Research Interview: Daniel Missailidis By Jason Murphy Smart people – people who keep an eye on ME/CFS research in Australia – are excited. A new paper by researchers from Latrobe University and Monash Health came out in February this year, with further research on the very tantalising evidence that people with myalgic encephalomyelitis/chronic fatigue syndrome have an energy production blockage in their mitochondria. The paper reports that cells from ME/CFS patients are trying to bypass that blockage by using inputs other than glucose to create energy. The paper gels with other research from around the world that has also suggested mitochondrial problem and changed use of energy inputs. It has created quite a splash – not least because the lead author is just 26 years old. Daniel Missailidis is that author. The young Australian researcher’s career is one worth watching in ME/CFS research. And given his age, that career could be long. Why Choose ME/CFS Research? ME/CFS research is a small pond. While for some people the underdeveloped nature of the research field might be a turn-off, for Missailidis the lack of research on ME/CFS is motivating. That’s why he chose to get involved, from the very beginning of his research career. “There were a few projects I could have chosen, to start working in the lab,” he says. “The CFS project stood out to me. I did some reading about it before I chose which project I wanted to take up and having seen the dire need for new research in the field it convinced me it was the project I wanted to pursue.” Missailidis has made a strong start on meeting that dire need of research, having published four scientific papers on ME/CFS already, based on his research during his honours year and his PhD. Missaildis works in the laboratory of well-known ME/CFS researcher professor Paul Fisher and mitochondria expert Dr Sarah Annesley, at Latrobe University in Melbourne. Is he well-regarded in the lab? To answer that question, I asked Professor Fisher to tell me a bit about his young staff member. “To complete a PhD in molecular biology you need good hands for the lab work, a good head for the data analysis and enormous discipline, commitment, passion and persistence in the face of adversity. Daniel has all of these and combines them with common sense, empathy and concern for the participants,” Professor Fisher said. “Daniel’s work has already made a difference to the ME/CFS community around the world” “One ME/CFS patient recently commented on social media, ‘We love Daniel’. We, his colleagues in the lab, agree. By revealing aspects of the underlying biomedical basis for ME/CFS and discovering biomarkers for a reliable blood test, Daniel's work has already made a difference to the ME/CFS community around the world." High praise. But actions speak louder than words. And so it is telling that Fisher doesn’t just talk the talk, he also nominated this researcher for the 2021 Young Achiever Awards. “Paul nominated me and I had no idea,” said Missailidis. “I got an email from the organisers.” The Young Achiever Awards are an annual event, sponsored by Channel Seven. Missailsidis was nominated in the Protective Services Health and Wellbeing category, and made it through the semi-finals, to the grand final. At the gala dinner, to his great surprise, he won the People’s Choice Award. “I think the ME/CFS community really got behind me and I am really grateful for that,” he says. “The best thing about it was that it was a really big event with some influential people present. The big win there was not for me but for the community, there was a lot of awareness spread not just of ME/CFS in Australia but that there’s work going on here to try to solve the disease. The awareness gain from that was the biggest boon.” The Curious Case of Alternate Substrates Missailidis’s research suggest problems with ‘substrate’ usage. Substrates are, if you like, the food that mitochondria use for energy. Experiments have shown that cells which should be simply taking up glucose and turning it into energy are instead relying more heavily upon using other inputs, like amino acids. The theory is that the changes are ‘an attempt to compensate’ for problems with the operation of a mitochondrial protein complex called complex five (written as ‘Complex V’). The big question that Missailidis hopes to tackle next is why this problem is occurring. He aims to focus on the mechanism of the disease, understanding which problems lie upstream of others. “Which abnormality is causing the others? That is going to be a big focus of our work moving forward,” he says. “Really the hope is that a greater understanding of mechanism will help to inform effective treatments. That’s the real goal here, right?” he says. A sentiment that patients everywhere will be glad to hear. “Once we clarify those relationships there should be cause to consider some targeted specific treatments and try them out and see what happens,” he says, referring to treating cells in the lab. The goal being that one day, if treatments show promise, they could be trialled on patients. “There is a tremendous need for funding in this field.” Of course, research gets nowhere without funding. Missailidis was funded as a PhD student for the last several years, but with his PhD about to be conferred, he needs a different funding source to back his enthusiasm for ME/CFS research. “There is a tremendous need for funding in this field,” says Missailidis. “Paul and Sarah, my supervisors, have spent all of this year looking for opportunities to keep us going, writing applications and looking for sources of funding. So I think the future is going to depend on that.” About Jason Murphy: Jason Murphy is a freelance journalist and economist who began his career in the Federal Department of Treasury before moving onto journalism. Now Jason's work can be found all over the internet in the Australian Financial Review, News.com.au, The Advertiser and many other Australian news outlets. Jason excels in taking complex information and breaking it down for readers to give a better understanding of intricate systems to the public.