An NIH-funded study uncovered changes to the gut microbiome in people at different phases of chronic fatigue syndrome, also known as myalgic encephalomyelitis (ME/CFS). Led by Julia Oh, Ph.D., a 2017 NIH Director’s New Innovator Award recipient at The Jackson Laboratory for Genomic Medicine, the study also identifies potential markers in the gut that could help diagnose ME/CFS and predict disease onset and progression.

ME/CFS is a complex chronic disease with a range of symptoms including pain, post-exertional malaise, sleep problems, and gastrointestinal issues. The Center for Disease Control estimates that up to 2.5 million Americans have ME/CFS, but the disease still is not well understood and the lack of a standard laboratory diagnostic test can lead to misdiagnoses. The research team studied patients with short-term and long-term ME/CFS to determine if ME/CFS is linked to changes in the community of microorganisms living in the gut, known as the gut microbiome, and if these changes predict disease progression.

Dr. Oh’s team found that patients who had been diagnosed with ME/CFS for less than four years had significant abnormalities in their gut microbiome compared to healthy controls. Patients who had long-term, more severe ME/CFS surprisingly did not have these microbiome abnormalities. However, the long-term ME/CFS patients had differences in the levels of specific metabolites in their blood. Because the gut microbiome can affect our metabolism, this may indicate a loss of beneficial microbes early in ME/CFS progression that cascades into long-term metabolic irregularities even as the gut microbiome returns to normal, which could lead to worsening symptoms later in the disease. By combining information on the gut microbiome, metabolic changes, and clinical survey data, the researchers were able to find a molecular and symptomatic signature to predict different characteristics of ME/CFS. These findings may help not only diagnose ME/CFS earlier and more accurately but also provide the foundation for therapeutic treatments.

Read more: Xiong R, Gunter C, Fleming E, Vernon SD, Bateman L, Unutmaz D, Oh J. Multi-'omics of gut microbiome-host interactions in short- and long-term myalgic encephalomyelitis/chronic fatigue syndrome patients. Cell Host Microbe. 2023 Feb 8;31(2):273-287.e5. doi: 10.1016/j.chom.2023.01.001.