Thread by @OxMEDiscovery

Could an upset liver be a key clue in ME/CFS?

Our recent results using a large metabolomics screen of 250 plasma samples from ME/CFS, MS and healthy controls has identified a consistent liver issue in mild, mod and severe patients. See last slide bit.ly/3OvT6jy
#pwme

The VIP scores show the importance of metabolites in our patient v control comparison. Blue lower than control, red higher. VIP scores > 1 are worth following up and may give clues on affected pathways.
We are looking at trends rather than highly significant differences.

Interestingly the liver issues are not observed in multiple sclerosis patients.

Why might the liver function be of interest?
The liver circulation is plumbed into the gut. The next stop for material coming into the blood stream from the gut is the liver.

The liver can show a very strong response to pathogens i.e. hepatitis, with fatigue being a key element. If low levels of pathogens are leaking from the gut into the liver you might see a milder response.

The altered ceramide/sphingolipid, ketone , tri-acyl glyceride, bile acid levels seen by many researchers could link to liver problems.
Liver function is assessed by measuring liver enzyme markers (AST & GLT) leaking into the blood. These are generally not elevated in ME/CFS.

Liver dysfunction could be more subtle in ME/CFS. In addition many ME/CFS patients have a low tolerance to alcohol potentially linking to liver vulnerability.

How do we study metabolism in the Liver? 7T Magnetic resonance spectroscopy will allow the study of key metabolic pathways in the livers of live subjects. This has to be an area for future research .