Myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) has been a controversial condition ever since it was first diagnosed and recognized. Some uninformed doctors still believe that the syndrome is a psychological phenomenon. Meanwhile, the cause of ME/CFS is still not well understood. Some caregivers still recommend treatments for patients, such as cognitive behavioral therapy and exercise therapy, that either ignore the physiological nature of the syndrome or can actually worsen symptoms, respectively. While ME/CFS is not rare, it is under-diagnosed and often mistreated.
However, the pace of research for ME/CFS has been ramping up, especially in recent years, with remarkable breakthroughs and biomarkers indicating more profoundly than ever before that ME/CFS is a definitive, objective, measurable syndrome that causes profound changes to the brain and body.
An excellent resource for the latest updates in research is a webinar lecture series called “Hot Areas in ME/CFS Research.” This series is presented by Dr. Anthony Komaroff, Professor of Medicine at Harvard Medical School. The webinar was first started in 2016, but a new version has been released this year as well, which is a reflection of the increasing momentum of research into this mysterious condition.
Some of the research areas that are highlighted in the presentation include:
- Research on changes to the brain and central nervous system
- The latest studies have revealed dysfunction of the neuroendocrine system, impairments in cognition (such as attention, memory, and info processing), and impaired autonomic nervous system function.
- MRIs also reveal significant changes to the brain. PET scans also highlight changes to immune system activity.
- Research on exercise and post-exertional malaise
- Studies show that patients have a heightened sensitivity to pain, experience dysfunction of their mitochondria (essential for creating usable energy), and increased muscle acidity after exercise.
- Research on changes to the immune system
- Increased plasma cytokine levels appears to correlate to the severity of symptoms. They go up greatly after exercise.
- Antibodies to a protein produced by both human cells and the Epstein-Barr virus are also elevated in CFS patients.
- Heightened immune activity causes cells to age more rapidy (chromosome telomeres are shorter)
- Research on metabolic changes
- Metabolite levels are reduced in general in CFS patients.
- Defect of pyruvate dehydrogenase enzymes.
- Defects in energy conversion pathways for sugars, lipids, and amino acids.
- Research on gene expression and structure
- Studies have found changes in genes responsible for regulating neurotransmitters, inflammation/immune response, and HPA axis regulation.
- Some structurally normal genes are expressed abnormally in CFS patients.
- Research on the human microbiome (ecosystem of bacteria in the body)
- “Leaky gut:” bacteria and their toxic waste can infiltrate the bloodstream, and bacterial levels in the blood increased after exercise.
- Different types of bacteria were more common in CFS patients compared to healthy people.