Latest research: hunting for biomarkers
August 25, 2017
Supporting you to stay informed about M.E. research, we publish regular round-ups by Action for M.E. volunteer and pharmacist Emily Beardall, covering a selection of papers published in peer-reviewed journals.
Please note this is not an exhaustive list – we have selected to highlight the studies that we think are most likely to resonate with the daily lives of those affected by the condition. We will also report separately on further studies of significance, as and when they are published.
You can search online directory PubMed for most studies about M.E. published in peer-reviewed journals. The following studies were published online between 17 June and 16 August 2017. In each case, we have used the same name for the illness as the researchers publishing the paper.
UK M.E. biobank
Details of the UK M.E. biobank were published in the Open Journal of Bioresources. Co-founded by Action for M.E., the biobank was launched in 2011 to accelerate progress in research and is now available for researchers to use, with ethical approval. This bioresource securely stores clinical and demographic data (such as age, sex and symptom questionnaires), and blood samples from people with M.E./CFS, people with multiple sclerosis (MS), and healthy controls. MS participants are included as previous studies have suggested that the two conditions may have symptoms, causes and underlying pathophysiology in common, and studying similar illnesses can help to reveal more about the underlying mechanisms of disease. Unlike many studies, severely ill patients have also been included through home visits.
A study using the UK biobank has been published in the journal BMC Neurology. The study compared the sleep disturbance and cognitive functioning, such as problems with short-term memory, concentration, attention, and information processing, in M.E./CFS and MS, along with investigating risk factors that may worsen these symptoms. All cognitive and sleep symptoms were more common and more severe in the M.E./CFS patients and smokers; and those with an income of under £15,000 were more likely to have severe cognitive and sleep symptoms. The authors suggest that strategies should be developed for those at the most risk to prevent worsening of these symptoms.
Searching for ways to improve diagnosis
The European ME/CFS Biomarker Landscape project is a project involving a network of European M.E./CFS researchers and clinicians, known as EUROMENE. The project pools biomarker research in a database with the aim of promoting collaboration between researchers to increase chances of discovering blood tests for diagnosing M.E./CFS and measuring the success of drug treatments for the illness, along with defining sub-groups.
An initial review published in the Journal of Translational Medicine categorised the biomarkers studied as metabolic, immunological, neurological or infection-associated but found that the majority of the studies were too small and too different in their methods to be able to compare and pool results. The authors recommend strategies for more powerful biomarker research, such as larger studies with standardised criteria for participants, methods and symptom measures, adding that increased funding is also needed for M.E./CFS research.
A primer for health professionals on the diagnosis and management of M.E./CFS in children was published in the journal Frontiers in Pediatrics. This paper reviews the evidence and fills gaps with recommendations based on the clinical observations and practices of the authors. The primer provides a review of the underlying biological mechanisms of the illness, along with treatments and common co-existing medical conditions in children, such as joint hypermobility and POTS.
Looking at sleep problems
A study in the journal NMR in Biomedicine is the first to find a link between differences in brain structure and the symptom of unrefreshing sleep in CFS. Brain scans of 38 patients with CFS were compared with 14 healthy controls. White matter volumes were lower in CFS patients in the areas of the brain responsible for strengthening memory for learned information during sleep, the autonomic nervous system such as regulating heartbeat, and communication between different brain regions. These findings were linked to their poor sleep quality questionnaire scores. The authors say the findings challenge the conclusion drawn from traditional sleep monitoring that sleep difficulties in CFS are just a perception.
A study in The Clinical Respiratory Journal performed sleep tests on patients with excessive daytime sleepiness that were referred to Swedish M.E./CFS specialists to discover what proportion had treatable sleep problems. A fifth of the patients referred to the clinics had symptoms of excessive daytime sleepiness. More than half of these had treatable sleep disorders, for example obstructive sleep apnoea (where breathing stops regularly during sleep, increasing the risk of heart problems if left untreated) or restless leg syndrome. The authors conclude that patients with the symptom of excessive daytime sleepiness should undergo sleep tests and questionnaires to rule out and treat sleep disorders before a diagnosis of M.E./CFS is given
Impact of UK specialist CFS/M.E. services
A study published in BMC Health Services Research looked at the long-term impact of attending in the UK. The study assessed the impact on health, employment, education and training, and domestic tasks or unpaid work. Just under a third (28%) reported their health as much better or very much better, while 65% reported little or no change, and 8% reported much worse or very much worse health.
In the long-term follow-up:
- 12% returned to or increased their hours of education, while 13% reported stopping or reducing it
- 24% of former patients reported being able to return to work or increase their working hours, while 27% reported stopping or reducing it
- 36% increased unpaid work and domestic tasks, while 32% reported a reduction
- 35% increased their social and leisure activities, while 39% reported a reduction.
When asked: “Do you think that you are still suffering from CFS/M.E.?”, the majority of former patients (85%) said yes. Only 6% said no, and 9% said they were uncertain.