Myalgic encephalomyelitis/chronic fatigue syndrome does not currently
have a diagnostic test. But this may soon change, as researchers have
developed a test that can predict it with an unprecedented level of
accuracy.

Currently, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
is estimated to affect more than 1 million people in the United States,
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.

However, this may soon change, as a team of researchers led by those at
the Center for Infection and Immunity (CII) at Columbia University’s
Mailman School of Public Health in New York City, NY, have engineered a
highly accurate test for the disorder. The researchers detail their
findings in a new study recently published in the journal Scientific
Reports. Dr. Dorottya Nagy-Szakal, a CII researcher, is the first author
of the paper.

Engineering an ME/CFS diagnostic test

Dr. Nagy-Szakal and team examined the blood samples of 50 people with
ME/CFS and compared them with those of 50 age-matched healthy controls.
Using a special technique that identifies molecules by measuring their
mass, the scientists found 562 metabolites that the ME/CFS patients had
in common.

Metabolites are byproducts of the body’s metabolism – that is, its
ability to process sugars, fats, and proteins. In the recent research,
the scientists excluded metabolites resulting from antidepressants or
other drugs.

Laboratory tests carried out by Dr. Nagy-Szakal and team revealed that
certain metabolites were altered in a way that suggested that the
patients’ mitochondria – which are the tiny organelles inside the cell
responsible for turning nutrients into energy – were not functioning
properly. The results are coherent with previous studies led by other
researchers, as well as with research carried out by Dr. Nagy-Szakal and
colleagues last year.

In 2017, the team found a distinct pattern of metabolites in people who
had both irritable bowel syndrome (IBS) and ME/CFS. Other studies have
reported that 35-90 percent of those with ME/CFS also have IBS. And in
the new study, half of the ME/CFS patients also had IBS.

Test yields 84 percent accuracy

Dr. Nagy-Szakal and her colleagues combined biomarkers from both their
2017 study and their new study. The result was a predictive model with a
0.836 score, which translates into an accuracy rate of 84 percent. ‘This
is a strong predictive model that suggests we’re getting close to the
point where we’ll have lab tests that will allow us to say with a high
level of certainty who has this disorder,’ explains Dr. Nagy-Szakal.

Corresponding author Dr. W. Ian Lipkin, director of CII and the National
Institutes of Health (NIH) Center for Solutions for ME/CFS, also weighs
in on the findings, saying, ‘We’re closing in on understanding how this
disease works. We’re getting close to the point where we can develop
animal models that will allow us to test various hypotheses, as well as
potential therapies. For instance, some patients might benefit from
probiotics to retune their gastrointestinal microflora or drugs that
activate certain neurotransmitter systems.’

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