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Dr. Ian Lipkin and Dr. Mady Hornig, Use Deep Sequencing and Proteomics to Hunt CFS Vi

Discussion in 'General ME/CFS News' started by Ember, Nov 5, 2011.

  1. Ember

    Ember Senior Member


    Dr. Ian Lipkin and Dr. Mady Hornig, Use Deep Sequencing and Proteomics to Hunt CFS Viruses

    In the end, cutting edge technology may be the game-changer in chronic fatigue syndrome a condition that strikes an estimated 1-4 million patients in the United States.

    Viral involvement and immune system abnormalities have long been suspected as contributing or causing the disease. But for many reasons, including the multiple definitions used, delays in diagnosis and small sample size, study results have been mixed.

    Now however, researchers have powerful state-of-the art tools at their disposal, and the Center for Infection and Immunity at Columbia University stands at the nexus.

    We have the best tools to do the work and the funding required to pursue it, said center director Dr. Ian Lipkin, and will bring the very best possible minds to the problem irrespective of institution. We will be taking a broad, open-minded approach to the problem.

    The CII, and other institutions, using venture philanthropist seed money provided by the Glenn Hutchins Foundation, will focus their efforts on three components:

    Identification of disease markers.
    Disease mechanisms.
    Finding the specific bacteria, fungi and or viruses alone or in combination responsible for causing or exacerbating the disease.

    The research will be two-pronged and coordinated by Dr. Mady Hornig, an associate professor of epidemiology at the Mailman School of Public Health and director of Translational Research at the CII.

    Multiple deep sequencing platforms will be used for pathogen discovery.

    One of the challenges in a chronic disorder like ME/CFS is that we may be dealing with a situation where the trigger, which we have good reason to believe is an infectious trigger, may precede the onset of symptoms or recognition of the chronicity of the pattern by quite a long period, said Dr. Hornig. The agent could have a hit and run; its levels reduce over time, or induce a biologic situation even in the absence of continued high levels of infectious agent.

    Unlike microarray chips that have a finite number of known pathogens for testing, deep sequencing allows researchers to find not only an unlimited number of varying strains of known pathogens, but novel pathogens as well. Testing will most likely be done at a sequencing center pooling the resources of several large centers as the equipment is very expensive and personnel have to be specially trained, according to Dr. Hornig.

    Researchers will be looking for patterns that are consistent across geographic areas, time and clinical status, said Dr. Lipkin.

    We show quite clearly a wide range of infectious agents can trigger similar pathways in immune system that result in similar outcomes so it may well be that there are many pathogens who have capacity to cause chronic fatigue syndrome by either inducing autoimmunity or some sort of impact on the immune function which results in activation, said Lipkin, who plans to examine other hypotheses as well depending on the results of initial tests.

    Defining biomarkers through the use of proteomics will also be carried out at the Yale Keck Biotechnology Resource Laboratory as well as at Columbia University.

    In terms of disease in general, biomarkers, that is proteins that carry out body functions, have been analyzed for diagnostic purposes for more than a century. Recent advances in protein analysis have expanded the opportunities. Proteomics, which is the study of proteins in a specific time frame, is currently the best bet for creating new approaches to diagnosing and treating human disease, and designing new drugs to treat disease.

    The effort in ME/CFS to try to find some biomarkers that will be likely to identify a set of pathways that are likely to involved. That will be an enormous gain for the field and of course the patient, said Dr. Hornig. Biomarkers in ME/CFS can be used to create diagnostic laboratory tests as well as to determine therapy response and prognosis.

    The key to maximizing the outcomes of these tests is the criteria of the patients selected, according to Dr. Lipkin. He said this will give the greatest possibility of finding objective measures for monitoring and measuring the disease. University of Miami researcher and physician Dr. Nancy Klimas, who has been involved in several clinical definitions of ME/CFS, is in charge of the cohort requirement to draw 200 patients from five sites located throughout the U.S.

    What we want to do is start with patients who have been characterized extensively using standardized criteria established by a group of widely respected clinical researchers, said Dr. Lipkin.

    Both Dr. Lipkin, who is a board certified neurologist, and Dr. Hornig, who is a board certified psychiatrist, stress that while they believe ME/CFS is a neuropsychiatric disorder because of the problems with concentration, memory and autonomic nervous system involvement, they do not consider it psychosomatic.

