Scientists in the US say they have taken a step towards developing a possible diagnostic test for chronic fatigue syndrome, a condition characterized by exhaustion and other debilitating symptoms. Researchers at Stanford University School of Medicine said a pilot study of 40 people, half of whom were healthy and half of whom had the syndrome, showed their potential biomarker test correctly identified those who were ill.
Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis or ME, is estimated to affect some 2.5 million people in the US and as many as 17 million worldwide. Symptoms include overwhelming fatigue, joint pain, headaches and sleep problems. No cause or diagnosis has yet been established and the condition can render patients bed- or house-bound for years.
The research, published in the journal Proceedings of the National Academy of Sciences on Monday, analyzed blood samples from trial volunteers using a “nanoelectronic assay” — a test that measures changes in tiny amounts of energy as a proxy for the health of immune cells and blood plasma. The scientists “stressed” the blood samples using salt, and then compared the responses. The results, they said, showed that all the CFS patients’ blood samples created a clear spike, while those from healthy controls remained relatively stable.
Photo: Bloomberg
照片:彭博
“We don’t know exactly why the cells and plasma are acting this way, or even what they’re doing,” said Ron Davis, a professor of biochemistry and genetics who co-led the study. “(But) we clearly see a difference in the way healthy and chronic fatigue syndrome immune cells process stress.”
Other experts not directly involved in this work cautioned, however, that its findings showed there is still a long way to go before a biomarker is found that can establish CFS diagnosis and distinguish it from other conditions with similar symptoms.
Simon Wessely, chair of psychiatry at King’s College London’s Institute of Psychiatry Psychology & Neuroscience, who has worked with CFS patients for many years, said the study was the latest of many attempts to find a biomarker for CFS, but had not been able to solve two key issues: “The (first) issue is, can any biomarker distinguish CFS patients from those with other fatiguing illnesses? And second, is it measuring the cause, and not the consequence, of illness?” he said in an e-mailed comment. “This study does not provide any evidence that either has finally been achieved.”
(Reuters)
美國科學家表示,他們已經向前邁進一步,可望研發出用於診斷慢性疲勞症候群的測驗。這種病況的特徵包括疲憊和其他衰弱症狀。史丹佛大學醫學院的研究人員指出,他們對四十名受試者進行前導性研究,其中健康和罹患該症候群的人數各佔一半。結果顯示,這項生物標記測試深具潛力,正確地辨識出哪些人是患者。
慢性疲勞症候群又稱為肌痛性腦脊髓炎(ME),估計大約影響兩百五十萬名美國民眾,全球則多達一千七百萬名病患。其症狀包括極度的疲憊感、關節疼痛、頭痛,以及睡眠問題。目前醫界對於病因或診斷方式仍無定論,然而病況卻會讓患者數年無法離開床鋪或走出家門。
在週一發表於《美國國家科學院院刊》的這份研究中,研究人員使用一種「奈米電子測定法」──藉由測量極少量能量中發生的變化,鑑定免疫細胞和血漿的健康狀況──對自願受試者的血液樣本進行分析。科學家利用鹽,對血液樣本製造「壓力」,接著再比較這些反應。實驗結果顯示,所有慢性疲勞症候群患者的血液樣本都產生了明顯的尖刺,而那些健康的控制組血液樣本則保持相對穩定。
生物化學與遺傳學教授朗‧戴維斯是研究共同主持人,他表示:「我們並不完全清楚這些細胞和血漿為什麼會有這類反應,我們甚至不知道它們在做什麼。」他也說:「但是我們清楚地看到,健康細胞和慢性疲勞症候群的免疫細胞,在處理壓力的方法上有著顯著差異。」
然而,其他並未直接參與這份研究的專家卻提出警示,認為這項發現反而顯示:科學家在找到某個生物標記,既可以用來確診慢性疲勞症候群,還能夠區分其他類似症狀的疾病之前,還有一段漫長的路要走。
賽門.衛斯里是倫敦國王學院的精神病、心理學及神經科學研究院院長,已研究慢性疲勞症候群患者多年,他認為這份研究只是尋找慢性疲勞症候群生物標記諸多嘗試中的最新一次,卻並未解決兩項關鍵問題:「(第一個)問題在於,任何生物標記都可以區別慢性疲勞症候群和其他疲憊性疾病嗎?第二個問題則是,該研究是在測量疾病的原因,還是它的結果?」在這封透過電子郵件發表的評論中,他表示「這份研究並未提供任何證據,解釋他們到底完成了哪一項研究。」
(台北時報章厚明譯)
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「慢性疲勞症候群」不同於一般性疲勞,目前仍不清楚確切病因,有一說法為病毒感染。符合該疾病定義的條件並不容易,首先患者的疲勞必須為新產生的疲勞、持續或反覆發作、造成日常生活困難、運動完特別累且恢復體力時間較久,同時帶有以下症狀:多處肌肉痛或關節痛、頭痛、喉嚨痛、淋巴結疼痛、全身倦怠、心悸、頭暈或嘔吐、睡眠障礙、認知功能異常(如:短期記憶困難、無法思考、注意力不集中),且症狀至少需持續6個月。
目前醫界認為,這個疾病有家族遺傳的可能,高危險因子包括突然增加的心理壓力、憂鬱、遭遇重大心理創傷等。「慢性疲勞症候群」的治療主要以非藥物療法為主,包含漸進式運動治療、認知行為治療。此外,日常生活管理亦有助於此疾病的改善,如注意睡眠、休息、飲食、放鬆。
Unlike with general fatigue, there is at present no clear and defined known cause for Chronic Fatigue Syndrome (CFS), although one possible explanation is that it is caused through viral infection. It’s not easy to pin down the exact definition of the disorder. First of all, the fatigue must be sudden onset, sustained or reoccurring, causing difficulty in carrying out everyday activities and producing abnormal tiredness following physical exercise, with relatively long recovery periods. It also entails the following symptoms: muscle or joint pain throughout the body, headaches, sore throat, pain around the lymph nodes, exhaustion in the whole body, heart palpitations, dizziness or nausea, trouble sleeping and loss of cognitive function (such as short-term memory loss, impeded thinking and difficulty concentrating). Finally, the symptoms must continue for at least six months.
Doctors believe that the disorder could be inherited, with high risk factors including sudden increases in mental stress, depression or major psychological trauma. The treatment for CFS is mainly non-pharmacological and includes progressive exercise therapy and cognitive behavioral therapy. In addition, management of daily activities, such as focusing on sleep, rest, diet and relaxation, can be of benefit to the improvement of the disorder.
(Translated by Paul Cooper)
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