Research Digest 27/11/20

Welcome to the 60th 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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Cardiac Dimensions and Function Are Not Altered among Females with the Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Authors: Iversen PO, von Lueder TG, Kardel KR, Lien K (University of Oslo, Norway)
Publication: Healthcare

In a previous study, the authors found increased lactate accumulation in ME/CFS patients after exercise. The purpose of this study was to examine cardiac function in ME/CFS patients to determine if this could explain the abnormal lactate production and low exercise tolerance in ME/CFS.

The sample included 16 females with ME/CFS (diagnosed according to the Canadian Consensus Criteria) and 10 healthy age and body mass index matched controls. Participants underwent supine transthoracic echocardiography.

There were no significant differences between the groups in cardiac function and dimensions. The results do not support the hypothesis that reduced cardiac dimensions or function may contribute to early exertional lactate accumulation, early gas exchange threshold, or low exercise capacity in women with ME/CFS.

The authors recommend that future research should analyse cardiac function during exercise testing, and examine whether cardiac variables are associated with markers of metabolic pathways such as enzymes and/or substrates for oxidative phosphorylation to generate ATP.

Plasma proteomic profiling suggests an association between antigen driven clonal B cell expansion and ME/CFS

Authors: Milivojevic M, Che X, Bateman L, Cheng A,  Garcia BA,  Hornig M,  Huber M, Klimas NG, Lee B, Lee H, Levine S, Montoya JG, Peterson DL, Komaroff AL, Lipkin WI (Columbia University, USA)
Publication: PLOS One

Metabolomic analysis of blood plasma has revealed disturbances in energy, amino acid and lipid metabolism in ME/CFS. The few studies which have undertaken proteomic analyses have similarly found differences in the proteomic profile in ME/CFS. The purpose of this study was to undertake a plasma proteome analysis using untargeted ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).  

The sample consisted of 39 ME/CFS patients (diagnosed according to both the Fukuda criteria and Canadian Consensus Criteria) and 41 matched controls. Logistic regression models were used to test the ME/CFS association and assess the predictive capacity of each protein analyte. Further analysis was conducted based on participants’ self-reported irritable bowel syndrome (sr-IBS) status, to test the hypothesis that ME/CFS patients with sr-IBS would have altered proteomic profiles. Machine learning algorithms were also applied to analyse the predictive utility of the proteomic analysis as a biomarker test for ME/CFS.  

A logistic regression model that included both linear and quadratic terms found a significant association between ME/CFS and immunoglobin heavy variable (IGHV) region 3-23/30. There was also a significant quadratic effect of immunoglobulin lambda constant region 7 on its association with ME/CFS with sr-IBS, while IGHV3-23/30 and immunoglobulin kappa variable region 3–11 were significantly associated with ME/CFS without sr-IBS. Algorithms identified proteomic profiles that predicted the status of ME/CFS patients with sr-IBS and ME/CFS without sr-IBS.

The authors conclude that their proteomic analysis confirms a significant association of ME/CFS with immune dysregulation and highlights the plasma proteome as a viable and untapped source of potential biomarkers for ME/CFS.
Substrate utilisation of cultured skeletal muscle cells in patients with CFS
Author: Tomas C, Elson JL, Newton JL, Walker M (Newcastle University, UK)
Publication: Scientific Reports

Previous research has shown that skeletal muscle cells from ME/CFS patients have lower levels of adenosine triphosphate (ATP) and have AMP-activated protein kinase (AMPK) dysfunction. ATP and AMPK are involved in energy production and transfer, and this study sought to examine the energy production in skeletal muscle cells of people with ME/CFS.

In this study, researchers examined skeletal muscle cells from 9 ME/CFS patients (diagnosed according to the Fukuda criteria) and 11 healthy controls. Results showed that ME/CFS skeletal muscle cells were unable to utilise glucose to the same extent as healthy control cells but oxidised galactose and fatty acids normally. ME/CFS skeletal cells also exhibited normal glycolysis function.  

The authors conclude that this may indicate the dysfunction lies upstream of the tricarboxylic acid (TCA) cycle, which is a chemical process used to release stored energy. 

Previous research has shown similar issues with glucose oxidation in the blood cells of ME/CFS patients, providing further support for the hypothesis that ME/CFS is a systemic disease.
Will lasting COVID symptoms shine a spotlight on those battling ME/CFS?
Author: Young E
Publication: SBS Insight

Evan Young is an SBS reporter who lives with ME/CFS. In this recent article, he describes his ME/CFS symptoms, highlighting the similarity with those experienced “COVID-19 long haulers”.

The article highlights other similarities between the conditions including patients seeking support from fellow sufferers through online groups, facing stigma and disbelief from doctors and becoming activists to address disbelief and improve patient care. It also acknowledges that the similarities between the two conditions has brought greater attention to ME/CFS, resulting in a positive shift in attitudes towards ME/CFS.

The article also draws attention to Emerge Australia’s 2019 Health and Wellbeing Survey, which found that two-thirds of Australian ME/CFS patients live below the poverty line.
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