A coordinated, collaborative approach is vital to understanding the origins of this complex, debilitating condition.

Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS), is a severely debilitating condition that is thought to affect up to 250,000 people in the UK. Symptoms include widespread pain, extreme tiredness and an inability to concentrate.

The causes of ME/CFS aren’t known, and there are no effective treatments. Symptoms range in severity, and there are no easily identifiable biomarkers of the condition, so diagnosis is sometimes difficult. There is a pressing need for biomedical research into ME/CFS, and within the Quadram Institute and the wider Norwich Research Park we have the interdisciplinary expertise needed to better understand this complex disease.

Our research builds on recent evidence that ME/CFS has a basis in the immune system. Our focus is on the interactions between the immune system and the microbiota in the gut. Many ME sufferers also have gut-related conditions and several studies have recorded altered microbiota communities.

The gut is a major focal point of the body’s immune system. It must deal with a constant barrage of potentially harmful microbes taken into the body with our food, whilst also supporting a large community of microbes that benefit health – the microbiota. Part of the Quadram Institute’s mission is to understand how this balance is maintained, and how changes in this balance lead to diseased states. One aspect of this includes the study of what happens when the lining of the gut, the intestinal epithelium, fails to act as a barrier and members of the microbiota are able to cross. This is known as leaky gut syndrome and may be important in a number of conditions, including ME/CFS, as it abnormally presents microbes to the immune system and potentially triggering an autoimmune response. With partners at UCL, we are looking at the nature of autoimmune reaction in patients with ME.

An important aspect of our research into links between the microbiota and ME/CFS is to better understand the role played by viruses in the microbiota. Much research has focused on the bacterial populations, but the microbiota contains many other organisms, including fungi and viruses, as well as bacteriophages (viruses that infect bacteria). Viruses in particular are of interest in the study of ME/CFS as there has been evidence suggesting a viral role in triggering ME/CFS without being able to identify specific causes. Working with colleagues at UEA, we are looking to fully study the viral component of the microbiome, the virome, and its relevance to ME/CFS.

Much of our work to date has been supported by the charity, Invest in ME Research, who, as well as raising funds for biomedical research are working to raise awareness of the condition and supporting collaborative efforts across the EU to tackle ME. One target is to establish a Centre for ME Research, building on excellent biomedical research, to act as a hub for European research and treatment of ME.

Targeting ME/CFS

Research Leaders Working on ME/Chronic Fatigue Syndrome

Carding group

Simon Carding

Gut microbes in health and disease

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