Markers for CFS/ME?

[Levi]

Since the CDC has revised its website to explicitly disavow the use of diagnostic markers for determining which patients fall within the parameters of CFS/ME, lets counter them with a list of the best markers we know of, and the tests used to find these markers.

Of course, everyone is looking at XMRV as a potential marker, but that is best tabled until the Alter FDA/NIH paper comes out. If it ever does. Cytokine levels? Cortisol? Viral reactivations? Reverse transcriptase? Cardio anomalies? Cerebral perfusion issues? What do you think the best potential markers are, and how would you weight them for reliably selecting CFS/ME patients apart from otherwise fatigued individuals?

I will start out with a possible marker; CFS/ME patients have Sanpaku eyes - http://en.wikipedia.org/wiki/Sanpaku

 

[leelaplay]

great idea Levi

I think Klimas' work on cytokines would be one http://www.plosone.org/article/info:doi/10.1371/journal.pone.0010817

 

[consuegra]

I was just watching tonight the round table discussion of the London conference . This is worth watching. There is a good amount of talk about markers.

Cytokines are a good bet, but who has access to this at the moment? Within the available commercial tests, as a combination, one might suggest XMRV, NK cell function, MMP-9, Immuknow, MSH, alpha interferon and Il-8.

This thing about the eyes, I wonder?

Chris

http://cfspatientadvocate.blogspot.com

 

[Levi]

The ayes have it . . .
http://www.sciencedaily.com/releases/2010/01/100114081158.htm
http://media-dis-n-dat.blogspot.com/2010/06/simple-eye-test-may-one-day-diagnose-ms.html
http://sfari.org/news/-/asset_publi...sponse-to-light-could-be-biomarker-for-autism

Sadly, you will not see the evil minions at the CDC rushing out to line up research on these interesting possible CFS/ME markers. There are a lot of capable albeit severely challenged folks here on PR. Why not put together a weighted list of markers and form a PR cohort? Then look for grant money etc. to test our internet cohort for the effectiveness of the markers? Just bypass the CDC, the Weasel, etc., and get the information out there.

Sick folks will have a choice, search thier past for incidents of childhood abuse, sign up for CBT and GET, or get testing for a bonafide set of markers to know exactly what they are dealing with in terms of thier own personal health.

This thing about the eyes, I wonder?

 

[leelaplay]

Good point Chris

We could probably take the list of tests that the CDC just posted as being NOT relevant for ME/CFS - and find the corresponding research that shows that they are all bio-markers for ME/CFS or its common comorbid entities

 

[usedtobeperkytina]

There isn't just one, except Peterson said if there was just one that seems most common and distinctive is NK Cell function. But all the others are like dots and the doc would have to connect the dots:

low cortisol (can't forget that one)
Other viruses reactivated
Growth hormones
Signs of inflammation (platelets)
Homocysteine
Fibrin monomer

That's it for me tonight.

Tina

 

[lono]

My opinion is that not everyone with CFS/ME became ill via the same mechanism (and that's a major reason why during several decades of trying they've been unable to find common biomarkers for the illness). As has been discussed on this board, a number of people with CFS/ME (though not everyone) have these abnormal biomarkers:

- Melanocyte stimulating hormone (MSH)
- Vasoactive Intestinal Peptide (VIP)
- C4a
- TGF-Beta1

 

[Tammie]

I can't list them offhand, but I would say that the various markers that have been found as a result of PEM would be excellent since they are objective and clearly very different from other illnesses

 

[Chris]

How about Cheney's favourite, the low circulating blood volume discovered by Peckerman et al back in 2003? That interprets "biomarker" a little broadly--anything that can be measured--but counts, I think. As do the findings on PEM from the Pacific University's Staci Stevens team and others--we have a quite atypical response to repeated exercise, with no recovery for over 24 hours. Chris

 

[SOC]

Would the Staci Stevens' (Pacific U) tests for PEM combined with Dr Klimas' decreased NK cell function cover us all? In other words, are there any of us who would likely test as "normal" on both tests? How many people are likely to have PEM per Stevens' tests and NOT have ME/CFS? Ditto for decreased NK cell function? Does anyone know?

They look to me like 2 tests that could be done at most facilities and cover most patients.

