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Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME / CFS) Post Treatment Lyme Disease Syndrome (PTLDS), Fibromyalgia Leading Research. Delivering Hope.Open Medicine Foundation® Canada
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Blood Flow and Exercise in ME/CFS and Orthostatic Intolerance

Study Aim

The study aims to investigate the effects of supine vs upright exercise on cerebral blood flow, blood pressure, heart rate, and the presence of autoimmune antibodies in ME/CFS patients with orthostatic intolerance, compared to controls, to understand the underlying mechanisms and differences in symptom severity and post-exertional malaise.

Investigators

 

  • Elena Christopoulos
  • Kegan Moneghetti, FRACP, PhD
  • Paul Gooley, PhD
  • Christopher Armstrong, PhD

Updates and Potential

  • IRB/Ethics approved for the design of at home positional detector in combination with hemodynamics tracking.
  • Activpal and CareTaker continuous BP devices in combination appear effective in monitoring BP at home.
  • IRB/Ethics approval for main project received.
  • Recruitment for main study occurs in June and we expect a 12-month recruitment period for this study. 8 visits a week is maximum capacity and 160 visits (20 weeks at max capacity) are needed.
  • Submitting systematic review paper to field interest.
STUDY HYPOTHESIS AND DESCRIPTION

Orthostatic intolerance (OI) is when people feel symptoms like light-headedness, dizziness, blurred vision, and sometimes fainting, especially when they stand up. This is because of instability in blood flow and pressure. Since 2003, recognizing these symptoms has been a key part of diagnosing ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome), a condition where OI is quite common. In some cases, these symptoms in ME/CFS patients are due to reduced blood flow to the brain rather than changes in how blood circulates upon standing.

We hypothesize that people with ME/CFS and OI will be impacted more by upright exercise versus supine exercise. This will be observed by reduced blood flow to the brain and/or reduced blood pressure and/or increased heart rate during and after exercise. We suspect this could lead to more severe post-exertional malaise (PEM), which is a worsening of symptoms following physical activity.

Additionally, the study predicts that there will be observable differences in metabolic processes in ME/CFS and OI patients before and after exercise, particularly during PEM, and these differences will be more pronounced in patients with both conditions.

OBJECTIVES

The image is a visual representation of blood flow, depicting a stream of elements against a gradient background that suggests movement and fluidity.

  1. Determine if CBF is further reduced in patients with both ME/CFS and OI during exercise and its effect on OI and PEM symptoms.
  2. Observe any hemodynamic abnormalities post-exercise/during PEM in ME/CFS and OI patients.
  3. Determine metabolic, genomic, proteomic or transcriptomic differences between patients with ME/CFS and OI.
  4. Investigate the presence of autoantibodies against adrenoceptors and muscarinic acetylcholine receptors in ME/CFS and OI.

Consent management

Consent Preferences

Data Subject Access Request (DSAR) Form 

Microvesicles and viral sequencing
Microvesicles are a type of extracellular vesicle that is released from the cell membrane. Vesicles are small, fluid-filled sacs or vacuoles within the body. Sequencing is a technique used to determine the exact sequence of bases (A, C, G, and T) in a DNA (or viral) molecule.
NMR Metabolomics
NMR (Nuclear Magnetic Resonance) is an instrument/tool used to perform metabolic studies, metabolic profiling, and metabolomics in biofluids and tissues for more than 40 years using magnetic fields. There is a very close connection between metabolic measurements and NMR. This connection has flourished because of NMR’s many unique strengths for characterizing complex mixtures’ chemical composition.
Proteomics
The large-scale study of proteins, which are large, complex molecules that are required for structure, function, and regulation of the human body's tissues and organs.
Autoantibodies
Antibodies that react with self-molecules and that occur in healthy individuals and are referred to as natural antibodies or autoantibodies.
Extracellular DNA for viral reactivation and Mitochondrial DNA
exDNA (extracellular DNA), exDNA is often secreted actively and is used to perform several tasks, thereby offering an attractive target or tool for biotechnological, medical, environmental, and general microbiological applications. Viruses are intracellular parasites that rely to a significant extent on the host cell for replication. Viral reactivation occurs when an active replication of the viral genome results in a lytic (degradation of the cell) infection characterized by the release of new progeny (descendant) virus particles.
Immune cell profiling
The immune system has many important regulatory roles in disease development and progression. Given the emergence of effective immune therapies, reliable predictors of response are needed. Immune cell profiling determines response by evaluating immune cell populations from treated and untreated samples. For our purposes, we will evaluate the white blood cell response to the viral infection using a process called “Cytof.”
Leukocyte Genomics
A leukocyte is a colorless cell circulating in the blood and body fluids and is involved in counteracting foreign substances and disease. A genome is all genetic material of an organism. Genomics is a biology field focusing on the structure, function, evolution, mapping, and editing of genomes. Therefore, leukocyte genomics is the study of all genetic material of leukocytes.
Metabolomics
Metabolomics is a way to study metabolism – that is, through measuring amounts of the metabolites (small molecules) produced by our bodies as we convert food into energy and other molecules that our cells need to survive. Metabolomics technology is ‘large-scale,’ meaning that several thousand metabolites can be measured from a single sample of e.g., blood or urine.
Micro RNA
Cells use Micro RNA to control whether a particular gene is making too much, too little or the normal amount of its protein at a particular time.