A nanoelectronics-blood-based diagnostic biomarker for ME/CFS
July 20, 2019 7:19 AM   Subscribe

“The idea is to stress the samples from both healthy and ill patients using salt, and then compare how each sample affects the flow of the electrical current. Changes in the current indicate changes in the cell: the bigger the change in current, the bigger the change on a cellular level. A big change is not a good thing; it’s a sign that the cells and plasma are flailing under stress and incapable of processing it properly. All of the blood samples from ME/CFS [myalgic encephalomyelitis/chronic fatigue syndrome] patients created a clear spike in the test, whereas those from healthy controls returned data that was on a relatively even keel.

While there are thousands of studies finding biological abnormalities in patients with ME/CFS, the illness has so far lacked a biomarker. The quote above is from the linked Stanford University website story about the paper "A nanoelectronics-blood-based diagnostic biomarker for ME/CFS," which appeared in April in Proceedings of the National Academy of Sciences.

Some selections from the paper itself:

“The ME/CFS samples’ response to the hyperosmotic stressor observed as a unique characteristic of the impedance pattern and dramatically different from the response observed among the control samples. We believe the observed robust impedance modulation difference of the samples in response to hyperosmotic stress can potentially provide us with a unique indicator of ME/CFS. Moreover, using supervised machine learning algorithms, we developed a classifier for ME/CFS patients capable of identifying new patients, required for a robust diagnostic tool.” (See this figure, graph A for the dramatically different impedance pattern over time for ME/CFS patients versus controls.)

“Additionally, our very attractive preliminary results (not included in this paper) involving severely ill ME/CFS patients and healthy controls indicated a clear difference in the behavior of PBMCs among ME/CFS patients when placed in the patients’ own plasma compared with when they were incubated in healthy plasma. These observations were one of the motivations behind experimenting with the components of ME/CFS patients’ plasma at the molecular level, in addition to studying cells.”

“Next, we aim to perform further experiments to understand the specific mechanisms contributing to the observed results, and to test the performance of the assay on other similar condition diseases. Additionally, we are working on adapting the technology to a platform capable of preclinical testing of drugs and therapies on cells from ME/CFS patients, leading toward development of a portable, handheld, and easy-to-use platform that can be operated by researchers and clinicians at any skill level.”

The paper is by Rahim Esfandyarpour (lead author, now at UC Irvine), Alex Kashi, Mohsen Nemat-Gorgani, Julie Wilhelmy, and (senior author) Ronald W. Davis.

Ron Davis, to whom The Atlantic states a substantial number of the major genetic advances of the past 20 years can be traced, is Professor of Biochemistry & Genetics at Stanford University, Director of the Stanford Genome Technology Center and the Chronic Fatigue Syndrome Research Center within it, as well as Director of the Scientific Advisory Board of the Open Medicine Foundation.

Dr. Davis has a personal interest in a cure for ME/CFS; his son Whitney Dafoe is a well-known severe sufferer. A CNN profile of Davis from May of this year notes ”He may need all his brilliance to save his son.”

The Open Medicine Foundation (here's their Twitter) focuses on medical research to find effective treatments and diagnostic markers for ME/CFS. The foundation’s End ME/CFS Project is conducting a variety of research projects into the “serious, chronic, complex and multisystem disease.”

For people who do better with audio or video, Davis provided a look at the nanoneedle research when it was in process in 2017 and more recently, gave a briefer overview here.

The paper is also covered in JAMA's Biotech Innovations section.

Full disclosure: I contribute financially to the Open Medicine Foundation. As mentioned in my profile, I’ve had ME/CFS since 2004 and have been disabled by it, mostly bedridden because of its effect on my cardiac function, since 2007. I would appreciate it if my fellow MeFites would refrain from comments doubting the existence of the illness or minimizing its seriousness.
posted by jocelmeow (13 comments total) 36 users marked this as a favorite
 
This is fantastic news for scores of people who've been dealt a really shitty hand by the medical establishment thus far, I hope it starts changing attitudes and opening up new treatment possibilities as quickly as possible.

