By Alan Cocchetto, NCF Medical Director © 2016

From Fall 2016 Forum

The “Just Ask.’ ” column is intended to act as a means for patients to inquire about issues related to the NCF ‘s research activities. This column is NOT intended to act as medical advice in any way, shape or form.’ The National CFIDS Foundation assumes no responsibilities for any action or treatment undertaken by readers. For medical advice, please consult your own personal healthcare providers.

Q: I just read that CFS may leave a ‘chemical signature’ in the blood. What does the NCF think of this?

A: The patient that sent us this question is referring to a new paper just published in the August issue of the Proceedings of the National Academy of Sciences¹. This research was completed by a team of scientists at UCSD (Naviaux et. al.) and was edited by Ron Davis at Stanford University.

According to the authors, they “performed targeted, broad-spectrum metabolomics to gain insight into the biology of CFS.” You might be thinking, What is metabolomics? Metabolomics is the scientific study of chemical processes involving metabolites. Specifically, metabolomics is the systematic study of the unique chemical fingerprints that specific cellular processes leave behind; the study of their small-molecule metabolite profiles. The metabolome represents the collection of all metabolites in a biological cell, tissue, organ or organism, which are the end products of cellular processes.

In this study, the authors looked at 612 metabolites from 84 patients. Their results show that “CFS has an objectively identifiable chemical signature in both men and women and that targeted metabolomics can be used to uncover biological insights that may prove useful for both diagnosis and personalized treatment.” Furthermore, “these data supported the notion that it is the unified cellular response, and not the specific trigger, that lies at the root of the metabolic features of CPS.” Therefore, the study concludes that their “data that despite the heterogeneity of factors leading to CFS, the cellular metabolic response in patients was homogeneous, statistically robust, and chemically similiar to the evolutionarily conserved persistence response to environmental stress known as dauer.” Thus, CFS is a hypometabolic response to environmental stress.

For those who aren’t familiar with the term dauer, dauer (German for “endurance”, “duration” or “permanent”) describes an alternative developmental stage of nematode worms, particularly Caenorhabditis elegans, whereby the larva goes into a type of stasis and can survive harsh conditions³.

What I found most interesting in this paper was to carefully examine the metabolic similarities between CFS, dauer, cell danger and the metabolic syndrome. This is clearly shown in Table 5 in this paper. The metabolites included sphingolipids, glycosphingolipids, phospholipids, cholesterol, purines, uric acid, arginine, riboflavin etc. When I looked up information relating to these metabolic components, hypometabolism was indicative of general decreases associated with many of these metabolites. However, what is known is that radiation can induce a hypometabolic state that ultimately may lead to the development of the metabolic syndrome over a long time period. The CFS metabolic state is opposite of that for the metabolic syndrome and this would be consistent with radiation sickness.

Briefly looking at the diagrams in this paper, sphingolipids were one metabolite that was highly effected in all CFS patients. lt has been shown that radiation greatly impacts sphingolipids to produce various anomalies. This too would also be consistent with radiation sickness. Thus, human exposure to ionizing radiation disrupts normal metabolic processes in cells and organs by inducing complex biological responses that interfere with gene and protein expression.

At this point, the NCF continues to be highly encouraged by the research we have completed to date and by the scientific direction our researchers have pursued. We wish that Naviaux, Davis and colleagues would at least consider the potential role for radiation exposure in patients because it would help to illuminate and identify the various intermediate stages ultimately associated with radiation sickness.

References

1. Metabolic features of chronic fatigue syndrome; Naviaux RK, Naviaux JC, Li K, Bright AT, Alaynick WA, Wang L, Baxter A, Nathan N, Anderson W, Gordon E; Proc Natl Acad Sci U S A. 2016 Aug 29; www.pnas.org/content/early/2016/08/24/1607571l13.full.pdf

2. https://en.wikipedia.org/wiki/Metabolomics

3. https://en.wikipedia.org/wiki/Dauer_larva