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，但许多患者的诊断被推迟了， 很大程度上是由于缺乏客观的疾病临床和实验室测试。另一项挑战是 患者和临床医生一样，ME/CFS的发病和病程是不同的，合并疾病也是如此。这个 变异性的含义是多种多样的，包括疾病途径、预后和 管理层。该项目将为解决诊断和预后的不确定性奠定基础， 辨别子类型，深入了解发病机制，并通过 追求三个具体目标。在目标1中，我们将建立一个最先进的翻译研究中心， 在CFS for ME/CFS临床网络上。该网络将完全致力于NINDS公共数据 元素项目，并收集严格的临床研究所需的调查数据和生物样本。 我们还将设计一款移动应用程序myME/CFS，以帮助患者和医生获得有价值的纵向 数据，并亲自和临床管理疾病。在目标2中，我们将挖掘现有数据库以确定 临床亚型在表现、病程、合并症、家族病史或其他特征上有所不同。在……里面 目的3，我们将评估一种简单的基于办公室的自主神经功能障碍测试--精益测试的临床实用性。 我们还将评估精益测试和运动耐量测试对血浆代谢组学和 PBMC转录，从而将该临床研究项目与两个基础科学项目整合在一起 ME/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.