Chronic fatigue syndrome: the current status and future potentials of emerging biomarkers

Abstract

Chronic fatigue syndrome (CFS) remains an incompletely characterized illness, in part due to controversy regarding its definition, biological basis and diagnosis. Biomarkers are objective measures that may lead to improvements in our understanding of CFS by providing a more coherent and consistent approach to study, diagnosis and treatment of the illness. Such metrics may allow us to distinguish between CFS subtypes – each defined by characteristic biomarkers – currently conflated under the single, heterogeneous condition of CFS. These delineations, in turn, may guide more granular, focused, and targeted treatment strategies based on more precise characterizations of the illness. Here, we review potential CFS biomarkers related to neurological and immunological components of the illness, and discuss how these biomarkers may be used to move the field of CFS forward, emphasizing clinical utility and potential routes of future research.

Orosomucoid (ORM) as a Potential Biomarker for the Diagnosis of Chronic Fatigue Syndrome (CFS)

“…Detecting and evaluating fatigue is a common task both in various society activities and in clinical practice. At present, there are still no specific factors that have been consistently associated with CFS, and there are no official or semi-official recommendations for the treatment of CFS [9]. We found in this study that ORM is significantly elevated in sera from individuals with CFS.…”

Metagenomic Investigation of Plasma in Individuals with ME/CFS Highlights the Importance of Technical Controls to Elucidate Contamination and Batch Effects

“…To reduce within-case heterogeneity, we chose to use the Canadian Case Definition for ME/CFS [13] as it was the most specific definition available at the time of study design; however, other definitions have since become available, such as the US Institute of Medicine case definition [38]. To further reduce heterogeneity between patients, some researchers have suggested dividing ME/CFS into subtypes, for example based on functional disability, speed of onset, or biomarkers [39, 40], which again may increase a study’s power to detect associations between groups. Subtyping would be highly useful in future studies, but was not practical with our sample size.…”

Cns Findings in Chronic Fatigue Syndrome and a Neuropathological Case Report

“…This manuscript will present a survey of literature reporting CNS abnormalities and studies related to potential mechanisms that may contribute to CNS disturbances in patients with CFS. For a more comprehensive review of CNS involvement, please see Fischer et al 2. We will also present neuropathological findings from a recent case study that illustrate vascular pathology, demyelination in focal areas and diffuse reactive astrogliosis, as well as the presence of Aβ plaques and axonal and neurofibrillary pathology.…”

“…Among the most striking evidence supporting CNS involvement are hundreds of imaging studies that point to brain abnormalities in patients with CFS. Neuroanatomically, reductions in gray and white matter are reported 2 5–10. Neural perfusion impairments have also been reported in some, but not all, patients with CFS 2 11–14.…”