 

[jeffrez]

I just sent a dozen or more studies to my PCP showing the immunological biomarkers for CFS. They include:

- Natural killer cytotoxic T cell dsyfunction
- Immune activation of T lymphocytes (CD8+/CD38)
- HLA-DR antigen activation
- Th1/TH2 imbalance
- RNase L upregulation
- Increased levels of pro-inflammatory cytokines

We know that there are also markers of cellular/mitochondrial energy impairment, HPAA dysregulation, possibly XMRV, cerebral spinal protein differences, specific genetic markers, and as Chris suggested, low cardiac Q score that directly correlates with degree of disability.

 

[consuegra]

I was reminded in watching the round-table discussion that took place the day prior to the InvestinME conference in London about Cheney's idea of a biomarker. He suggested oxygen toxicity and indicated that it was easy enough for any cardiologist to measure (provided that they wanted to do so.). Of course no one has picked up on this idea of Cheney's, no one else using the IVRT to measure oxygen toxicity, very few people believe this. However it is my sense - call it a hunch - that this is going to change and we are going to see Cheney's ideas tested more thoroughly in the near future.

Chris

http://cfspatientadvocate.blogspot.com

 

[Stone]

How about the Light and Light study in The Journal of Pain entitled "Moderate Exercise Increases Expression for Sensory, Adrenergic, and Immune Genes in Chronic Fatigue Syndrome Patients But Not in Normal Subjects"

If these aren't biomarkers, I don't know what would be! A great paper!

 

[SOC]

How about the Light and Light study in The Journal of Pain entitled "Moderate Exercise Increases Expression for Sensory, Adrenergic, and Immune Genes in Chronic Fatigue Syndrome Patients But Not in Normal Subjects"

If these aren't biomarkers, I don't know what would be! A great paper!

Are there readily available tests for those abnormalities? If so, they might be great diagnostic tests.

 

[tolduiwuzsic]

Biomarkers

Are there readily available tests for those abnormalities? If so, they might be great diagnostic tests.

What about Adrenal Functioning problems, is that the same as the HPA stuff? What types of results could we use from Saliva and Live Blood Testing? I know lots of us see alternative medicine folks.

 

[Chris]

Hi, Sickofcfs, a good question--I think very few with CFS would test "normal" on both of those tests, but would have to do some homework to say more--might get back in few days on this. If one then included the results of impedance cardiography, I think the three together would give a very high percentage of correct diagnoses.

Probably higher than many accepted tests--in 2004 I took a treadmill test because of what seemed like cardiac issues--a generally respected test--and passed all 10 mins with no signs of evident ischemia. The cardio pronounced "it's not your heart"; unfortunately, he was wrong--I had a "severely stenotic aortic valve" shown by echo some 10 weeks later. I would suspect that many accepted tests are less than 100% sensitive and selective.

But I will see if I can find the info among the "Supporting Info" with the Klimas paper, or find the slide on her DVD presentation, and dig out the Stevens papers and the Peckerman paper and see what the statistics are. But probably not today... Chris

 

[Chris]

Hi; checked the Klimas paper, and her figures for NK cell cytotoxicity (not the easiest test to perform, I believe) is pretty diagnostic---the range for CFS patients is 8-21, with a median of 12; the range for healthy controls is 20-37, with a median of 28; very little overlap. There may of course be other conditions that involve lowered NKC toxicity so this test alone would not suffice. Chris

 

[Angela Kennedy]

I will start out with a possible marker; CFS/ME patients have Sanpaku eyes - http://en.wikipedia.org/wiki/Sanpaku

Any source for that claim Levi?

 

[Levi]

Angela,

Well, I just sort of made that up. But its easy to just go to a mirror and check for yourself; my eyes are not Sanpaku. You may find this of interest:
http://www.bbc.co.uk/dna/h2g2/A25323518

Or this:http://www.redicecreations.com/article.php?id=4762
Three whites, or sanpaku, is common among those who are ill or exhausted. It is most severe among those who are gravely ill and approaching death.

Any source for that claim Levi?

 

[jeffrez]

I think non-specific/non-lab "markers" like that actually just tend to reduce credibility. I think Cheney or someone also talks about "crimson crescents" in the back of the throat, but that can be pretty non-specific also. I for one don't have either one, and I definitely have CFS. It's better imo to stick to more objective biological/laboratory markers.