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Naviaux et. al.: Metabolic features of chronic fatigue syndrome

Discussion in 'Latest ME/CFS Research' started by A.B., Aug 29, 2016.

  1. Leopardtail

    Leopardtail Senior Member

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    I read it differently Johnathon. They tested a fair number of metabolites of which some reasonably consistent patterns were found across patients. In addition to those some metabolites were markedly different in separate patients (to be expected in any group).
     
  2. Gingergrrl

    Gingergrrl Senior Member

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    I did the Metabolon test (not for ANY research study and completely for my own knowledge) and I think my results matched with the overall research that maybe 25% matched with ME/CFS but 75% was unique to me and my situation. I made up the percents and they are just a guess. I don't think any two patients would have the same Metabolon results, even if they lived in the same house, but I could be wrong.
     
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  3. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    Fluoxetine and its metabolite, norfluoxetine, both have very long half-lives:
    http://www.rxlist.com/prozac-drug/clinical-pharmacology.htm
     
  4. ash0787

    ash0787 Senior Member

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    I guess if you include lots of 'mild' CFS patients that can still walk freely it will rule out deconditioning as a cause for the metabolic signature, and presumably just being extremely tired e.g. after a marathon / staying up for 36 hours
    wouldn't cause such a shift in certain nutrients that are only used in a particular way.

    I do believe in this research, I think it will become the main diagnostic tool, but at the same time I am becoming a bit skeptical about whether the disease is primarily caused by a change in behavior of the mitochondria for various reasons ( some studies not finding mitochondrial dysfunction or lack of ATP, only effective drugs so far target the immune system )
     
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  5. Leopardtail

    Leopardtail Senior Member

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    Thanks for the info, my point actually applied to a wide range of medicines I have tried. It actually stuck around STRONGLY for over six weeks and shocked my doctor (minimum dose for only two days). Hypometabolism was simply a plausible explanation for this general pattern.
     
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  6. FMMM1

    FMMM1 Senior Member

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    First of all I recall folks running statistics training pointing out the risks re "big data fishing trips" and advising that you should have a theory to test. If you check out Chris Armstrong's webinar I think that he's proposing that this is a response to low grade ongoing sepsis reaction and pointing out "evidence" in the form of Hornig/Lipkin's cytokine paper and Hanson's recent metabolmics paper (looking at evidence of translocation across gut into bloodstream); also other papers re chronic encephalitis (inflamation) come to mind. So if I understand this correctly there is a theory re what's maintaining the condition.

    I think the theory that proteins are being used as fuel when glucose is available is interesting. If this is an objective change in metabolism, and it can be measured, then presumably it can assist doctors in diagnosing the condition.

    Also, the increased allantoin in urine (and plasma?), presumably indicating oxidative stress, may provide the basis for a diagnostic test. However, something to enable a correction for the dilution factor in urine is needed.

    In terms of autoantibodies, I'm strongly in favour of maintaining that line of research. If I understand this correctly Chris Armstrong reckons that this is a heterogeneous condition i.e. more than one biochemical condition. Therefore, there may be an autoantibody form in a portion of those with the condition. It may be that metabolmics testing is a way of separating out groups of people with different metabolic conditions and assisting in identifying the underlying cause be it autoimmune or other.

    As for Sphingolipids, TRIP receptors (Griffiths University), and much else, it's all extremely complicated but they may help to explain some/all of the ME/CFS spectrum.
     
  7. Kati

    Kati Patient in training

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    There was a question/comment by Vogt et all on the naviaux et al paper:
    http://www.pnas.org/content/early/2016/11/02/1615143113.extract
    Full text viewable here

    Naviaux et al. team's answer was just published here is a preview:
    http://www.pnas.org/content/early/2016/11/02/1616261113.extract.html?etoc
    Full text

     
    Last edited: Nov 3, 2016
  8. Woolie

    Woolie Senior Member

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    Wow, this comment is a great example of "do as I say and not as I do". They set out all the very high standards that biomed research should meet, that are of course never met by psychosocial research.

    I have to laugh at them saying Naviaux et al need to compare their CFS cohort with a dozen other cohorts, including depression, PTSD, fibromyalgia. Again and again, I've seen psychosocial research that fails to do this - which, when it comes to claims about psychosocial causation, would be to compare the CFS cohort with another with similar impairment of known aetiology (e.g., MS).

    Actually, I can't think of a single psychosocial study of CFS that does this at all. I expect this is because such comparisons would not work in their favour.

    And the big punchline of this commentary is that even if there were a biological signature, this wouldn't necessary mean we've found a cause, which could still be psychological/psychosocial!

    They neglect of course, to point out that the argument for CFS being psychological/psycholosocial is founded entirely on the absence of a biological signature in the first place. Therefore, if we are to find one, the remaining arguments in favour of a psychological model become almost nonexistent.

    I am so sick and tired of these double standards being applied, where biomed research has to be flawless, but psychological research can be loose, free and generally sloppy. Clean up your own house first! :mad::mad::mad::mad::mad:
     
  9. Woolie

    Woolie Senior Member

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    PS you'll notice that biomed researchers never criticise the psychosocial research like this, even though they could have a field day is they so desired. I suspect that's because they think it beneath them. But there's also a general feeling that this psycho stuff is probably useless but also harmless. I wish we could show that it isn't!
     
  10. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    In case anyone needs a reminder, this is Henrik Vogt, who got into some Twitter-fits:
     
  11. Kati

    Kati Patient in training

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    Good catch. This is just horrible. However I really like the answer provided by Naviaux et al.
     
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  12. NL93

    NL93 Senior Member

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    Very ironic criticism coming from a guy that promotes the lightning proces and defends the PACE trial
     
  13. Sidereal

    Sidereal Senior Member

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    Mr "clonidine for sustained stress response" is listed as an author I see.
     
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  14. Snow Leopard

    Snow Leopard Hibernating

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    The fact is the HPA axis his one of the few areas of CFS research that has extensive attention. No specific HPA axis abnormality has been found. Likewise Wyller's pet "sustained arousal" theory was disproven by his failed Clonidine trial - so the authors of the letter should stop applying a double standard to what they believe is evidence and what they believe isn't evidence.
     
  15. John Mac

    John Mac Senior Member

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  16. Ben H

    Ben H OMF Correspondent

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    Jenny TipsforME likes this.
  17. TrixieStix

    TrixieStix Senior Member

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    Anyone have any thoughts on the difference in opinion between Dr. Naviaux and Dr. Fluge? In the video of his October presentation in Stockholm I believe Dr. Fluge states that he does not believe it is a "dauer like state".
     
  18. paolo

    paolo Senior Member

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    Fluge and Mella think that the alteration of the metabolism in ME/CFS is due to the immune response (maybe to an autoantibody) and that several compensatory mechanisms are active in order to produce energy and bypass the blockage produced by the immune system on the energetic metabolism.

    Naviaux thinks that the origin of the shut off of mitochondria is an evolutionary conserved response to stress (whether it is an infection or any other trigger) which is manteined by some sort of signalling.

    In other words, while Fluge and Mella describe a damage of the energy metabolism produced by an abnormal response of the immune system, Naviaux describe an orchestrated response to a trigger, which has evolved to defend the host against several stressors.
     
    Last edited: Dec 17, 2016
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  19. Snow Leopard

    Snow Leopard Hibernating

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    I think calling it a "dauer" like state was inappropriate and doesn't quite describe the illness in humans...
     
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  20. Gijs

    Gijs Senior Member

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    Naviaux is wrong!
     

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