Medical news today blog post, by Ana Sandoiu, 4 April 2017: Biological basis of ‘atypical’ chronic fatigue syndrome revealed


…CFS is difficult to identify as there is no test for it, and because it shares some of its symptoms with other illnesses. However, new research investigates the biological basis for the illness and identifies two subgroups of CFS that go on to develop differently: the so-called classical CFS and an “atypical” variant.

The study was carried out by researchers at the Center for Infection and Immunity (CII) at Columbia University’s Mailman School of Public Health in New York, and it was led by Dr. Mady Hornig, director of translational research at CII and associate professor of epidemiology at the university. The results were published in the journal Translational Psychiatry.

Those with atypical CFS found to have lower levels of immune molecules

Hornig and team performed immunoassays to measure 51 immune biomarkers in the cerebrospinal fluid of 32 people with classical CFS, and another 27 with atypical CFS.

The tests showed lower levels of immune molecules in those with atypical CFS than in those with the classical variant. The analyses revealed drastically lower levels of interleukin 7 (a protein that plays a key role in the adaptive immune response to infections), interleukin 17A, and chemokine ligand 9 (molecules with a key role in the adaptive immunity to neurological illnesses).

Additionally, these biological features were accompanied by different trajectories of disease history and comorbidities. Those with atypical CFS tended to have a history of viral encephalitis and tended to fall ill after traveling abroad or receiving a blood transfusion.

Furthermore, people with atypical CFS went on to develop simultaneous conditions such as seizure disorders, several types of cancers, or demyelinating disorders – that is, multiple sclerosis-like diseases that damage myelin, the protective sheath around the nerve cells in our brains and spinal cords.

“We now have biological evidence that the triggers for ME/CFS may involve distinct pathways to disease, or, in some cases, predispose individuals to the later development of serious comorbidities.

Importantly, our results suggest that these early biomarker profiles may be detectable soon after diagnosis of ME/CFS, laying a foundation for better understanding of and treatments for this complex and poorly understood illness.”    Dr. Mady Hornig

Read the full article with comment by Dr Ian Lipkin

Immune network analysis of cerebrospinal fluid in myalgic encephalomyelitis/chronic fatigue syndrome with atypical and classical presentations, by Hornig, C G Gottschalk, M L Eddy, X Che, J E Ukaigwe, D L Peterson and W I Lipkin in Translational Psychiatry: (2017) 7 [Published online 4 April 2017]

Columbia University blog post, 4 April 2017: Scientists Discover Biological Evidence of “Atypical” Chronic Fatigue Syndrome   Defining subgroups may help clinicians identify and treat the complex, debilitating disease also known as myalgic encephalomyelitis or ME/CFS


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