Unique proteins discovered in spinal fluid can distinguish neurologic post-treatment Lyme disease (nPTLS) and myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) from one another and also from people in normal health, according to a study published last week in the journal PloS ONE.
There are many similarities between nPTLS (sometimes called chronic Lyme disease) and ME/CFS besides the fact that they both have rather long names.
- The two illnesses have strikingly similar symptoms, which include muscle and joint pain, severe fatigue and cognitive functioning problems like difficulty with memory and concentration.
- Both conditions can be very difficult to diagnose. Many patients have suffered for years and are often misdiagnosed before finally getting an accurate diagnosis.
- It is not unusual for nPTLS and ME/CFS patients to also be diagnosed with fibromyalgia.
- Both conditions have a long history of controversy, with much disagreement among medical professionals not only about diagnosis and treatment, but also about whether they are even real illnesses.
It is because of these similarities that this new study is especially exciting. The ability to identify nPTLS and ME/CFS and differentuate them from one another as well as from healthy individuals could not only make diagnosis much easier and faster, but could also lead to more effective treatments for both illnesses.
Another plus – this study also also suggests that both conditions involve the central nervous system and that protein abnormalities in the central nervous system may be related to causes and/or effects of both conditions.
Study Design and Results
Researchers analyzed spinal fluid from three groups of people. Group 1 consisted of 43 patients who fulfilled the clinical criteria for ME/CFS. Group 2 consisted of 25 patients who had been diagnosed with, and treated for, Lyme disease but did not completely recover. Group 3 consisted of 11 healthy control subjects.
The fluids were analyzed by means of high powered mass spectrometry and special protein separation techniques, which has only recently become available. They found that each group had more than 2,500 detectable proteins. The research team discovered that there were:
- 738 proteins that were identified only in CFS but not in either healthy normal controls or patients with nPTLS.
- 692 proteins found only in the nPTLS patients.
Previously there had been no available candidate biomarkers to distinguish between the two conditions, nor even strong evidence that the central nervous system is involved in those conditions.
What This Study Means for Future Research
According to one of the lead researchers Steven E. Schutzer, MD of the University of Medicine and Dentistry of New Jersey – New Jersey Medical School, spinal fluid proteins can likely be used as a marker of disease, and this study provides a starting point for research in that area. “One next step will be to find the best biomarkers that will give conclusive diagnostic results,” he says. “In addition, if a protein pathway is found to influence either disease, scientists could then develop treatments to target that particular pathway.”
“Newer techniques that are being developed by the team will allow researchers to dig even deeper and get more information for these and other neurologic diseases, says the other lead researcher Richard D. Smith, Ph.D. of Pacific Northwest National Laboratory. "These exciting findings are the tip of our research iceberg”
I find this discovery to be terribly exciting. Of course, the study will have to be validated before spinal fluid proteins can even be considered as a biomarker and possible diagnostic tool, but the findings thus far are certainly encouraging.
This study offers yet another piece of biological evidence demonstrating that both nPTLS and ME/CFS are very real physiological illness rather than phychological disorders. I'd like to think this would make a difference and patients would no longer have to battle the forces that are determined to slap the psychological label on both conditions, but many years of experience tells me it it probably won't dull the efforts of the psychology flag wavers. Regardless, this study shows great promise – not only by validating patients, but by offering new pathways to diagnosing and treating these difficult illnesses.
Schutzer SE, et al. (2011) Distinct Cerebrospinal Fluid Proteomes Differentiate Post-Treatment Lyme Disease from Chronic Fatigue Syndrome. PLoS ONE 6(2): e17287. doi:10.1371/journal.pone.0017287.
Published On: February 27, 2011