When it comes to biomarker discovery and clinical trials, disease heterogeneity is the bane of clinical researchers existence. I am showing my age here, but think of it like static on the radio: too much noisy static makes it hard to hear the nice music sound and when you tune in, the signal is loud and clear. The same goes for biomarkers: disease heterogeneity is the equivalent of noisy static making it very difficult to identify the signal. Delineating heterogeneity can amplify signals in a subset – the signal might be a symptom or a specific immune cell.
A team led by Armin Alaedini published a Letter in Gut titled, “Markers of non-coeliac wheat sensitivity in patients with myalgic encephalomyelitis/chronic fatigue syndrome”. Alaedini’s research explores the immune response in celiac disease and non-celiac wheat sensitivity. Recently he identified biomarkers of intestinal barrier damage and systemic immune activation in people that consumed wheat but did not have celiac disease. Notably these people experience similar symptoms as people with ME/CFS so Alaedini analyzed blood samples from ME/CFS patients and healthy controls.
Alaedini and his team identified a subset of ME/CFS patients that had similar biomarkers including increased serum levels of soluble CD14 and lipopolysaccharide (LPS)-binding protein, and antibodies to bacterial LPS and flagellin. ME/CFS patients in this subset also had severe gastrointestinal symptoms including abdominal pain, nausea and bloating. These are promising biomarkers for identifying this ME/CFS subset to target novel treatment strategies. You can access the full text of this publication here.
BHC is leading the way, working collaboratively with many others to put ME/CFS and FM into the medical mainstream. But we can’t do it alone; you play an important role in our progress.