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J Clin Pathol 2007;60:113-116 doi:10.1136/jcp.2006.042374
  • Review

Current research priorities in chronic fatigue syndrome/myalgic encephalomyelitis: disease mechanisms, a diagnostic test and specific treatments

  1. J R Kerr1,
  2. P Christian2,
  3. A Hodgetts2,
  4. P R Langford2,
  5. L D Devanur1,
  6. R Petty1,
  7. B Burke1,
  8. L I Sinclair3,
  9. S C M Richards4,
  10. J Montgomery4,
  11. C R McDermott4,
  12. T J Harrison5,
  13. P Kellam6,
  14. D J Nutt3,
  15. S T Holgate7,
  16. and the Collaborative Clinical Study Group*
  1. 1Department of Cellular & Molecular Medicine, St George’s University of London, London, UK
  2. 2Department of Paediatric Infectious Diseases, Imperial College London, London
  3. 3Psychopharmacology Unit, University of Bristol, Bristol, UK
  4. 4Dorset CFS Service, Poole Hospital, Dorset, UK
  5. 5Department of Medicine, University College London, London
  6. 6Department of Infection, University College London
  7. 7MRC Department of Immunopharmacology, University of Southampton, Southampton, UK
  1. Correspondence to:
 J R Kerr
 Department of Cellular & Molecular Medicine, St George’s University of London, Cranmer Terrace, London SW17 0RE, UK;jkerr{at}sgul.ac.uk
  • Accepted 31 July 2006
  • Published Online First 25 August 2006

Abstract

Chronic fatigue syndrome (CFS) is an illness characterised by disabling fatigue of at least 6 months duration, which is accompanied by various rheumatological, infectious and neuropsychiatric symptoms. A collaborative study group has been formed to deal with the current areas for development in CFS research—namely, to develop an understanding of the molecular pathogenesis of CFS, to develop a diagnostic test and to develop specific and curative treatments. Various groups have studied the gene expression in peripheral blood of patients with CFS, and from those studies that have been confirmed using polymerase chain reaction (PCR), clearly, the most predominant functional theme is that of immunity and defence. However, we do not yet know the precise gene signature and metabolic pathways involved. Currently, this is being dealt with using a microarray representing 47 000 human genes and variants, massive parallel signature sequencing and real-time PCR. It will be important to ensure that once a gene signature has been identified, it is specific to CFS and does not occur in other diseases and infections. A diagnostic test is being developed using surface-enhanced, laser-desorption and ionisation-time-of-flight mass spectrometry based on a pilot study in which putative biomarkers were identified. Finally, clinical trials are being planned; novel treatments that we believe are important to trial in patients with CFS are interferon-β and one of the anti-tumour necrosis factor-α drugs.

Footnotes

  • * Members of the Collaborative Clinical Study Group: D Honeybourne (Birmingham Heartlands Hospital, Birmingham, UK), AP Smith (Cardiff University, Cardiff, Wales, UK), M Thomas (Cardiff University, Cardiff, Wales, UK), JG Ayres (University of Aberdeen, Aberdeen, Scotland), J Main (Imperial College London, London, UK), T Daymond (University of Sunderland, Sunderland, UK), A Bansal (St Helier Hospital, Surrey, UK), BK Puri (Hammersmith Hospital, London, UK), R Morgan (Imperial College London, London, UK), RC Peveler (University of Southampton, Southampton, UK), JS Axford (St George’s University of London, London, UK), W Weir (Harley Street, London, UK), D Enlander (New York CFS Association, Fifth Avenue, New York, New York, USA), JK Chia (ID Med, Torrance, California, USA).

  • Published Online First 25 August 2006

  • Competing interests: None declared.

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