My first thought when reading this was "I hope/assume No Poster Girl has heard about this", and then was glad to see it was you who posted it; I've always enjoyed reading your blog updates.
posted by terretu at 7:57 AM on July 20, 2019 [6 favorites]


Wow! This is big news. Thank you for posting.
posted by stoneweaver at 9:02 AM on July 20, 2019


This is such exciting news for something that has been ignored and dismissed for far too long.
posted by AlexiaSky at 9:14 AM on July 20, 2019 [1 favorite]


Biomarkers for complex syndromes are so hot right now.
posted by meehawl at 11:40 AM on July 20, 2019


“But there is scientific evidence that this disease is not a fabrication of a patient’s mind. We clearly see a difference in the way healthy and chronic fatigue syndrome immune cells process stress.”

So funny how all of medicine is just this:
Patient: I am sick and need help
Doctor: no you're not
Patient: i promise I'm sick and need help
Doctor: If i can't see it in your blood I don't believe it.
*does test*
Doctor: nope you do not need help but you are sick, you lying sicko

I hope that it's not like you get the blood test and it doesn't show ME/CFS so go peddle your malingering elsewhere and get back to work.

I also hope that everyone who doesn't feel well gets to feel better soon.
posted by bleep at 1:39 PM on July 20, 2019 [7 favorites]


Biomarkers for complex syndromes are so hot right now.

When walls of denial crumble at last, the end is sudden — and those on the other side must step lively if they don't want to be buried in the rubble.
posted by jamjam at 4:19 PM on July 20, 2019


Fascinating. I just had CFS added to my diagnostic list. Of all of the things I've been diagnosed with, a few of them don't have a definitive test. And it can be frustrating to feel like, "well, I guess we have to assume I have this." Yet science continues to change and show that people don't make this stuff up.
posted by Crystalinne at 5:44 PM on July 20, 2019 [1 favorite]


bleep, you said just about what I came here to add.... my first reaction to this post was “shit, yet another thing I might test negative for despite clearly having something very like it, this is great news and might also in the future be used to fuck me over”

who knows though, maybe I’ll test positive! I have never tested positive for anything in my life (except for hypermobility, but that’s not even a normal medical test, it’s just “do your elbows do the thing”); it’d sure be nice to get a “yep you’re sick” result for a change
posted by some_kind_of_toaster at 5:47 PM on July 20, 2019 [4 favorites]


and Crystalinne, HEY ME TOO high five “I guess this is what I have ¯\_(ツ)_/¯” buddies
posted by some_kind_of_toaster at 5:51 PM on July 20, 2019 [1 favorite]


Something other than a diagnosis of exclusion would be awfully nice. Something to shut up those doctors who say, "I don't know why you're wasting my time." I join everyone in wondering what a negative result to this test would mean for me. For the moment, though, this feels more hopeful than threatening. If anyone joins the rolling test, I'd really like to know what that entails and how it goes for you.
posted by bryon at 8:10 PM on July 20, 2019 [1 favorite]


SO hopeful.

The only other thing I’m likely to have if I do not have ME/CFS is Ehlers-Danlos, so the real issue for me is “what’s causing the post-exertional malaise and orthostatic intolerance that I’ve been suffering for most of my life.” Not whether or not they legitimately exist.

If an ME/CFS patient fails this test in the future and has not been assessed, there’s the Beighton Scale for hypermobility, and other forms of EDS can be diagnosed with a genetic test. That might help someone who gets stuck with the “what now?” nightmare.
posted by verbminx at 10:15 PM on July 20, 2019


There's definitely a recognized hypermobility syndrome distinct from CFS, and yet associated with pain and fatigue as well other problems.

The linked 2017 article gives it a 3% incidence in the general population, and puts it in a context of a 10% prevalence of hypermobility in the general population.
posted by jamjam at 3:55 PM on July 21, 2019


Australia has just launched its first biobank and registry for people with ME/CFS.

'The $1 million biomedical research initiative - the result of a philanthropic trust grant from the Mason Foundation – will allow researchers to work with ME/CFS advocacy group Emerge Australia and scientists all over the world to study the cause and cure of the debilitating illness.

Researchers will use the DNA samples, tissue and blood cells stored at the Australian Red Cross Blood Service to examine whether patients struck down with the disorder have similar molecular and cellular abnormalities' (source).
posted by brushtailedphascogale at 7:08 PM on August 13, 2019 [1 favorite]


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