with the designer.

By the end of the process we will hopefully know what is meant by menu mapping, SEO optimisation, plug-ins, navigation, cross browser compatibility, hosting, SSL certificates etc. but if we want an effective website it will be essential that someone else is in charge of making it all happen!

£1,500 will cover the design, build and launch of the new website with initial hosting and support plan costs and rebranding.

Let the adventure begin!

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Research: Gut dysfunction found in ME/CFS

Posted on 02/09/2023 by wames

Gut bacteria could have answers for ME/CFS

 

Two separate US studies have found significant differences in the gut microbiomes of people with ME/CFS  compared to healthy people, although it was not possible to tell if they were a cause or consequence of ME/CFS. Researchers hope the findings will help to  develop a diagnostic tool, interventions (dietary, probiotic, prebiotic, or synbiotic) and divide patients into sub-groups to better treat them.

The microbiome may weigh as much as five pounds. The bacteria in the microbiome help digest our food, regulate our immune system, protect against other bacteria that cause disease, and produce vitamins including B vitamins B12, thiamine and riboflavin, and Vitamin K, which is needed for blood coagulation. (University of Washington)

Jackson Laboratory study

Julia Oh’s study compared microbiome samples from people with both short-term ME/CFS (under 4 years; 74 patients) and long-term ME/CFS over 10 years; 75 patients) as well as 79 age- and sex-matched healthy controls. The investigators also looked at blood plasma samples.

There was less diversity found in patients with short-term disease fewer microbes known to be butyrate producers. Butyrate is important for protecting the integrity of the gut barrier and is also known to play an important role in modulating the immune system.

In contrast, the gut microbiomes had re-established in those with long-term disease and were more similar to the healthy controls. However, there were a number of changes in the metabolites in their blood plasma, including many of those related to the immune system. They also had differences in levels of certain types of immune cells compared with the healthy controls.

Highlights

  • Multi-‘omics identified phenotypic, gut microbial, and metabolic biomarkers for ME/CFS
  • Reduced gut microbial diversity and increased plasma sphingomyelins in ME/CFS
  • Short-term patients had more severe gut microbial dysbiosis with decreased butyrate
  • Long-term patients had more significant metabolic and clinical aberrations

Multi-‘omics of gut microbiome-host interactions in short- and long-term ME/CFS, by Ruoyun Xiong, Courtney Gunter, Elizabeth Fleming, Suzanne D Vernon, Lucinda Bateman, Derya Unutmaz, Julia Oh

The Center for Solutions study

Williams’s study looked at the microbiomes of 106 people with ME/CFS and 91 healthy controls that were matched for age, sex, geography, and socioeconomic status. It also looked at levels of microbial species in the stool. It didn’t include analysis of blood plasma, though this group has already published plasma metabolomics analyses elsewhere. It did look at metabolites in the stool, which demonstrated reduced levels of butyrate metabolites in ME/CFS.

Highlights

  • ME/CFS patients have substantial gut microbiome dysbiosis
  • Bacterial abundances, functions, SCFAs and species interactions deviate in ME/CFS
  • Reduced F. prausnitzii and E. rectale in ME/CFS may contribute to butyrate deficiency
  • Low F. prausnitzii abundance correlates with more severe fatigue symptoms in ME/CFS

Deficient butyrate-producing capacity in the gut microbiome is associated with bacterial network disturbances and fatigue symptoms in ME/CFS, by Cheng Guo, Xiaoyu Che, Thomas, Briese, Amit Ranjan, Orchid Allicock, Rachel A Yates, Aaron Cheng, Dana March, Mady Hornig, Anthony L Komaroff,
Susan Levine, Lucinda Bateman, Suzanne D Vernon, Nancy G Klimas, Jose G Montoya, Daniel L Peterson, W Ian Lipkin, Brent L Williams

In the media:

NIH: Studies find that microbiome changes may be a signature for ME/CFS

NIH Director’s blog: More Clues into ME/CFS Discovered in Gut Microbiome

New Scientist: Chronic fatigue syndrome linked to lower levels of some gut bacteria

National Geographic: Chronic fatigue syndrome is a puzzle. Your gut microbiome may hold the key

Neuroscience news: Microbiome changes may be a signature for ME/CFS

Health rising: The NIH ME/CFS Gut Studies Pt. I: A Biomarker for Chronic Fatigue Syndrome (ME/CFS)?

News-medical: Research reveals differences in the gut microbiomes of people with ME/CFS

Science media centre: Expert reaction to two studies on the gut microbiome and ME/CFS

Yahoo news: Our gut bacteria may have the answers to this mystery illness affecting millions

Technology networks: Chronic Fatigue Syndrome patients have altered gut microbiota

EurekAlert: Myalgic encephalomyelitis/chronic fatigue syndrome is associated with distinct changes in the microbiome and gut metabolites

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Research: Endothelial dysfunction in ME/CFS

Posted on 02/08/2023 by wames

Endothelial dysfunction and vascular homestasis in ME/CFS

 

A sub-study of the RituxME trial by Norwegian researchers found a problem in the blood vessels on the heart in a group of people with ME/CFS. Treatment with Rituximab caused a slight but significant improvement in symptoms within 18 months. They conclude that the vascular or circulatory system could play a role in ME/CFS.

