Treatment avenues in ME/CFS: A split-gender pharmacogenomic study of gene-expression modules, 2019, Jeffrey, Broderick. Klimas et al

Source: Clinical Therapeutics

Preprint

Date: March 6, 2019

URL:
https://www.sciencedirect.com/science/article/abs/pii/S0149291819300475

Treatment avenues in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A split-gender pharmacogenomic study of gene-expression modules
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Mary G. Jeffrey(1,2), Lubov Nathanson(1,3), Kristina Aenlle(1,3,4), Zachary M. Barnes(1,4,5,6), Mirza Baig(1), Gordon Broderick (1,2,3,7,8), Nancy G. Klimas(1,2,3), Mary Ann Fletcher(1,3,4), Travis J.A. Craddock(1,2,3,9,*)

1 Institute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA

2 College of Psychology, Nova Southeastern University, Ft. Lauderdale, FL, USA

3 Department of Clinical Immunology, Nova Southeastern University, Ft. Lauderdale, FL, USA

4 Miami Veterans Affairs Medical Center, Miami, FL, USA

5 Miller School of Medicine, University of Miami, Miami, FL, USA

6 Diabetes Research Institute, University of Miami, Miami, FL, USA

7 Department of Medicine, University of Alberta, Edmonton, Alberta, Canada

8 Center for Clinical Systems Biology, Rochester General Hospital, Rochester, NY, USA

9 Department of Computer Science, Nova Southeastern University, Ft. Lauderdale, FL, USA

* Corresponding author. Institute for Neuro-Immune Medicine, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314, USA. Email: tcraddock@nova.edu

Received 7 November 2018

Revised 9 January 2019

Accepted 18 January 2019

Available online 6 March 2019.

Abstract

Purpose

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multisymptom illness impacting up to 1 million people in the United States. As the pathogenesis and etiology of this complex condition are unclear, prospective treatments are limited. Identifying US Food and Drug Administration-approved drugs that may be repositioned as treatments for ME/CFS may offer a rapid and cost-effective solution.

Methods

Here we used gene-expression data from 33 patients with Fukuda-defined ME/CFS (23 females, 10 males) and 21 healthy demographically comparable controls (15 females, 6 males) to identify differential expression of predefined gene-module sets based on nonparametric statistics.

Differentially expressed gene modules were then annotated via over-representation analysis using the Consensus Pathway database.

Differentially expressed modules were then regressed onto measures of fatigue and cross-referenced with drug atlas and pharmacogenomics databases to identify putative treatment agents.

Findings

The top 1% of modules identified in males indicated small effect sizes in modules associated with immune regulation and mitochondrial dysfunction. In females, modules identified included those related to immune factors and cardiac/blood factors, returning effect sizes ranging from very small to intermediate (0.147<Cohen delta<0.532). Regression analysis indicated that B-cell receptors, T-cell receptors, tumor necrosis factor alpha, transforming growth factor beta, and metabolic and cardiac modules were strongly correlated with multiple composite measures of fatigue. Cross-referencing identified genes with pharmacogenomics data indicated immunosuppressants as potential treatments of ME/CFS symptoms.

Implications

The findings from our analysis suggest that ME/CFS symptoms are perpetuated by immune dysregulation that may be approached via immune modulation-based treatment strategies. (Clin Ther. 2019;41:XXX-XXX) (c)

2019 Elsevier Inc.

 

33 patients, Fukuda criteria, 23 female, 10 male

Sci Hub link, https://sci-hub.se/https://www.sciencedirect.com/science/article/abs/pii/S0149291819300475

 

Why are they using Fukuda?

 

Paywall, but with "section snippets", https://www.sciencedirect.com/science/article/abs/pii/S0149291819300475