Tired or sick? This study may give us an answer

In “I Love My Home”, the ecstatic figure of the “Er Bun” on the sofa created the image of “Ge You lying” beyond the classic.

The laziness of the second bastard is ridiculous. However, now that we see people like this again, it may be worth ruling out the following diagnoses: depression, hypothyroidism… and “chronic fatigue syndrome”.

Image source: Xintuwang

So, fatigue can also be a disease?

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex disease of unknown etiology. (ME/CFS). Its main symptoms include: unexplained fatigue that persists for at least 6 months, worsens with physical or mental activity, and does not improve with rest. Other symptoms include: cognitive dysfunction, orthostatic intolerance, or gastrointestinal disturbances, among others. At present, the medical community believes that the disease may be caused by multiple factors such as virus, immunity, nerve, and spirit. So far, there is no single laboratory test result that can be used for the diagnosis of ME/CFS. The clinical history is mainly based on medical history and exclusion of other diseases.

In July of this year, researchers from Columbia University, University of California, Davis and other institutions collaborated to discover the potential of “chronic fatigue syndrome” in plasma through metabolomic analysis Disease biomarkers. The research was published in the special issue Metabolomics in Health and Disease of the International Journal of Molecular Sciences.

Chronic Fatigue Syndrome was officially named Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in 2015, redefining the diagnostic criteria. It is estimated that the disease affects 0.4-2.5% of the global population. Among them, the prevalence of females is much higher than that of males.

ME/CFS is a chronic disabling disease that, in addition to fatigue, is often accompanied by memory loss, difficulty concentrating, muscle and joint pain, cognitive difficulties, chronic and severe Symptoms such as weakness and collapse. ME/CFS not only reduces the quality of life of patients, but also imposes a huge burden on society.

The etiology and pathogenesis of ME/CFS are unclear, but there are significant body dysfunctions. Studies have shown that patients with ME/CFS have immune dysfunction, inflammation, and autoimmune symptoms, including cytokines, differences in NK cell function, or T cell responses.

At present, there are also a large number of related metabolomics studies, which prove that ME/CFS patients have disorders of energy, lipid, amino acid and redox metabolism. There were also gender differences in metabolic dimensions and plasma biomarkers, with women being more severely affected.

To determine changes in metabolomic profiles among ME/CFS patients and gender subgroups and controls, researchers collected 106 ME/CFS patients and 91 ME/CFS patients from 5 US cities. Samples from healthy controls were analyzed for 888 metabolic analytes in plasma.

Their findings suggest that peroxisomal metabolism, CDP-choline pathway and tricarboxylic acid cycle are dysregulated in ME/CFS patients.

Through a series of statistical analysis methods, the researchers found that compared with the control group, the levels of plasmalogen, carnitine, phosphatidylcholine, and sphingomyelin in the ME/CFS group were significantly lower, and the levels of dicarboxylate were significantly reduced. Acid levels were significantly elevated.

In the case of plasmalogens, they protect phospholipid and lipoprotein particles from oxidative stress and related damage, and maintain the structural integrity of cell membranes. The reduction of plasmalogen is also a typical feature of neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease. At the same time, it is also related to metabolic diseases and aging.

To identify biomarkers of ME/CFS, researchers explored 3 sets of predictors and 5 different machine learning models. Using a machine learning model, the investigators were able to distinguish ME/CFS or ME/CFS subgroups from controls with area under the receiver operating characteristic curve (AUC) values ​​up to 0.873.

Our findings suggest that a series of interconnected metabolic changes may be responsible for the pathogenesis of ME/CFS:

● Decreased levels of plasmalogens, unsaturated phospholipid ethers, and carnitine, indicating peroxisomal dysfunction;

● Decreases in choline and phosphatidylcholine levels indicateDysregulation of the CDP-choline pathway also provides evidence for the hypothesis of lipid remodeling;

● Elevated levels of dicarboxylic acids, especially alpha-ketoglutarate and succinic acid, two tricarboxylic acid cycle intermediates, The blocked carboxylic acid cycle does not produce sufficient adenosine triphosphate (ATP), which may partly explain the physical and cognitive fatigue in ME/CFS patients.

Not only that, but the lead author of the article, Dr. Xiaoyu Che, Assistant Professor of the Department of Biostatistics at Columbia University School of Public Health, said, “Currently, the effects of Long-COVID and ME/CFS are The symptoms are very similar, and it cannot be ruled out that there is a serious overlap between the two diseases in terms of pathogenesis. The metabolomics study of ME/CFS can also lay the foundation for future research on the sequelae of COVID-19.”

This study not only contributes to the exploration of the pathology of ME/CFS, but also lays a foundation for the possible laboratory diagnosis of ME/CFS. At the same time, this research direction will also allow more medical practitioners and the public to have a more comprehensive understanding of the disease.

Writing | Viewing sir

Edit | Swagpp