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Study offers hope to patients suffering from Chronic Fatigue Syndrome

New research by PhD student Wilfred de Vega and Associate Professor Patrick McGowan may offer hope to patients suffering from Chronic Fatigue Syndrome. (Photo by Ken Jones)

A new study looking at epigenetic changes in patients with Chronic Fatigue Syndrome (CFS) is the first to identify differences in sensitivity to a specific hormone found in the body. 

The study is the first to identify epigenetic differences among CFS patients in sensitivity to glucocorticoids, a type of hormone that plays a role in the immune system and is used to treat immune system disorders. 

“Hopefully these results will offer CFS patients some hope,” says lead author Wilfred de Vega, a PhD student in Associate Professor Patrick McGowan’s lab at U of T Scarborough.

Epigenetics, which is McGowan’s area of expertise, looks at changes in gene function. An epigenetic change doesn’t change the gene itself, rather it influences how and when a gene is turned off. Epigenetic changes can be caused by environmental triggers like toxins, stress, nutrition or infections.  

McGowan and de Vega compared immune cells in CFS patients to a control group first by looking at epigenetic differences across the entire genome. Then they tested patient immune response to glucocorticoids, in this case a version of cortisol, which has anti-inflammatory properties. 

“When we tested immune response, we found two different sub-groups of CFS patients,” says de Vega. “There are some that are hypersensitive to the drug, and others that have a regular response, one that you would typically find in non-CFS patients.”

CFS, or Myalgic Encephalomyelitis (ME), is a chronic disease characterized by debilitating fatigue that cannot be resolved with rest. It affects the brain and multiple body systems, but its cause is not understood. It’s thought to affect millions across North America.

McGowan, who runs one of the few labs in Canada doing active research on the disease, says historically CFS been treated as a psychiatric illness because medical doctors simply didn’t know how to treat patients. He likens it to fibromyalgia, a disease that that is now recognized as a biological disorder. 

“The patient response to this work has been eye-opening,” says de Vega, adding he’s received personal emails from patients who are looking for information.

The study, which is published in the journal BMC Medical Genomics, found there’s a lot of differences across the genome in CFS patients, including more than 12,000 sites related to cellular metabolism or other metabolic processes that are epigenetically different. They also found 13 specific sites that indicate a sensitivity to glucocorticoids.  

In the past glucocorticoids were used as a therapy for CFS but many patients suffered terrible side effects. McGowan says being able to identify which patients would respond positively to the treatment would signify a major advance.

“For years they have felt largely ignored and not taken seriously, so they’re happy to know there’s active research happening here in Canada.” 

The hope, adds McGowan, is that by finding different epigenetic marks in CFS patients there’s an opportunity to develop treatments that can alter those marks. 

“If you can identify specific epigenetic changes in the immune system of CFS patients, you can then start to develop ways of testing drugs already in use or develop new therapies."  

 




© University of Toronto Scarborough