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
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)
#Disability rates have skyrocketed in the United States in the wake of #COVID, with infection-associated chronic illnesses like #MECFS, #POTS, & #MCAS surging. US Census figures currently report that 14% of Americans are now disabled. (1/7) 🧵
Rather than address the growing crisis of an ongoing pandemic, not to mention those already disabled, the US Census is responding by changing the definition of disability.
And if they do so, the rate of disability as identified by the Census is slated to drop to 8%. (2/7)
Dr. Bonnie Swenor, Director of the Johns Hopkins Disability Health Research Center, says, "These changes have moved forward w/o the input of the disability community & have far-reaching, negative implications for disabled people..." (3/7)
Overjoyed to announce my Concise Clinical Review of ME/CFS in Mayo Clinic Proceedings (with updated diagrams!) Very glad to have worked with @GrachStephanie and Ravi Ganesh and Tony Chon on this! 🧵#MedEd #MedTwitter mayoclinicproceedings.org/article/S0025-…
A concise clinical review is limited to a specific word count and a specific citation count, so we did our best to include the most vital information for diagnosis and treatment of #MECFS. (2/)
Concise clinical reviews are also a way to offer CME credit. Medical providers can take the free CME by reading the paper carefully and then answering the case-based questions that follow. #MedEd (3/) mayoclinicproceedings.org/article/S0025-…
"We... emphasize the need to build on and complement, rather than merely repeat, existing research from similar conditions, such as #MECFS, #Lyme disease, #dysautonomia..." (2/)
"Further exacerbating PASC’s time pressure is the NIH’s historic underfunding of overlapping illnesses with potential post-viral origins that have extremely similar phenotypes to #LongCOVID (Komaroff, 2019). If research for diseases such as #MECFS... (3/)