Research

Research can be a financial bottomless pit at times, so it is vital that quality research be undertaken and in this regard The Irish M.E. Trust currently confine its financial support to those projects either under the direct stewardship of or fully endorsed by ME Research UK (formerly MERGE), who are a UK charity with the principal aim of commissioning and funding scientific (biomedical) investigation into the causes, consequences, and treatment of Myalgic Encephalomyelitis. We consider this work to be of vital importance in the quest for quality markers in the diagnosis of ME which can subsequently lead to effective treatment.

As well as high quality research, other small-scale studies listed on this page have served two-fold. The results give information to the wider ME community as well as giving the participant the opportunity to avail of a particular treatment which they might otherwise not be in a position to.

Also listed here is an Awareness of ME & CFS Study undertaken by the Lansdowne Market Research agency.

We are currently part funding 2 research projects with ME Research UK. Please scroll down for details.

Confirmatory study of gene expression in peripheral blood of patients with Gulf War Syndrome

Dr Jonathan R Kerr

Gulf War Syndrome (GWS) is a constellation of symptoms which were reported with a significant incidence in military personnel who fought in the first Gulf War. The most frequent complaints among veterans are fatigue, rashes, joint pains, muscle pains, neuropsychiatric complaints, shortness of breath, sleep disturbances and gastrointestinal problems. Various triggers and mechanisms have been proposed, and it has been shown that the symptoms in veterans with GWS are associated with cellular immune activation though the precise abnormalities remain to be determined and alternative approaches are urgently needed.

There is controversy surrounding this illness, and the situation has clear parallels with Chronic Fatigue Syndrome (CFS). These syndromes exhibit similar symptoms and Gulf War Syndrome patients often also fulfil the CDC criteria for diagnosis of CFS (Fukuda et al, 1994). In addition, they probably have aetiologic triggers and disease mechanisms in common; for example, both illnesses diseases have a Th2 lymphocyte response. Importantly, both Gulf War Syndrome and ME/CFS exhibit indisputable organic and biological abnormalities, and these must be characterised.

Dr Kerr’s team has performed a pilot study of gene expression in CFS patients compared with controls (Kaushik et al, 2005) and has demonstrated marked human gene dysregulation, principally affecting the immune system.

The aim of this confirmatory study is therefore to elucidate the pathogenesis of Gulf War Syndrome through characterisation of human gene expression and protein analysis in 25 Gulf War Syndrome patients and 25 matched healthy blood donors, and to determine if these mechanisms are similar to those that the group has already identified in ME/CFS. Whatever the outcome, the comparison will be instructive, and will help elucidate the meaning of the genetic ‘signature’ for ME/CFS.

Confirming Your (Gene) Signature

Gene expression is the way in which the information inherited from our parents (usually “recorded” as a gene, a sequence of DNA) is translated into a product, such as a protein or an RNA molecule, that can be used by the body. There are now a number of world-wide research groups investigating gene expression in people with ME/CFS, and over the past few years the number of published scientific reports in this field has been steadily increasing (as shown in the table). Some of these studies have not, unfortunately, confirmed their microarray results with real-time polymerase chain reaction (PCR), a flaw which makes interpretation of the results extremely difficult. However, when PCR-confirmed studies are examined, the genes identified in ME/CFS seem related to ‘‘immunity and defence’’, supporting what is already known about the role of the immune system in the illness.

ME Research UK and the Irish ME Trust have actioned “seed corn” funding for Dr Kerr’s group at St George’s University of London to perform a “confirmatory” study of the putative ME/CFS gene signature in a group of 25 patients who became ill after service in the Gulf War 1990-1991, and who report the standard ME/CFS symptoms of fatigue, joint and muscle pain, cognitive complaints, sleep disturbances, and gastrointestinal problems. After full clinical assessment and characterisation of gene expression and protein analysis, it will be possible to tell if the gene signature is similar (suggesting a common pathogenesis) or different (suggesting an entirely different aetiology) to the illness known as ME/CFS.

Gene expression studies in ME/CFS

Autonomic Nervous System dysfunction
A new two-year investigation

The autonomic nervous system controls cardiovascular, digestive and respiratory functions, and has a range of other important roles. When it goes wrong, the consequences can be severe. One of the key difficulties that ME/CFS patients face is standing, most especially standing still, without experiencing symptoms such as dizziness, altered vision, nausea, fatigue etc. The possibility therefore exists that there could be a problem with the autonomic nervous system.

Professor Julia Newton (pictured middle with nurses Katharine Wilton and Jessie Pairman) of the School of Clinical Medical Sciences, University of Newcastle received a grant from ME Research UK and the regional ME/CFS service in 2007 to examine a large group of patients using a battery of tests of heart rate and blood pressure. The Cardiovascular Laboratory in which the tests were done is one of the largest autonomic testing labs in Europe with all the necessary equipment and expertise for comprehensive autonomic testing.

Professor Newton’s results – published in the Quarterly Journal of Medicine (August 2007) – showed that in three-quarters of the patients, autonomic dysfunction was present, a very unexpected finding. Furthermore, in a separate study (see box below), Professor Newton has reported that a simple-to-measure assessment of the heart rate response to standing was abnormal in a significant proportion of patients.

ME Research UK, the John Richardson Research Group and the Irish ME Trust have provided funding for the next phase of the work – a two-year project exploring some of the mechanisms behind these autonomic problems in ME/CFS patients. The investigation has two broad aims. The first is to fully examine the people attending the Newcastle CFS/ME Clinical Service, and develop a database of patients who can be followed up over the long-term. The second is to begin to answer the question, “Does the autonomic dysfunction in people with ME/CFS arise in association with abnormalities of brain, muscle and liver, as has already been shown in other patients with other illnesses?” For this investigation, a series of linked studies will examine muscle bioenergetics – using state of the art magnetic resonance techniques, including assessment of liver fibrosis and percentage fat.