[CFS-L] Metabolic phenotypes in PWCs

[Dr. Marc-Alexander Fluks]

Source: The Journal of Clinical Investigation Insight
Vol 6, #16, p 149217
Date: August 23, 2021
URL: https://insight.jci.org/articles/view/149217
https://insight.jci.org/articles/view/149217/pdf
Opm: Not to be confused with today's press release
by the same authors


A map of metabolic phenotypes in patients with myalgic
encephalomyelitis/chronic fatigue syndrome
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Fredrik Hoel(1), August Hoel(1,2), Ina Kn Pettersen(1), Ingrid G
Rekeland(3), Kristin Risa(3), Kine Alme(3), Kari Sorland(3),
Alexander Fossa(4,5), Katarina Lien(6), Ingrid Herder(6), Hanne L
Thurmer(7), Merete E Gotaas(8), Christoph Schafer(9), Rolf K Berge
(10), Kristian Sommerfelt(10,11), Hans-Peter Marti(2,12), Olav
Dahl(3,10), Olav Mella(3,10), Oystein Fluge(3,10), Karl J
Tronstad(1)
1 Department of Biomedicine and.
2 Department of Clinical Medicine, University of Bergen, Bergen,
Norway.
3 Department of Oncology and Medical Physics, Haukeland University
Hospital, Bergen, Norway.
4 Department of Oncology, Norwegian Radium Hospital, Oslo
University Hospital, Oslo, Norway.
5 KJ Jebsen Centre for B-cell malignancies, University of Oslo,
Oslo, Norway.
6 CFS/ME Center, Division of Medicine, Oslo University Hospital,
Oslo, Norway.
7 Department of Medicine, Telemark Hospital, Notodden, Norway.
8 Department of Pain and Complex Disorders, St. Olav's Hospital,
Trondheim, Norway.
9 Department of Rehabilitation Medicine, University Hospital of
North Norway, Tromso, Norway.
10 Department of Clinical Science, University of Bergen, Bergen,
Norway.
11 Department of Pediatrics and.
12 Department of Medicine, Haukeland University Hospital, Bergen,
Norway.

Submitted: March 9, 2021
Accepted: July 7, 2021
Published: August 23, 2021


Abstract

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a
debilitating disease usually presenting after infection. Emerging
evidence supports that energy metabolism is affected in ME/CFS, but a
unifying metabolic phenotype has not been firmly established. We
performed global metabolomics, lipidomics, and hormone measurements, and
we used exploratory data analyses to compare serum from 83 patients with
ME/CFS and 35 healthy controls. Some changes were common in the patient
group, and these were compatible with effects of elevated energy strain
and altered utilization of fatty acids and amino acids as catabolic
fuels. In addition, a set of heterogeneous effects reflected specific
changes in 3 subsets of patients, and 2 of these expressed
characteristic contexts of deregulated energy metabolism. The biological
relevance of these metabolic phenotypes (metabotypes) was supported by
clinical data and independent blood analyses. In summary, we report a
map of common and context-dependent metabolic changes in ME/CFS, and
some of them presented possible associations with clinical patient
profiles. We suggest that elevated energy strain may result from
exertion-triggered tissue hypoxia and lead to systemic metabolic
adaptation and compensation. Through various mechanisms, such metabolic
dysfunction represents a likely mediator of key symptoms in ME/CFS and
possibly a target for supportive intervention.

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(c) 2021 American Society for Clinical Investigation