NIH Announces Awards in Chronic Fatigue Syndrome Research

The Office of Research on Women’s Health (ORWH) and the Trans-NIH Working Group for Research in Chronic Fatigue Syndrome (CFSWG) of the National Institutes of Health (NIH) are pleased to announce seven (7) awards in Chronic Fatigue Syndrome (CFS) research. The proposed studies will help researchers understand how the diverse symptoms in CFS are related to the interactions between the immune and neurological systems—an important step towards developing effective treatments for a disabling condition.

The awards were funded by ORWH, Office of the Director, and four member institutes: The National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Environmental Health Sciences (NIEHS), the National Institute of Arthritis Musculoskeletal and Skin Diseases (NIAMS), and the National Institute of Neurological Disorders and Stroke (NINDS).

Katherine Light, Ph.D., University of Utah, St. Lake City, Utah, plans to first explore in humans the suggested mechanisms for the perception of pain and fatigue in CFS by assessing repeated patterns in the immune and neurological systems that are present before, during and immediately after mental and physical exertion. There is a possibility that findings will lead to the development of a biomarker for CFS. Her second pilot study will focus on identifying family risk patterns in CFS using the Utah Family Data Base (large genealogy data base) to explore the familial/genetic component of CFS. Identifying a genetic predisposition to CFS will assist in the development of more effective medications.

Theoharis Theoharides, M.D.,Ph.D., Tufts University, Boston, Massachusetts, will explore the relationship of human mast cells (molecules released in stress) in the brain, not only in explaining the development of CFS but also in explaining the effects of antidepressants in relieving symptoms in CFS patients. Dr. Theoharides will examine the cellular changes that explain CFS symptoms using three different classes of antidepressants: tricyclic, serotonin uptake inhibitors and bupropion. Future studies will build on these findings to develop clinical trials of select antidepressants or other molecules that inhibit CFS.

Mary Ann Fletcher, Ph.D., University of Miami, Miami, Florida, plans to study the role of specific peptides: neuropeptide Y (NPY) and dipeptidyl-peptidase (CD26) in the development of CFS. These peptides, formed from amino acids (the basic building blocks of the body that are essential in combating illness), regulate many physiological and disease processes in the cardiorespiratory, immune, nervous and endocrine systems. This study will also examine aspects of the relationship between different levels of peptides and the severity of CFS symptoms and may lead to the development of biomarkers.

Dianne Lorton, Ph.D. at the Sun Health Research Institute in Sun City, Arizona, will establish a tissue bank to make brain and spinal cord tissue available to study CFS/FM (fibromyalga). She has gathered an interdisciplinary research team that will determine the extent to which chronic pain in these patients is associated with glial (support cells of the nervous system) activation and resulting cytokine production (compounds essential to engage the immune response). While studies in rodents have shown this activation leads to inflammation and chronic pain, Dr. Lorton will test the extent that this process is involved in humans in order to target mechanisms to treat the chronic pain associated with CFS.

James Baraniuk, M.D., Georgetown University, Washington D.C., has found that despite its diverse clinical syndromes, the CFS proteome (the entire group of proteins in an organism or system) is the same, suggesting a strong relationship with malfunctioning of the central nervous system. Dr. Baraniuk developed the first predictive model of CFS based solely on objective data and he now proposes to recruit a new group of CFS and Healthy Control subjects to determine if the proteins in their cerebrospinal fluid will be a predictive marker of the spectrum of CFS symptoms. There is a high probability that these methods and markers will be of diagnostic value and will be useful for assessing changes over time in disease severity and treatment effects.

Michael Antoni, Ph.D., at the University of Miami, Miami, Florida, has demonstrated the positive effects of participation in group cognitive behavioral stress management (CBSM) on quality of life, perceived stress, fatigue, memory, muscle pain and post-exertional malaise for CFS patients compared to those in a control condition. Many CFS patients are too debilitated to attend regular therapy sessions. Therefore, in the present study, he will test the physiological effects of a telephone-based cognitive behavioral stress management intervention to illuminate CFS patients’ neuroimmune mechanisms in relation to stress and stress management. The correlation of the neuroimmune parameters and the behavioral components promises to identify a biologically useful marker for CFS.

Italo Biaggioni, M.D. at Vanderbilt University in Nashville, Tennessee, will explicate the role of the sympathetic nervous system (SNS) in the cardiovascular and inflammatory abnormalities in the subset of patients with postural tachycardia (POTS) –increase in heart rate and often decrease in blood pressure on standing. Preliminary studies indicate a relationship between the mechanisms underlying POTS and CFS symptoms. Dr. Baggioni will test these hypotheses in a comprehensive set of experiments with appropriate controls.

“These innovative, interdisciplinary studies to help us better understand the role of the central nervous system in the origin and development of CFS; represent efforts of the Trans-NIH Working Group for Research on Chronic Fatigue Syndrome, chaired by the ORWH, to expand interest in CFS research. I am excited that these efforts could lead to major advances in understanding the disease processes of CFS and that they may also provide diagnostic biomarkers that can be used to measure treatment effects. These studies may also help us understand why some of the known treatments are effective and lead to the development of newer and more targeted remedies,” stated Dr. Vivian W. Pinn, M.D., Director of the ORWH.