Endothelial dysfunction is a type of non-obstructive coronary artery disease (CAD) in which there are no heart artery blockages, but the large blood vessels on the heart’s surface constrict (narrow) instead of dilating (opening). This condition tends to affect more women than men and causes chronic chest pain. (Stanford)

 

Endothelial dysfunction in ME/CFS patients, by Miriam Kristine Sandvik, Kari Sørland, Elisabeth Leirgul, Ingrid Gurvin Rekeland, Christina Særsten Stavland, Olav Mella, Øystein Fluge in PLoS One, 2023 Feb 2;18(2):e0280942 [doi: 10.1371/journal.pone.0280942]

 

Research abstract

Objective:

A few earlier studies have found impaired endothelial function in patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The present study investigated large-vessel and small-vessel endothelial function in patients with ME/CFS.

Study design:

The study was a substudy of the RituxME trial, a national, multicenter, randomized, double-blind, placebo-controlled phase III study on the effect of rituximab vs. placebo in ME/CFS patients in Norway.

Flow-mediated dilation (FMD) and post-occlusive reactive hyperemia (PORH) was measured at baseline and after 18 months of treatment in 39 patients and compared with healthy controls. Other outcome measures were symptom severity and various physical function measures.

Results:

ME/CFS patients had markedly reduced FMD compared to healthy controls at baseline (5.1% vs. 8.2%, p< 0.0001, adjusted for arterial diameter and sex), and significantly lower microvascular regulation measured by PORH than healthy controls (1354 PU vs. 2208 PU, p = 0.002).

There were no differences between the treatment and placebo groups in symptom changes or vascular measures. As a group, the ME/CFS patients experienced a slight, but significant improvement in clinical symptoms after 18 months. PORH, but not FMD, was similarly improved (1360 to 1834 PU, p = 0.028). There was no significant correlation between FMD and PORH.

There were non-significant tendencies towards associations between symptom severity/physical function measures and lower FMD and PORH, and a significant correlation between PORH and steps per 24 hours at baseline.

Conclusions:

ME/CFS patients had reduced macro- and microvascular endothelial function, indicating that vascular homeostasis may play a role in the clinical presentation of this disease.

 

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Research: Gut symptoms in ME/CFS

Posted on 02/07/2023 by wames

Gastrointestinal symptoms in ME/CFS

 

The RituxME study team  in Bergen, Norway have turned their attention to the little studied topic of gut symptoms in ME/CFS.

 

Key summary:

Gastrointestinal symptoms are common in ME/CFS, but there is a knowledge gap in the literature concerning gastrointestinal motility features and detailed symptom description.

In this study, patients with ME/CFS had signs of impaired gastric accommodation after a liquid meal.

Out of 20 patients, 15 patients reported fullness/bloating, 9 reported abdominal pain, and 7 reported nausea. The patients showed signs of visceral hypersensitivity on a drink test.

Our findings suggest that patients with ME/CFS share many similarities with patients with Functional Dyspepsia. The findings were not typical for Irritable Bowel Syndrome.

 

Gastric dysmotility and gastrointestinal symptoms in myalgic encephalomyelitis/chronic fatigue syndrome, by Elisabeth K Steinsvik, Trygve Hausken, Øystein Fluge, Olav Mella, Odd Helge Giljain in Scand J Gastroenterol. 2023 Feb 2;1-8. [doi: 10.1080/00365521.2023.2173533]

 

Research abstract:

Background:

Gastrointestinal symptoms are common in ME/CFS, but there is a knowledge gap in the literature concerning gastrointestinal motility features and detailed symptom description.

Objective:

In this study, we aimed to characterize gastric motility and gastric symptoms in response to a liquid meal.

Methods:

We included 20 patients with ME/CFS with abdominal complaints who were recruited to a double-blind randomized placebo-controlled trial of Rituximab. The patients of this sub study were examined with an ultrasound drink test, and gastrointestinal symptoms were evaluated using the Rome III questionnaire and Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS) questionnaire.

Results:

We found that patients commonly reported fullness/bloating (75%), abdominal pain (45%) and nausea (35%). Ultrasound measurements revealed lower proximal measurements of the stomach after a meal (p <0.01) and larger fasting antral area (p = 0.019) compared to healthy controls. The patients had a stronger symptomatic response to the liquid meal compared to healthy controls regarding epigastric pain, discomfort and nausea (p < 0.05). Ninety percent of the patients reported bowel movement frequencies within the normal range but scored high on bowel habit dissatisfaction and life disruption.

Conclusion:

The patients presented with fullness/bloating, nausea and epigastric pain, showed signs of impaired gastric accommodation and visceral hypersensitivity, showing that the gastrointestinal symptoms of ME/CFS patients are similar to functional dyspepsia.

 

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