Project 3 : Clinical correlates and diagnostics in ME/CFS

项目3 摘要 尽管最近在建立ME/CFS的临床标准方面取得了进展，但许多患者的诊断延迟， 这主要是由于缺乏对疾病的客观临床和实验室测试。另一个挑战是 患者和临床医生都认为ME/CFS的发病和病程是可变的，合并症也是如此。的 变异性的含义是无数的，包括疾病途径、预后和 管理该项目将为解决诊断和预后不确定性奠定基础， 区分亚型，使洞察发病机制，并促进疾病的管理， 追求三个具体目标。在目标1中，我们将建立一个中心，以最先进的翻译研究为基础， 在CfS for ME/CFS临床网络上。该网络将完全致力于NINDS共同数据 元素项目和收集调查数据和生物样本所需的严格的临床研究。 我们还将设计一个移动的应用程序，myME/CFS，以帮助患者和医生获得有价值的纵向 数据和个人和临床管理的疾病。在目标2中，我们将挖掘现有数据库， 在表现、病程、合并症、家族病史或其他特征方面不同的临床亚型。在 目的3，我们将评估一个简单的办公室为基础的测试自主神经功能障碍，精益测试的临床效用。 我们还将评估精益测试和运动耐量测试对血浆代谢组学的影响， PBMC转录组学，从而将该临床研究项目与两个基础科学项目结合起来， 我/CFS的CfS。

Project 3 Abstract Despite recent progress in establishing clinical criteria for ME/CFS, diagnosis is delayed in many patients, largely due to an absence of objective clinical and laboratory tests for disease. An additional challenge for patients and clinicians alike is that the onset and course of ME/CFS are variable, as are comorbidities. The implications of variability are myriad and include potential for differences in pathways to illness, prognosis, and management. This project will lay the foundation for resolving diagnostic and prognostic uncertainty, distinguishing sub-types, enabling insights into pathogenesis, and facilitating management of illness through pursuit of three specific aims. In Aim 1, we will establish a hub for state-of-the-art translational research based on the CfS for ME/CFS clinical network. The network will be fully committed to the NINDS Common Data Elements project and to collection of survey data and biological samples needed for rigorous clinical research. We will also design a mobile app, myME/CFS, to help patients and physicians acquire valuable longitudinal data and personally and clinically manage the illness. In Aim 2, we will mine existing databases to identify clinical sub-types that differ in presentation, course, comorbidities, family medical history, or other features. In Aim 3, we will assess the clinical utility of a simple office-based test for autonomic dysfunction, the Lean Test. We will also assess the impact of the Lean Test and an Exercise Tolerance Test on plasma metabolomics and PBMC transcriptomics, thereby integrating this clinical research project with the two basic science projects in the CfS for ME/CFS.