Research Digest 1/05/20

Welcome to the 46th Emerge Australia Research Digest, where you will find summaries of some of the latest research and information about ME/CFS, with links to the complete articles.

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Paediatric patients with myalgic encephalomyelitis/chronic fatigue syndrome value understanding and help to move on with their lives

Author: Rowe, K.

This study aimed to document qualitative feedback relating to ME/CFS management in young people. Feedback was sought from patients about ways to improve their ME/CFS management, as well as what information and strategies they found to be helpful.

Between 1991 and 2009, a total of 784 young people, age 6‐18 years, were diagnosed with ME/CFS at Melbourne’s Royal Children’s Hospital. Over a 14-year period, these patients were asked for feedback on their care up to seven times via questionnaires. A total of 626 patients (79.9%) returned completed questionnaires at least once during this period. 

An early diagnosis, contact with empathetic and informed physicians, better self‐management strategies and educational liaison were all frequently cited as helpful for patients to regain some control over their lives. Ongoing support, especially to help navigate the education system and achieve educational and/or life goals, was frequently reported to be necessary as well. Respondents rated flexibility and support for education as important as medical care in the management of their illness. 

The author concludes that distress associated with this illness in young people could be significantly reduced with improved support and awareness of helpful strategies by doctors and teachers.

The effect of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) severity on cellular bioenergetic function.

Author: Tomas, C., Elson, J.L., Strassheim, V., Newton, J.L., Walker, M.
This study aimed to determine whether ME/CFS disease severity was related to cellular bioenergetic function (how well cells transform energy). The researchers used new techniques to re-examine previous bioenergetics data in peripheral blood mononuclear cells (PBMCs).
The participants included 52 ME/CFS patients (who met both Fukuda and Canadian Consensus criteria) and 35 healthy controls. The patient cohort was divided into moderate (mostly housebound) and severe (mostly bedridden) groups in order to determine the impact of severity on cellular bioenergetic function.

Results showed that both the moderate and severe ME/CFS patient cohorts had reduced mitochondrial function compared to the healthy controls. There was no significant difference between the moderate and severe patient groups’ mitochondrial function, which further suggests that mitochondrial function is not related to disease severity, and that the mitochondrial dysfunction found in ME/CFS is not due to deconditioning as deconditioning would predict significantly worse dysfunction in severe patients. 
Severely affected ME/CFS patients were also found to have higher rates of respiratory acidification compared to both the moderately affected patients and the healthy controls (who did not differ significantly from the moderate group). While there was no significant difference in glycolysis between the three groups, when respiratory acidification was taken into account and the data reanalysed, the severe ME/CFS group was again significantly lower than both the moderate group and the healthy controls. The authors caution that this result could reflect deconditioning in the severe cohort, but nonetheless suggest that respiratory acidification is an important factor to be taken into account when measuring glycolytic function in ME/CFS.

Unravelling myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): Gender-specific changes in the microRNA expression profiling in ME/CFS

Authors: Cheema, A.K., Sarria, L., Bekheit, M., Collado, F., Almenar-Pérez, E., Martín-Martínez, E., Alegre, J., Castro-Marrero, J., Fletcher, M.A., Klimas, N.G., Oltra, E., Nathanson, L.
As there is evidence the immune system has a role in ME/CFS, microRNAs (miRNAs) have been explored as potential biomarkers for ME/CFS because of their impact on immune cells. This study investigated miRNA expression in 63 ME/CFS patients (meeting both Fukuda and Canadian Consensus criteria) and 55 healthy sedentary controls in response to an exercise challenge. The study also aimed to examine gender differences and the impact of fasting on miRNA expression.

According to the authors, this was the first ME/CFS exercise challenge study which evaluated gender differences in ME/CFS utilising miRNA expression profiles. The authors found that:

Prior to the exercise challenge, only one miRNA was differentially expressed in ME/CFS patients compared to healthy controls overall, though eight were different between ME/CFS males and healthy males (no significant differences were found between ME/CFS females and healthy females)
Following exercise, there were several differences in miRNA expression between ME/CFS and healthy controls
There were gender differences in miRNA expression in response to exercise
Fasting-induced miRNA differences were also found, emphasising their possible role in ME/CFS-associated disease biology

The findings of this study should be useful not only in understanding gender-dependent disease-specific ME/CFS pathology, but also in the identification of therapeutic regimes suited to ME/CFS gender-specific biology demands.

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