1-31-15

David W. Maughan, Ph.D.

Department of Molecular Physiology & Biophysics

University of Vermont College of Medicine

Burlington VT 05404

dmaughanh@uvm.edu; 802.314 3176

Summary of ME/CFS Human Subject Pilot Project at University of Vermont

Four University of Vermont medical faculty members are preparing to conduct a pilot study designed to investigate the molecular basis of a severely debilitating chronic disease, whose hallmark symptom is severe, prolonged, post-exertional fatigue. The disease, ME/CFS (Myalgic Encephalomyelitis, also known as Chronic Fatigue Syndrome) probably stems from the body’s autoimmune reaction to a viral, bacterial, or environmental pathogen. The proposed study is motivated by earlier research by Mercedes Rincon, Ph.D. a Professor of Immunology at the UVM Medical College, who heads the current study. Previously, Dr. Rincon discovered that a specific chemical modification of a structural protein in joints of patients suffering from rheumatoid arthritis, another autoimmune disease, was partly responsible for the patient’s severe arthritic conditions. This chemical modification is called citrullination. We hypothesize that citrullination of another protein that ordinarily helps maintain healthy cell function in many systems of the body - and the resulting autoimmune reaction to it - underlies many of the physical and cognitive impairments experienced by ME/CFS patients. The purpose of this pilot study is to test the hypothesis that plasma from blood drawn from ME/CFS patients contains an anti-citrullinated protein antibody not present in healthy subjects. This presence would suggest a role for citrullination of a target protein, as yet unknown, in the pathophysiology of ME/CFS. The blood samples will be obtained from a national repository of biological samples administered by the Solve ME/CFS Initiative (SolveCFS.org), under the direction of Dr. Suzanne D. Vernon (Scientific Director, Solve ME/CFS Initiative), who is part of the research team. Other members of the team include David Maughan, Ph.D. and George Webb, Ph.D., both Professor Emeriti of Molecular Physiology & Biophysics, and Terence Naumann, M.D., Adjunct Professor of Family Medicine, at the UVM Medical College. If we discover an anti-citrullinated protein antibody unique to ME/CFS patients and further studies corroborate our work, a number of therapies now available for RA treatment could potentially be adapted to ameliorate or reverse the progress of this terrible disease.