    Its very difficult in my mind to make this a psychological disorder, said Dr. Hornig, who is also board certified as a psychiatrist. We do patients a disservice if we focus solely on secondary phenomena of being disabled or being unable to carry on life to your capacity that shouldnt ever be viewed as being the primary problem.
  2. meadowlark

    meadowlark Senior Member

    Toronto, Canada
    As a PR member who always needs help with the science, can someone define "neuropsychiatric disorder" for me? Thanks.
  3. Esther12


    Bit of a bullshit term imo.


    It could mean anything, which is one of the reasons I don't like it. Autism, schizophrenia, etc are often mentioned as typical examples of neuropsychiatric conditions. I get the impression that some people feel rather sophisticated just for using the term 'neuropsychiatric conditions' - I prefer 'dodgy brain sicknesses'.
  4. it's got a bit fuzzy alas, but the meaning I was used to is "physical ailment of the brain/central nervous system often leading to mental problems"
    ie, Lyme Disease, syphilis, rabies, meningitis
    and "mental problems" include cognitive issues, irritability, etc that we do suffer from.
    IIRC, HIV has now been linked ot a form of Alzheimers?

    ie, it's no surprise that some diseases which effect the brain are in the "psychiatric" area, they should be after all
    our issue though is with the psychobabblers, huge difference

    psychosomatic is purely mental from belief/experiences/thinking too much on a thing and has over years largely been discredited by everyone except...TA DA!! *scary bad guy music plays* :p The Weasels!
  5. Andrew

    Andrew Senior Member

    Los Angeles, USA
    IMO, a neuropsychiatric illness is any neurological dysfunction that affects mental functioning. This could include anything from Alzheimers to insomnia.
    anne_likes_red likes this.
  6. Daffodil

    Daffodil Senior Member

    they will look for new pathogens too, right?
  7. snowathlete


    In their defence, they could (as i think they are) just be saying, ME/CFS is not a psychological disorder, but elements of the disease (phyciological) do affect the brain. Which is fair and accurate given what we know of the illness.

    Also, this work looks to be well planned and determined to find something, focusing primarily on a theorised infection cause.

    What more could we want?
    Ember likes this.
  8. ruben


    This all sounds pretty fair and sensible to me. Speaking as someone who has had ME/CFS since the 1970s and I'm now in my mid 50s all I'm interested in is a cure. If a doctor says to me I'm physically ill and he can get me well that's great. If he says my ME/CFS is mental and he can make me well that's great too. And who knows it might well be a bit of both.
  9. Tristen

    Tristen Senior Member

    Northern Ca. USA
    Excellent, thanks for posting Ember
  10. Sean

    Sean Senior Member

    Promising stuff.

    Exactly. The failure, or unwillingness, by certain powerful interests to differentiate between primary and secondary aspects is what has got us into all this trouble.
  11. justinreilly

    justinreilly Senior Member

    NYC (& RI)
    I don't like her using the term neuropsychiatric. The symtoms she lists- problems with memory, cognition and ANS are neurological symptoms and signs, not psychiatric.
  12. taniaaust1


    Sth Australia

    that is why it is said to be "neuro"psychiatric and was exactly what was being said. ...

    Most of us cant deny that our brains seem to be affected too along with the rest of us.
  13. taniaaust1


    Sth Australia
    This is such great news :) . We finally have serious researchers looking at the right patient cohorts.. (the sickest of "CFS", the ME cohort).

    200 patients :) .. finally a big ME study one could say seeing Nancy Klimas is selecting the participants for it. (will this be the biggest ME study ever??

    I dont count the big studies the CDC has been involved in in the past using the definations it did for the georgia study etc etc
  14. alex3619

    alex3619 Senior Member

    Logan, Queensland, Australia
  15. Esther12


    Sorry - I didn't mean to sound like I was attacking these particular researchers. Their work sounds entirely positive, and hopefully it will be useful for us.

    I know that lots of respectable researchers find the term 'neuropsychiatric' useful, and parts of me see why. It's just not a term I feel is terribly good at communicating any clear information about an illness or how it should be treated. Our minds are the result of the functioning of our brains, and this means that all psychiatric problems could be considered neuropsychatric. Equally, all illnesses, neurological or not, will have psychological affects upon individuals.

