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People with a debilitating and often often underestimated condition called Chronic Fatigue Syndrome may soon be looking for something they have been looking for for decades: scientific evidence of their disease.
Researchers at Stanford University's School of Medicine have created a blood test that can detect the disease, which currently lacks a standard and reliable diagnostic test.
"Too often, this disease is classified in the category of the imaginary," said Ron Davis, PhD, professor of biochemistry and genetics. When people with Chronic Fatigue Syndrome seek the help of a doctor, they can undergo a series of tests that check the liver, kidney and heart functions, as well as the number of blood and immune cells, a said Davis. "All of these different tests should normally guide the doctor to one disease or another, but for patients with chronic fatigue syndrome, the results are normal," he said.
The problem, he said, is that they do not search deeply enough. Now, Davis; Rahim Esfandyarpour, PhD, former research associate at Stanford; and their colleagues developed a blood test to successfully identify participants in a chronic fatigue syndrome study. The test, which is still in the pilot phase, is based on the response of immune cells to stress. With blood samples taken from 40 people – 20 with chronic fatigue syndrome and 20 others – the test yielded accurate results, accurately indicating all patients with chronic fatigue syndrome and none of the healthy individuals.
The diagnostic platform could even help identify possible medications for treating chronic fatigue syndrome. By exposing participants' blood samples to drug candidates and rerunning the diagnostic test, scientists could eventually determine whether the drug improves immune cell response. The team is already using this platform to screen potential drugs that it hopes will help people with chronic fatigue syndrome to come.
An article describing the results of the research was published online on April 29 in the Proceedings of the National Academy of Sciences. Davis is the main author. Esfandyarpour, who is currently a professor at the University of California at Irvine, is the principal author.
Provide proof
The diagnosis of chronic fatigue syndrome, when it is actually diagnosed, is based on symptoms – exhaustion, sensitivity to light and unexplained pain, among others – and it only occurs when other diseases have been eliminated. It is also known as myalgic encephalomyelitis and is referred to by the acronym ME / CFS. An estimated 2 million people in the United States are suffering from chronic fatigue syndrome, but that's a rough approximation, Davis said, and it's probably a lot higher.
For Davis, the search for scientific evidence of the disease is personal. This comes from a desire to help his son, who has been suffering from EM / CFS for about a decade. In fact, it was a biological clue Davis first discovered in his son who led him and Esfandyarpour to develop the new diagnostic tool.
We clearly see a difference in how healthy immune cells and chronic fatigue syndrome treat stress.
The approach, of which Esfandyarpour led the development, uses a "nanoelectronic test", which involves measuring changes in minute amounts of energy to determine the health of immune cells and blood plasma. The diagnostic technology contains thousands of electrodes that create electrical current, as well as chambers to contain simplified blood samples composed of immune cells and plasma. Inside the chambers, the immune cells and the plasma interfere with the current, changing its flow from one end to the other. The change in electrical activity is directly correlated to the health of the sample.
The idea is to stress the samples of healthy and sick patients by using salt, then to compare the impact of each sample on the flow of electrical current. The changes in the current indicate changes in the cell: the greater the change in the current, the greater the change at the cellular level. A big change is not a good thing. it is a sign that cells and plasma are flickering under stress and are unable to process it properly. All blood samples from patients with ME / CFS created a sharp tip in the test, while those from healthy controls returned relatively consistent data.
"We do not know exactly why cells and plasma act that way, or even what they do," Davis said. "But there is scientific evidence that this disease is not a fabrication of the patient's mind. We clearly see a difference in how healthy immune cells and chronic fatigue syndrome treat stress. Recruitment for the larger project, which aims to further confirm the success of the diagnostic test, is being done on an ongoing basis. Those interested in participating should contact Anna Okumu, Clinical Research Coordinator.
Double
In addition to diagnosing EM / CFS, researchers are also exploiting the platform to screen for drug-based treatments because the options are currently slim. "By using the nanoelectronics test, we can add controlled doses of many potentially therapeutic drugs to the patient's blood samples and repeat the diagnostic test," Esfandyarpour said.
If blood samples taken from people with ME / CFS still respond poorly to stress and generate a peak of electrical current, then the drug probably did not work. However, if a medication seems to lessen the jump in electrical activity, it could mean that it helps the immune cells and the plasma to better treat stress. Until now, the team has already found a drug candidate that appears to restore the healthy functions of immune cells and plasma once tested in the test. The drug, although successfully tested, is currently not used in people with EM / CFS, but Davis and Esfandyarpour hope to test their results in a clinical trial in the future.
All drugs tested are either already approved by the Food and Drug Administration, or will soon be widely available to the public, which is essential for quick access and dissemination if any of these compounds were to go away.
Davis is a member of Stanford Bio-X, the Stanford Cancer Institute, and the Stanford Institute for Maternal and Child Health.
The other authors of the Stanford study are researchers Neda Nemat-Gorgani and Julie Wilhelmy and research assistant Alex Kashi.
The study was funded by the Open Medicine Foundation. Davis is the director of the foundation's scientific advisory board.
Stanford's Genetics and Biochemistry Departments also supported the work.
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