Accurate Test for Chronic Fatigue Syndrome Developed

Currently, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is estimated to affect more than one million people in the USA, and up to 24 million people worldwide. This often-debilitating condition is characterized by feelings of extreme exhaustion, muscle and joint pain, and insomnia, as well as difficulty concentrating or remembering things.

The causes of ME/CFS remain unknown, and in the absence of a proper diagnostic test for it, healthcare professionals have to exclude other disorders and examine a patient's history before they can tell whether a person has ME/CFS or not. Patients with ME/CFS frequently report a prodrome consistent with infection that includes a sore throat and cervical lymphadenopathy.

Scientists at Columbia University Mailman School of Public Health (New York, NY, USA) and their colleagues examined the blood samples of 50 people with ME/CFS and compared them with those of 50 age-matched healthy controls. The team reported association modeling, biomarker discovery, biochemical enrichment analysis and topological network visualization of plasma metabolomic, fecal bacterial metagenomic and clinical data.

The team performed three untargeted metabolomic assays and one targeted assay for 562 metabolites from over 20 biochemical pathways with gas chromatography time-of-flight (GCTOF) and liquid chromatography–tandem mass spectrometry (LC-MS/MS) instruments by the West Coast Metabolomics Center (University of California, Davis, CA, USA). Irritable bowel syndrome (IBS) co-morbidity was based on self-reported diagnosis of IBS on the medical history form. IBS was diagnosed in 24 of the 50 ME/CFS patients (48%).

The team confirmed reports of altered plasma levels of choline, carnitine and complex lipid metabolites and demonstrate that patients with ME/CFS and IBS have increased plasma levels of ceramide. Integration of fecal metagenomic and plasma metabolomic data resulted in a stronger predictive model of ME/CFS (cross-validated AUC = 0.836) than either metagenomic (cross-validated AUC = 0.745) or metabolomic (cross-validated AUC = 0.820) analysis alone. Among the top plasma biomarkers differentiating ME/CFS patients from controls were decreased levels of betaine, complex lipids (lysophosphatidylcholine (LPC), phosphatidylcholine (PC) and sphingomyelin (SM), and increased levels of triglycerides (TG), α-N-phenylacetyl-glutamine, ε-caprolactam and urobilin.

The authors concluded that identification of ME/CFS subgroups characterized by specific metabolomic profiles that integrate primary metabolites, biogenic amines, complex lipidomics and oxylipins may enable delineation of subtypes and lead to specific diagnostic and therapeutic strategies. The study was published on July 3, 2018, in the journal Scientific Reports.

Related Links:
Columbia University Mailman School of Public Health
West Coast Metabolomics Center