Low cold temperature (Cryotherapy) project
This project is part of a long-term collaboration with Professor Pawel Zalewski (Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Torun). Pawel’s group have run and published a series of excellent papers investigating the physiology and impact of treatments in ME/CFS. In order to identify “candidate” causal elements in a condition like ME/CFS you really need to observe changes in patient’s symptoms which correlate with a disease associated variable. Just comparing ME/CFS patients with a control group or other similar conditions at a single time point will not identify causal elements and just give you an association. ME/CFS and similar conditions such as fibromyalgia and Long Covid are at best linked to associated markers.
Our Oxford based studies are identifying lots of associations (
Diagnosis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome with Partial Least Squares Discriminant Analysis: Relevance of Blood Extracellular Vesicles | Medicine (frontiersin.org). How do we move from associations to identify causal elements which could lead us to novel treatment targets? Pawel’s whole-body cryotherapy (WBC) project is an extremely valuable source of information. Both patients and controls enjoyed participating in the cryotherapy programme which involved 10 exposures over 10 days to short bursts of extreme cold (
Changes in the Allostatic Response to Whole-Body Cryotherapy and Static-Stretching Exercises in Chronic Fatigue Syndrome Patients vs. Healthy Individuals (mdpi.com) . Unlike a Structured Exercise programme (SEP) (
Prediction of Discontinuation of Structured Exercise Programme in Chronic Fatigue Syndrome Patients (mdpi.com) (
Relationship between Cardiopulmonary, Mitochondrial and Autonomic Nervous System Function Improvement after an Individualised Activity Programme upon Chronic Fatigue Syndrome Patients (mdpi.com) all patients and controls completed the 10 day programme. Some patients showed symptom improvement for 3 months with symptoms reverting to baseline levels after 12 months (unpublished data). Although not a cure, cryotherapy could offer (i) short term treatment and more importantly (ii) give us unique insights into the potential causal elements in the disease. Which biological variable changes when patients improve? Do these same variables go back to disease levels when patients get worse? Are these the same for all patients?
Metabolomics is a relatively new technique which looks at all the chemicals in a blood sample. Cells are removed and we study the chemicals which originate from unknown organs in the body. We are looking for a signature which could (i) tell us if someone has ME/CFS or (ii) tell us which chemicals link to increased or decreased symptoms. The whole-body cryotherapy cohort of thirty-two ME/CFS patients meeting the Fukuda criteria for ME/CFS have also had a wide range of clinical test at each time point. The gut microbiome in the same subjects has already been assessed at each time point. This new study will investigate the plasma metabolomics profile working with the National Phenome centre in UK (
Home - National Phenome Centre). Both targeted and untargeted profiling will be used. Targeting identifies known chemical signatures and allow us to compare to previous studies. Untargeted is more compound discovery and will look for differences in any chemical in the sample. Approach to work on untargeted molecules is more challenging but has the potential to unearth “golden” molecules in the sample. These “golden” molecules if linked to improvements or worsening of symptoms can be identified and explored as potential therapeutic targets.
Speed and cost of the study: Our previous work with metabolomics although identifying interesting insights into the condition due to lack of resources has been slow. Jamie Strong in the Morten group has been leading the research efforts and has done a marvellous job. Jamie came into the group with no research experience and continues to suffer with ME/CFS. He supports the team in translating the experience of ME/CFS symptoms to setting an approach for research into the molecular underpinnings of this debilitating disease. Although Jamie’s research skills have excelled substantially, Jamie still has ME/CFS and for the last 18 months has been taking on the part-time Oxford University MSc in Medical statistics course. Although Jamie has little time now we are keen to get him back in the future! The National Phenome Centre is an MRC NIHR funded resource which will allow us to have a much faster turn-around time for our samples. Our data will be back in 6 months which will allow us to work with the data and integrate it with the other data generated on the same samples and patients. This is a much faster approach than our poorly funded metabolomics studies which after several years are just coming to the paper drafting stage.
Total cost of the study
£38,500
