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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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Precision Medicine
for Myalgic Encephalomyelitis
Drug Discovery and ClinicaI Trials (REMEDIAL)

STUDY AIM
The REMEDIAL project continues the work commenced with MAESTRO and will lead to a better understanding of the molecular mechanisms underlying ME/CFS pathophysiology, the persistence and variability of the symptoms, and will contribute to the identification of targets and therapeutic agents for intervention.
LEAD INVESTIGATORS
  • Alain Moreau, PhD
UPDATES AND POTENTIAL

We conducted a comprehensive analysis and found 27 circulating microRNAs that were significantly different in people with ME/CFS and POTS (postural orthostatic tachycardia syndrome) compared to those with ME/CFS alone or POTS alone.

  • We identified two microRNAs that were only elevated in patients with both ME and POTS, and two others that were elevated only in patients with POTS but not ME.
  • By examining the targets of these microRNAs, we discovered new genes and proteins that could lead to new treatment options.
  • We also found a potential shared mechanism between people with both ME and POTS and those with POTS alone, which involves dopamine receptors.

Cognitive assessments using BrainCheck enabled the stratification of ME/CFS patients into three distinct clusters based on cognitive response.

  • These clusters led us to discover specific microRNAs associated with particular cognitive domains, which may provide insight into mechanisms underlying cognitive impairment in ME/CFS.
  • Our studies have identified three key microRNAs—miR-29a-3p, miR-150-5p, and the miR-181 family—that show promising connections to cognitive function and decline in the context of ME/CFS.

Our recent study about a hormone called FGF-21 in the blood can help explain why people with ME/CFS, FM, or both experience different symptoms and levels of brain fog. Instead of focusing only on diagnosis, we grouped patients by low, normal, or high FGF-21 levels and discovered clear patterns—like worse fatigue and thinking problems in those with low levels. This matters because it shows that FGF-21 could be used to personalize care, helping doctors better understand each patient’s condition and choose treatments that match their unique biology.

Multiple manuscripts on this work are in preparation. Two have been published:

STUDY HYPOTHESIS AND DESCRIPTION

Our study will couple a deep phenotyping
characterization of ME/CFS patients to the
development of cellular and animal models
for repurposing current drugs to accelerate
the proof-of-concept of different therapeutic
interventions for ME/CFS. Indeed, precision
medicine is essential to address the clinical
complexity of ME/CFS and to identify the
best therapeutic options to cure ME/CFS.

Three researchers, two men and a woman in a lab. The man in the foreground is recording findings.

OBJECTIVES

  • Deep phenotyping of ME patients through precision medicine.
  • Development of cellular and mouse models for the validation of targets.
  • Preparation and launch of pilot phase 2b clinical trials..

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.