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>>>>> Help ME Circle <<<<
>>>> 9 November 2011 <<<<
Editorship : j.van.roijen@chello.nl
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I=92m far behind in posting, because of 1) bad health and 2)
a lot of members read *Help ME Circle* at their office and
I didn=92t want to overwhelm them with messages during the
holidays. I will keep the date of editing.
~jvr
````
Cure talk
Dr. Ian Lipkin and Dr. Mady Hornig, Use
Deep Sequencing and Proteomics to
Hunt CFS Viruses
Nov 04, 2011
In the end, cutting edge technology may be the
game-changer in chronic fatigue syndrome =96 a condition
that strikes an estimated 1-4 million patients in the United
States.
Viral involvement and immune system abnormalities have
long been suspected as contributing or causing the
disease. But for many reasons, including the multiple
definitions used, delays in diagnosis and small sample
size, study results have been mixed.
Now however, researchers have powerful state-of-the art
tools at their disposal, and the Center for Infection and
Immunity at Columbia University stands at the nexus.
*We have the best tools to do the work and the funding
required to pursue it,*
said center director Dr. Ian Lipkin,
*and will bring the very best possible minds to the problem
irrespective of institution. We will be taking a broad,
open-minded approach to the problem.*
The CII, and other institutions, using venture philanthropist
seed money provided by the Glenn Hutchins Foundation,
will focus their efforts on three components:
* Identification of disease markers.
* Disease mechanisms.
* Finding the specific bacteria, fungi and or viruses =96
alone or in combination =96 responsible for causing or
exacerbating the disease.
The research will be two-pronged and coordinated by Dr.
Mady Hornig, an associate professor of epidemiology at the
Mailman School of Public Health and director of
Translational Research at the CII.
Multiple deep sequencing platforms will be used for
pathogen discovery.
*One of the challenges in a chronic disorder like ME/CFS is
that we may be dealing with a situation where the trigger,
which we have good reason to believe is an infectious
trigger, may precede the onset of symptoms or recognition
of the chronicity of the pattern by quite a long period,*
said Dr. Hornig.
*The agent could have a hit and run; its levels reduce over
time, or induce a biologic situation even in the absence of
continued high levels of infectious agent.*
Unlike microarray chips that have a finite number of known
pathogens for testing, deep sequencing allows researchers
to find not only an unlimited number of varying strains of
known pathogens, but novel pathogens as well.
Testing will most likely be done at a sequencing center
pooling the resources of several large centers as the
equipment is very expensive and personnel have to be
specially trained, according to Dr. Hornig.
Researchers will be looking for patterns that are consistent
across geographic areas, time and clinical status, said Dr.
Lipkin.
*We show quite clearly a wide range of infectious agents
can trigger similar pathways in immune system that result
in similar outcomes so it may well be that there are many
pathogens who have capacity to cause chronic fatigue
syndrome by either inducing autoimmunity or some sort of
impact on the immune function which results in activation,*
said Lipkin, who plans to examine other hypotheses as well
depending on the results of initial tests.
Defining biomarkers through the use of proteomics will also
be carried out at the Yale Keck Biotechnology Resource
Laboratory (http://bit.ly/AozFbv) as well as at Columbia
University.
In terms of disease in general, biomarkers, that is proteins
that carry out body functions, have been analyzed for
diagnostic purposes for more than a century.
Recent advances in protein analysis have expanded the
opportunities. Proteomics, which is the study of proteins in
a specific time frame, is currently the best bet for creating
new approaches to diagnosing and treating human disease,
and designing new drugs to treat disease.
*The effort in ME/CFS to try to find some biomarkers that
will be likely to identify a set of pathways that are likely to
involved. That will be an enormous gain for the field and of
course the patient,*
said Dr. Hornig.
Biomarkers in ME/CFS can be used to create diagnostic
laboratory tests as well as to determine therapy response
and prognosis.
The key to maximizing the outcomes of these tests is the
criteria of the patients selected, according to Dr. Lipkin. He
said this will give the greatest possibility of finding objective
measures for monitoring and measuring the disease.
University of Miami researcher and physician Dr. Nancy
Klimas, who has been involved in several clinical definitions
of ME/CFS, is in charge of the cohort requirement to draw
200 patients from five sites located throughout the U.S.
*What we want to do is start with patients who have been
characterized extensively using standardized criteria
established by a group of widely respected clinical
researchers,*
said Dr. Lipkin.
Both Dr. Lipkin, who is a board certified neurologist, and Dr.
Hornig, who is a board certified psychiatrist, stress that
while they believe ME/CFS is a neuropsychiatric disorder
because of the problems with concentration, memory and
autonomic nervous system involvement, they do not
consider it psychosomatic.
*It=92s very difficult in my mind to make this a psychological
disorder,*
said Dr. Hornig, who is also board certified as a psychiatrist.
*We do patients a disservice if we focus solely on
secondary phenomena of being disabled or being unable to
carry on life to your capacity =96 that shouldn=92t ever be viewed
as being the primary problem.*
~~~~=20
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