Review Unravelling shared mechanisms: insights from recent ME/CFS research to illuminate long COVID pathologies, 2024, Annesley et al.

https://www.sciencedirect.com/science/article/pii/S1471491424000285

Trends in Molecular Medicine
Available online 4 March 2024

Review

Unravelling shared mechanisms: insights from recent ME/CFS research to illuminate long COVID pathologies

Sarah J. Annesley 1, Daniel Missailidis 1, Benjamin Heng 2, Elisha K. Josev 3 4 5 7, Christopher W. Armstrong 6 7

1 Department of Microbiology, Anatomy, Physiology and Pharmacology, La Trobe University, VIC, Australia

2 Macquarie Medical School, Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, NSW, Australia

3 Neurodisability & Rehabilitation, Clinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC, Australia

4 Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Parkville, VIC, Australia

5 Mercy Hospital for Women, Heidelberg, VIC, Australia

6 Department of Biochemistry and Pharmacology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, VIC, Australia Available online 4 March 2024.

What do these dates mean?

https://doi.org/10.1016/j.molmed.2024.02.003

Highlights

Approximately half of patients with long COVID (LC) fulfil the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The two conditions share clinical similarities and proposed disease pathologies, but it is still unclear whether they also share common molecular abnormalities.

Most consistently altered pathologies in ME/CFS and LC include an increased reliance on alternatives to carbohydrates as substrates for energy production and altered gut microbiota, with a reduction in butyrate-synthesising bacteria.

Therapeutic approaches targeted at the autoimmune response showed early promising results, but have not passed further clinical trials.

ME/CFS and LC research has identified potential biomarkers, which need to be replicated and validated, with the most accurate and clinically practicable appearing to be measurements of RNAs for ME/CFS.

Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating chronic illness often triggered by an initiating acute event, mainly viral infections.

The transition from acute to chronic disease remains unknown, but interest in this phenomenon has escalated since the COVID-19 pandemic and the post-COVID-19 illness, termed ‘long COVID’ (LC).

Both ME/CFS and LC share many clinical similarities.

Here, we present recent findings in ME/CFS research focussing on proposed disease pathologies shared with LC.

Understanding these disease pathologies and how they influence each other is key to developing effective therapeutics and diagnostic tests.

Given that ME/CFS typically has a longer disease duration compared with LC, with symptoms and pathologies evolving over time, ME/CFS may provide insights into the future progression of LC.

Keywords ME/CFS long COVID (LC) biomarkers immune system metabolic dysfunction neuroinflammation

 

“Chronic fatigue condition offers clues to Long COVID”
https://www.nationaltribune.com.au/chronic-fatigue-condition-offers-clues-to-long-covid/

Newspaper article that looks like it is based on a press release

 

They give this overview in the article but I don't think the evidence for these 'biomarkers' is convincing enough to call them a biomarker for ME/CFS or Long Covid.

 

As described in the paper:

• They are prospective or proposed only.
• They all need to be replicated and validated.
• Disease specificity has not been determined.
• Clinical practicability is still a question.
• Inclusivity of ethnically of geographically diverse populations is lacking.
• Some of the results are contradictory.
• The phrasing describing the overall body of work saying "recent work attempting to identify diagnostic biomarkers" was very carefully chosen.

I worked hard throughout the drafting of this review to keep the biomarker discussion restrained and realistic despite it being a greatly encouraged hot topic.

There was more along these lines to qualify and emphasise these aspects in earlier drafts that had to be cut out due to length which is unfortunate. But since the few dot points I have just provided more or less summarise the work anyway, maybe writing more about it is unnecessary. The tldr is that it's too early to really place bets on anything. Maybe one could guess that approaches that fit well into existing path workflows might be more viable than alternatives (which is why RNAs were noted specifically, they are being researched a lot in this space and RT-PCRs are easy to do as evidenced by the rapid rollout of COVID-19 PCR testing to existing path infrastructure).

I only clarify all of this here because I know pwME may not have the capacity to read the paper thoroughly and the information ended up scattered apart and minimised due to structural changes imposed by the journal. Tone not intended to be defensive or anything like that.

 

No, but it's fantastic that the course is being prepared, even if the race isn't yet under way.

 

ME Research UK:

ME Research UK is currently supporting Dr Sarah Annesley at La Trobe University for two projects looking at mitochondrial abnormalities in ME/CFS. Dr Annesley and colleagues also recently published a review article discussing many of the pathological mechanisms that could be shared between ME/CFS and long COVID, and whether insights from ME/CFS research might be used to illuminate long COVID, and vice versa.

Read more:
https://www.meresearch.org.uk/research/insights-from-me-cfs-research-that-illuminate-long-covid/