    We've seen how poor and misleading much of the psychiatric research around CFS is, and I think it's best to have as few people as is possible under psychiatric care. When we still have such a limited understanding of psychological factors of illness, I'm worried that an ever growing expanse of patients are having their emotional and cognitive responses being judged in a pragmatic psychological manner, and that the term 'neuropsychiatric' helps enable this.

    None of this is meant to be an attack on Lipkin or his study though.

    Also - I'm still entirely open to the possibility of psychological treatments being helpful for CFS patients - I just don't think that this is necessarily the case if (for example) CFS is the result of some sort of brain damage. If patients are suffering from cognitive distortions, then treatments aimed at correcting them would be entirely appropriate. If patients are feeling angry and upset about their illness and the unreasonable way they have been treated by medical staff, then those responses could be entirely appropriate, even if they do serve to limit functionality: the 'treatment' should be to hold those responsible for the unreasonable way in which CFS has been treated accountable.
    justinreilly likes this.
  16. Starlight

    Starlight Senior Member

    One can be diagnosed with neuropsychiatric lupus it simply means the lupus is or can cause stroke depression lack of concentration and similar things.it does not suggest that lupus is not a physical illness.i think this is what is meant by this ref to me in this context
  17. snowathlete


    I understand, and indeed there has been alot of history which makes us all a little defensive when words about the brain are used, and i would agree that the use of the term, neuropsychiatric would be worrying if it wasnt qualified by the next sentence.

    Personally im not. I think there are cognitive issues as a consequence of ME/CFS, but I dont believe they are treatable psychologically. I think if you clear up the infective cause then the connitive problems will resolve themselves. Until recently, my father had terrible migraines for about 40 years and they got so frequent and bad that it was very disabling, and he was losing his speech and motor skills. After trying 'everything' he tried another treatment and it instantly made him 100% better. We were worried that he might have lasting brain damage, but he had tests and found that he didnt, in fact his brain was said to be good in all areas, which is incredibly rare (usually people are high in certain areas, and low in others). Anyway, my point is that i think the brain issues will clear up when the primary cause is treated.

    Anyway, we have reason to believe this will lead to discovering alot more about the illness and how to treat it.
  18. xchocoholic

    xchocoholic Senior Member

    I had extensive neuropsychological testing in1992 and failed miserably. It's comprised of multiple tests to determine if you can think clearly. For example, I was asked to perform several simple math problems, given a list of things to remember and repeat, and pick which variable didn't fit in with the others.

    I didn't look but assumed this diagnostic criteria is called neuropsych since the ability to perform these functions can't be seen in an mri, etc.

    Overall, this research looks promising. Did they mention looking for heavy metals or other toxins ?

    Good news tho ... X
  19. Desdinova

    Desdinova Senior Member


    Sigh why does their always have to be a psychiatric aspect to our Condition. I've had some sort of health issue or another since I was about 20. And my Fatigue from Hell started nearly Five years ago Friday December 16, 2006.

    It wasn't until long after I came down with this that I was ever down emotionally or mentally to any point I would even begin to call depressed. And that is because of personal relationship issues with people whom I didn't even know until after I had been sick for almost three years.

    Sorry if that's TMI. But I can't help but feel that the PTB sure seem to be trying to really sell this. It's almost being billed IMO as if the Ian Lipkin Hunt is the end all be all. If he don't find it then we've tried everything, it doesn't exist, stick a fork in it were done here. Now move along there's nothing to see here the case is closed.
  20. Ok, despite our andobviously my, lol, dislike of the psychobabblers...
    psychological treatments ARE helpful in many patients lives when dealing chronic, delibilitating illness, we should never forget that.

    There is a world of difference between the damn Weasels saying "ME is caused by wrong illness beliefs" (what a load of bloody COBBLERS that is!)
    "We can help you cope with living with this awfull illness"

    it's liek a GP giving you morphine to help cope with pain caused by cancer, which is perfectly valid and helpful when appropriate...
    the GP is out of order if he tries to tell you morphine can cure the cancer or the cancer is just hysteria!

    *sings Springsteen*


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