Press Release: Riordan Clinic Research Institute
Riordan Clinic scientists Dr. Nina Mikirova, Dr. Joseph Casciari, and Dr. Ronald Hunninghake have patented a new technology that may help doctors determine the severity of fatigue in their patients. The research, recently published in the January/February 2012 issue of the journal, Alternative Therapies, is entitled “The Assessment of the Energy Metabolism in Patients with Chronic Fatigue Syndrome by Serum Fluorescence Emission.”
Chronic fatigue syndrome (CFS) is characterized by long-lasting disabling fatigue. It includes non-specific symptoms such as weakness, malaise, subjective fever, sore throat, lymph node pain, and decreased memory. There are no conclusive diagnostic tests for CFS. Since the underlying mechanism for CFS is not known, finding reliable biomarkers for diagnosing are important.
The purpose of this study was to examine the use of serum nicotinamide adenine dinucleotide (NAD(P)H) levels as a metabolic marker of fatigue state and alterations in metabolism and homeostasis in CFS patients.
The Riordan Clinic scientists have developed a method of determining NAD(P)H levels based on fluorescence emission of serum at 450 nm. Serum NAD(P)H concentrations were compared for subjects with CFS and healthy controls. NAD(P)H concentrations in the serum of CFS subjects averaged 8.0 ± 1.4 (SD) uM while those in healthy controls averaged 10.8 ± 0.8 (SD) uM, a statistically significant difference (p < 0.001). The sensitivity (detection of positives) and specificity (non-detection of negatives) of the test in matching CFS patients to control subjects at NAD(P)H cut-off of 9.5 uM were 0.73 and 0.98. The researchers also compared NAD(P) H concentrations to other endocrine and metabolic parameters. A factor analysis, based on the correlation matrix between all variables, demonstrated that the best correlations were between the NAD(P)H, serum coenzyme Q10 and urine pyrroles. As coenzyme Q10 is the component of a complex series of reactions that occur within mitochondria, the function of Q10 ultimately is linked to the generation of energy within the cells. The correlation between the lower level of coenzyme Q10 and lower NAD(P)H signals for patients with CFS suggests lower bioenergetics for these subjects. An inverse correlation was found between the level of serum emission and the level of pyrroles in urine. The pyrroles are often elevated in patients with mental illness. This molecule is well known for bio-toxicity and is associated with emotional stress. As a result of the study, researchers proposed that fatigue level and metabolic slowdown in CFS patients can be evaluated and monitored by serum NAD(P)H concentration measurements. The measurement of the fluorescence of reduced nicotinamide adenine dinucleotide in serum provides a non-invasive assay to estimate metabolism and fatigue levels in CFS patients. Following patient NAD(P)H levels over time may aid in selecting therapeutic strategies and monitoring treatment outcome. To read this and other articles written by Riordan Clinic researchers, visit our website at www.riordanclinic.org.