A Pair of Identical Twins Discordant for ME/CFS Differ in Physiological Parameters and Gut Microbiom

[Kyla]

http://www.amjcaserep.com/abstract/index/idArt/900314

A Pair of Identical Twins Discordant for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Differ in Physiological Parameters and Gut Microbiome Composition
Ludovic Giloteaux, Maureen R. Hanson, Betsy A. Keller

(Department of Molecular Biology and Genetics, Cornell University, Ithaca, NY, USA)

Am J Case Rep 2016; 17:720-729

DOI: 10.12659/AJCR.900314

Published: 2016-10-10

BACKGROUND: Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) present with profound fatigue, flu-like symptoms, pain, cognitive impairment, orthostatic intolerance, and post-exertional malaise (PEM), and exacerbation of some or all of the baseline symptoms.
CASE REPORT: We report on a pair of 34-year-old monozygotic twins discordant for ME/CFS, with WELL, the non-affected twin, and ILL, the affected twin. Both twins performed a two-day cardiopulmonary exercise test (CPET), pre- and post-exercise blood samples were drawn, and both provided stool samples for biochemical and molecular analysis. At peak exertion for both CPETs, ILL presented lower VO2peak and peak workload compared to WELL. WELL demonstrated normal reproducibility of VO2@ventilatory/anaerobic threshold (VAT) during CPET2, whereas ILL experienced an abnormal reduction of 13% in VAT during CPET2. A normal rise in lactate dehydrogenase (LDH), creatine kinase (CK), adrenocorticotropic hormone (ACTH), cortisol, creatinine, and ferritin content was observed following exercise for both WELL and ILL at each CPET. ILL showed higher increases of resistin, soluble CD40 ligand (sCD40L), and soluble Fas ligand (sFasL) after exercise compared to WELL. The gut bacterial microbiome and virome were examined and revealed a lower microbial diversity in ILL compared to WELL, with fewer beneficial bacteria such as Faecalibacterium and Bifidobacterium, and an expansion of bacteriophages belonging to the tailed dsDNA Caudovirales order.
CONCLUSIONS: Results suggest dysfunctional immune activation in ILL following exercise and that prokaryotic viruses may contribute to mucosal inflammation and bacterial dysbiosis. Therefore, a two-day CPET and molecular analysis of blood and microbiomes could provide valuable information about ME/CFS, particularly if applied to a larger cohort of monozygotic twins.

Keywords: Cytokines, Exercise Test, microbiota, Plasma, Twins, Monozygotic

 

[RogerBlack]

The biome results - is there actually enough understanding of this to say which of two biomes is 'better', or reflective of a disease state. Diet can massively change the biome as an example, as can exposure to outside influences - both of which may vary in a severely affected CFS patient.

 

[Aurator]

As they say, they need to do a bigger study on twins.

I'm a monozygotic twin, with a healthy other half, and would like to know where I went wrong to get what I've got. We both tended to get the same illnesses and even have the same kinds of accidents while we were growing up.

 

[Cheesus]

As they say, they need to do a bigger study on twins.

I'm a monozygotic twin, with a healthy other half, and would like to know where I went wrong to get what I've got. We both tended to get the same illnesses and even have the same kinds of accidents while we were growing up.

It would be good if you and your twin could sign up to a biobank, as I am sure monozygotic twins are in hot demand:

http://solvecfs.org/biobank/

 

[alicec]

is there actually enough understanding of this to say which of two biomes is 'better', or reflective of a disease state.

There seems to be a universal finding that less diversity is associated with a variety of health problems and western guts in general are less diverse than those of people eating traditional diets, not to mention the few examples of traditional hunter gatherers.

I haven't had a chance to read the detail of the study yet - am particularly interested in the virome study.

 

[Cheesus]

@alicec Would I be correct in thinking that prokaryotic viruses are the same thing as bacteriophages?

 

[alicec]

@alicec Would I be correct in thinking that prokaryotic viruses are the same thing as bacteriophages?

Yes. A phage is a virus that infects a bacterium. I am not sure if the same term is used for a virus which infects an archaeon (also a prokaryote). Archaea are present in the gut though in small amounts compared with bacteria.

 

[Sea]

I would be surprised if 34 year old healthy twins had the same microbiome. Has there been any study of that?

 

[alicec]

I would be surprised if 34 year old healthy twins had the same microbiome. Has there been any study of that?

There does appear to be a heritable component to the microbiome - ie host genes play a role. Here is a report of an interesting recent study.

 

[RogerBlack]

There does appear to be a heritable component to the microbiome - ie host genes play a role. Here is a report of an interesting recent study.

There is.
But after you've moved out and not been living with someone for a decade, it looks lots less similar.
No useful cite other than it was mentioned on this week in virology.

 

[alicec]

But after you've moved out and not been living with someone for a decade, it looks lots less similar.

The recent twin study found that at least a dozen microbes are heritable and that these are temporally stable.