Why this research?

Chronic Fatigue Syndrom is a poorly understood illness.

Gordon Medical Research Center’s collaboration Naviaux Lab has led to the conclusion that CFS is not a problem with energy “deficiency”. It is a problem with cellular energy “distribution”.

Commonly used clinical diagnostic criteria for  ME/CFS include the Fukuda, Canadian, and Institute of Medicine, now known as the National Academy of Medicine (NAM) criteria:  

All 3 of the following core symptoms must be present:

• Life altering fatigue lasting for more than 6 months

• Post-exertional malaise

• Unrefreshing sleep

One of the following two symptoms must be present:

• Episodes of cognitive impairment (sometimes called “brain fog”)

• Postural orthostatic tachycardia syndrome (POTS)

These clinical criteria are essential for accurately identifying possible cases of ME/CFS.

However, the accuracy of clinical diagnosis is improved when additional objective testing is available.

What we are learning

In the lab’s studies of genetic forms of mitochondrial disease a novel mass spectrometry-based method that allows for the measurement of over 500 molecules in the blood was developed. Some people have likened these NextGen metabolomics methods to a new lens, like the Hubble telescope, that allow us to see deeper and with greater clarity into the universe of the cell than has been possible before.

Chronic fatigue syndrome is a multisystem disease that causes long term pain and disability. It is difficult to diagnose because of its protean symptoms and the lack of a diagnostic laboratory test. The Naviaux Lab report that targeted, broad-spectrum metabolomics of plasma not only revealed a characteristic chemical signature but also revealed an unexpected underlying biology.

The team at Gordon Medical Research contributed to patient recruitment for the study. Uniquely we were able to provide well defined personal histories and clinical data to create a well defined patient population. In the discovery of metabokin patterns, it is essential to that the study group does in fact have a true chronic fatigue clinical diagnosis. Clear case histories allow for a more accurate analysis of the metabolomic patterning.

Through this clinical and Metabolomic view of the patients, we were able to see that chronic fatigue syndrome is a highly concerted hypometabolic response to environmental stress that traces to mitochondria and was similar to the classically studied developmental state of dauer.

This discovery opens a fresh path for the rational development of new therapeutics and identifies metabolomics as a powerful tool to identify the chemical differences that contribute to health and disease.

Where we are now

In new research funded by the Steven and Alexandra Cohen Foundation and private donors, the Naviaux Lab and its clinical partners will be using advanced methods in targeted metabolomics and exposomics to answer the following questions:

• Can metabolomics and exposomics be used to diagnose acute Lyme disease?

• Can these methods predict who is at increased risk to develop Post Treatment Lyme Disease Syndrome (PTLDS)?

• Is there an overlapping chemical signature in PTLDS and ME/CFS?

• Can a new test called “Dynamic Metabolomic Analysis” (DMA) be used to personalize metabolomic results, identify subtypes, and predict outcomes in Lyme or ME/CFS?