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   Indicator of chronic fatigue syndrome found in gut bacteria   
      
   June 27, 2016 by Krishna Ramanujan   
      
    Indicator of chronic fatigue syndrome found in gut bacteria   
   Colorized scanning electron micrograph of E. coli; some strains are common,   
   beneficial gut bacteria. Credit: National Institute of Allergy and Infectious   
   Diseases, National Institutes of Health   
   Physicians have been mystified by chronic fatigue syndrome, a condition where   
   normal exertion leads to debilitating fatigue that isn't alleviated by rest.   
   There are no known triggers, and diagnosis requires lengthy tests administered   
   by an expert.   
      
      
   Due to this lack of information, some people have even suggested the disease   
   may be psychosomatic.   
      
   Now, for the first time, Cornell researchers report they have identified   
   biological markers of the disease in gut bacteria and inflammatory microbial   
   agents in the blood.   
      
   In a study published June 23 in the journal Microbiome, the team describes how   
   they correctly diagnosed myalgic encephalomyeletis/chronic fatigue syndrome   
   (ME/CFS) in 83 percent of patients through stool samples and blood work,   
   offering a noninvasive    
   diagnosis and a step toward understanding the cause of the disease.   
      
   "Our work demonstrates that the gut bacterial microbiome in ME/CFS patients   
   isn't normal, perhaps leading to gastrointestinal and inflammatory symptoms in   
   victims of the disease," said Maureen Hanson, the Liberty Hyde Bailey   
   Professor in the Department    
   of Molecular Biology and Genetics and the paper's senior author. "Furthermore,   
   our detection of a biological abnormality provides further evidence against   
   the ridiculous concept that the disease is psychological in origin."   
      
   Ruth Ley, associate professor in the Departments of Molecular Biology and   
   Genetics and Microbiology, is a co-author.   
      
   "In the future, we could see this technique as a complement to other   
   noninvasive diagnoses, but if we have a better idea of what is going on with   
   these gut microbes and patients, maybe clinicians could consider changing   
   diets, using prebiotics such as    
   dietary fibers or probiotics to help treat the disease," said Ludovic   
   Giloteaux, a postdoctoral researcher in both Hanson's and Ley's labs and first   
   author of the study.   
      
   Researchers have evidence that an overactive immune system plays a role in   
   chronic fatigue. Symptoms include fatigue even after sleep, muscle and joint   
   pain, migraines and gastrointestinal distress. One hallmark of the condition   
   is post-exertional    
   malaise, meaning patients may take weeks to recover from minor exertion. To   
   test for ME/CFS, clinicians may give patients a cardio-pulmonary exercise test   
   where they ride a bike until they become fatigued. If the test is repeated the   
   following day, ME/   
   CFS patients usually cannot reproduce their performance from the first day.   
      
   "That's very typical and specific of people with ME/CFS, because healthy   
   people, or even people who have heart disease, can reproduce the exercise on   
   the second day, but these people cannot," Giloteaux said.   
      
   In the study, Ithaca campus researchers collaborated with Dr. Susan Levine, an   
   ME/CFS specialist in New York City, who recruited 48 people diagnosed with   
   ME/CFS and 39 healthy controls to provide stool and blood samples.   
      
   The researchers sequenced regions of microbial DNA from the stool samples to   
   identify different types of bacteria. Overall, the diversity of types of   
   bacteria was greatly reduced and there were fewer bacterial species known to   
   be anti-inflammatory in ME/   
   CFS patients compared with healthy people, an observation also seen in people   
   with Crohn's disease and ulcerative colitis.   
      
   At the same time, the researchers discovered specific markers of inflammation   
   in the blood, likely due to a leaky gut from intestinal problems that allow   
   bacteria to enter the blood, Giloteaux said.   
      
   Bacteria in the blood will trigger an immune response, which could worsen   
   symptoms.   
      
   The researchers have no evidence to distinguish whether the altered gut   
   microbiome is a cause or a whether it is a consequence of disease, Giloteaux   
   added.   
      
   In the future, the research team will look for evidence of viruses and fungi   
   in the gut, to see whether one of these or an association of these along with   
   bacteria may be causing or contributing to the illness.   
      
      
       
   More information: Ludovic Giloteaux et al. Reduced diversity and altered   
   composition of the gut microbiome in individuals with myalgic en   
   ephalomyelitis/chronic fatigue syndrome, Microbiome (2016). DOI:   
   10.1186/s40168-016-0171-4   
      
   Provided by: Cornell University   
      
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   https://m.medicalxpress.com/news/2016-06-indicator-chronic-fatig   
   e-syndrome-gut.html   
      
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