Now we're up to Ron Davis and the metabolic trap hypothesis for #MECFS: yeast model for the metabolic trap. (1/7) #metabolism#fatigue
Tryptophan is largely metabolized by a protein made by an enzyme called IDO-1. A second enzyme, called IDO-2, may be a "more primitive" version of the same enzyme. IDO-1 is substrate-inhibited. (2/7) #metabolism#MECFS
In a small study with ~20 severe patients, all had at least one mutation in IDO-2. "It's not a requirement that you have a mutation in IDO-2" to have ME/CFS, says Davis. It doesn't rule out that mutations here can play a role. (3/7) #metabolism#MECFS
~Needs to be demonstrated in vivo
~Did in yeasts first, by putting in the human IDO-1 gene
~Look for depletion vs none of tryptophan
~Look at kynurenine levels (4/7) #metabolism#MECFS
BH4 also of potential interest in ME/CFS, says R. Davis. (5/7) #metabolism#MECFS
IDO-1 is also affected by low iron, since the enzyme has a heme group. Davis hypothesizes this may in part explain why women are more likely to get ME/CFS. (6/7) #metabolism#MECFS
The cardinal symptom of #MECFS is #PEM, a flare of symptoms after exertion, often with a characteristic, 24-hr delay. To measure PEM, researchers perform a two-day CPET: a pair of cardiopulmonary exercise tests one day apart. (1/5) 🧵
2-day CPETs are expensive, so larger studies are tough. This study is the largest to date.
#MECFS folks didn't replicate day one performance, w/significant declines at peak exertion in work, exercise time, Ve, VO2, VCO2, VT, HR, O2pulse, DBP, & RPP. (2/) tinyurl.com/53xt4xvs
Results were similar in pairs of healthies vs #MECFS matched for aerobic capacity, indicating that fitness level does not predispose to exertion intolerance in #MECFS.
IOW, #pwME don't have an aberrant response to exertion b/c of deconditioning. (4/5)
According to this article, xylitol increased the risk of cardiovascular events. On further examination, they found that xylitol acted on platelets, increasing clotting. #LongCOVID #MECFS (1/4)
Then, researchers gave ppl a drink w/xylitol & another w/glucose. Xylitol levels jumped 1000x in the plasma, correlating to increased clotting factors-- but not after the glucose drink. (2/4)
First, you should know that this is NOT a real segment! We are not trying to claim that @iamjohnoliver.
The previous image is @StarTrek's 'Crystalline Entity' meets 'Graphic Design is our Passion', and we feel this should be proof enough.
Got it? Good.
@LastWeekTonight
Myalgic encephalomyelitis, sometimes called #MECFS, is an infection-associated illness. That means it is often triggered by an infection, often a viral one. About half of those with #LongCOVID meet the diagnostic criteria for #MECFS, so it's a HUGE problem. #JohnVsJonVsME
A few years ago, Jaime Seltzer was helping coordinate research projects, grant applications & funding for a Stanford research group studying a condition called myalgic encephalomyelitis/chronic fatigue syndrome (#MECFS). (1/)
#LongCOVIDtime.com/5897992/long-h…
“What is it going to take for researchers to take ME seriously?” she and her colleagues often wondered aloud.
The morbid answer, they hypothesized, was a pandemic. (2/) #MECFS #LongCOVID time.com/5897992/long-h…
This article was produced on October 16, 2020 by @Jamie_Ducharme @TIME. Ducharme was an excellent, thorough interviewer and seemed to intimately understand the most important aspects to revisit in depth. (3/) #MECFS #LongCOVID
Let's say you have #MECFS or #LongCOVID and you think you might be ready to work again.
But only if you received the right kind of accommodations at your workplace... how would your employer (or you, even!) know what to suggest?
A few years back, our own Ben Hsuborger (1/5)
...worked with a work accommodations website called AskJan to revise and update their page on #MECFS, and he did an incredible job. The best aspect is that, when you scroll down, you can see accommodations by symptom. (2/4) #DisabilityTwitter (2/5)
Issues with concentration, memory, and executive function are central to #MECFS presentation. You can find AskJan's list of accommodations for #ADHD and executive functioning here (note: two links to follow). (3/5)
Excellent news! #CDC has a new page on infection-associated chronic sequelae. Of particular import: these chronic symptoms linger "even after appropriate treatment". 🧵 (1/4)
Some highlights:
✨Lists pathogens known to lead to chronic issues, inc. COVID, Borrelia, EBV
✨Talks about how some symptoms are specific to pathogen, others are common to many infection-associated chronic illnesses
✨Lampshades #MECFS multiple times in the article (2/4)
Highlights, cnt'd
✨Common-language etiology section that outlines a very complex picture very clearly
✨Mentions that everyday testing may not show anything but this does not mean symptoms aren't impairing
✨Lists their current projects (could be more/better, but still) (3/4)