Imagine going to work or school every day, working out at the gym, spending time with family and friends—basically, living your life in a full and vigorous way. Then one day, you wake up, feeling sick. A bad cold maybe, or perhaps the flu. A few days pass, and you think it should be over—but it’s not, you still feel achy and exhausted. Now imagine that you never get better— plagued by unrelenting fatigue not relieved by sleep. Any exertion just makes you worse. You are forced to leave your job or school and are unable to participate in any of your favorite activities; some days you can’t even get out of bed. The worst part is that your doctors don’t know what is wrong and nothing seems to help.
Unfortunately, this is not fiction, but reality for at least a million Americans—who suffer from a condition that carries the unwieldy name of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a perplexing disease that biomedical research desperately needs to unravel . Very little is currently known about what causes ME/CFS or its biological basis . Among the many possibilities that need to be explored are problems in cellular metabolism and changes in the immune system.
A number of studies suggest that abnormalities in cellular metabolism, a complex biological process that the body uses to create energy , may underlie ME/CFS. A recent study of metabolite pathways in blood samples from people with ME/CFS reported a signature suggestive of a hypometabolic condition, similar to a phenomenon biologists have studied in other organisms and refer to by the term “dauer” (a hibernation-like state) . A number of other studies have suggested that changes in the immune system may play a causal role in ME/CFS , either due to a post-infectious autoimmune process or due to a unknown chronic infection.
To date, most studies in ME/CFS have looked at relatively small numbers of people with ME/CFS and employed different methods—and rarely has a finding been replicated. Given the heterogeneity of the illness and complexity of the assays, rigorous confirmatory studies in larger groups of people with ME/CFS are necessary to provide the evidence base for effective therapy development. ME/CFS, as much as any other disorder, is in need of a concerted effort by the scientific community to understand its biological basis.
The NIH is committed to stimulating additional research to reveal the causes of this debilitating disease. ME/CFS is such a complex condition, affecting so many body systems, that we do not know where the answers will come from. Informed by results from a 2014 ME/CFS workshop , NIH initiated a call to action to all of its relevant Institutes and Centers in October 2015. The resultant NIH research effort, led by Trans-NIH ME/CFS Working Group, leverages an impressive scope of expertise across the NIH to attack this research gap.
The Trans-NIH ME/CFS Working Group recently solicited research applications to seed a nationally coordinated approach to understand the cause(s) and mechanisms of ME/CFS. In January, NIH issued two Funding Opportunity Announcements (FOAs). These FOAs seek to establish a research consortium for ME/CFS research, including a coordinating center to facilitate collaborative science among the sites and enable widespread data sharing. The consortium will provide a foundation upon which rigorous ME/CFS research can build to make new discoveries, validate research findings, and attract new investigators from various disciplines to study ME/CFS.