The CDC's Pharmacogenomic's Studies: An Introduction by Cort Johnson (2006)
The recent CDC efforts to better
characterize CFS using a large data set resulted in the simultaneous
publication of 14 research papers in the Journal of /Rsrch/Pharmacogenomics in
April, 2006. This complex effort which involved almost 20 researchers, many
of them working for free, is the first to attempt to integrate gene
expression with laboratory and clinical data. It could re-orient our
thinking on CFS. Below you can find a laymen's summaries of these papers.
Pharmacogenomics I: Overview-
Vernon and Reeves, the two principal
investigators, provided an overview of the project.
Pharmacogenomics II: Allostatic Load and CFS -
This is the first time allostatic load - an measure of the
health of the stress response - has been measured in CFS. These researchers
examined data from multiple systems in the body (endocrine, sympathetic
nervous, immune, cardiovascular) to assess if the allostatic stress response
has been impaired in CFS, and, if so, where.
- Hypocortisolism,
Artifact or Central Factor in CFS? -
The hypocortisolism (low cortisol
levels) found in CFS has apparently played a major role in convincing
the CDC to devote a good deal of research funding to examine the stress
response in CFS. This paper explores the evidence for hypocortisolism in
CFS looks at it's possible causes and effects. Finally it looks at
whether hypocortisolism plays a secondary or central role in CFS.
- Do
CFS Patients Have Selfish Brains?
- The authors of the allostatic load papers on CFS propose that an
altered energy 'set point' in the brains of CFS patients may be at the
heart of CFS. In this Selfish Brain paper we explore the theory behind
the idea of energy 'set points' in the brain.
Pharmacogenomics III:
The Gene Expression Papers - The CDC pioneered gene
expression studies in CFS and gene expression was at the heart of the
Wichita effort. These three papers present the most complete and complex
efforts yet at understanding the genetic activity present in CFS.
Pharmacogenomics IV: The Gene Polymorphisms in CFS
- There is no evidence that mutations in a single gene can cause CFS but
more and more evidence is emerging that in CFS, like other complex diseases,
a group of gene mutations may predispose one to getting the disease. The
gene mutation studies in the Pharmacogenomics studies are the most
comprehensive yet done.
Pharmacogenomics V: The Subsets in CFS - There may be no more
important issue in CFS than identifying the subsets present in it. Several
researchers believe that until the subsets in CFS are identified research
efforts in CFS will be problematic at best. This, the most extensive
effort to uncover the subsets in CFS yet attempted, utilized clinical,
laboratory, gene mutation and gene expression data.
The CAMDA Conference
- The analyses of the
2003 CDC Wichita data did not stop with the publications in the
Pharmacogenomics Journal. An international group of researchers took
their shot at this large data set at the
2006 Critical
Assessment of Microarray Data Analysis (CAMDA) Conference. This conference,
devoted to expanding our understanding of and utilization of gene microarray
data, featured an array of sometimes mind-bogglingly sophisticated ways of
examining this data. The top paper at the conference may have found a
biomarker for CFS.