Workwell Foundation collaborates on several presentations at the 2022 IACFS/ME meeting

Workwell Foundation and collaborators from Cornell University and Ithaca College presented new research on 2-day cardiopulmonary exercise testing (CPET) at the recent IACFS/ME meetings (July 27 - July 30, 2022). These studies used CPET as a research tool to provoke and study various aspects of post-exertional malaise (PEM) in people with myalgic encephalomyelitis (ME/CFS). 

Below is a round-up of some of the exciting research presented at this year’s conference:

Provocative Maneuvers: Methods to induce symptomatic features of ME/CFS - with Rochelle Joslyn, PhD, J. Mark VanNess, PhD, Peter Rowe, MD, Lucinda Bateman, MD, Dane Cook, PhD, Alain Moreau, PhD, Luis Nacul, MD. 

This 45-minute panel discussion focused on methodologies, including 2-day CPET, used to provoke symptoms in ME/CFS for research. The panel featured Workwell Foundation’s Mark VanNess, Ph.D. 

Recovery from 2-day cardiopulmonary exercise testing in persons with ME/CFS, Geoffrey E. Moore, MD, Ithaca College, and Cornell University.

This study confirmed that 2-day CPET exacerbates symptoms of ME/CFS, including fatigue, impaired cognition, recurrent sore throat, tender lymph nodes, muscle pain, joint pain, headache, sleep disturbance, and PEM. The mean recovery time was 12 days for people with ME/CFS; the risk of not recovering from 2-day CPET was very low (1 of 85 people with ME/CFS did not recover). 

Urine metabolomics exposes anomalous recovery after maximal exertion

in ME/CFS female patients, Katherine Glass, PhD, Cornell University. 

Previous studies have found many changes in compounds in the blood following exercise; this study looked at 1403 urine metabolites. Strikingly, urine metabolites were altered only in control subjects after exercise, indicating more evidence of altered recovery after exertion in people with ME/CFS. 

Alterations of the extracellular vesicle proteome of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome following exercise. Ludovic Giloteaux, PhD, Cornell University. 

Extracellular vesicles (EVs) are packets of molecules released by cells that allow communication among tissues. This CPET study looked at the number, size, and contents of EVs before and after exercise. People with ME/CFS had higher levels of EVs before and after exercise compared to healthy controls. The compounds found in EVs also differed in ME/CFS, including those involved with the immune response, redox reactions, and carbon metabolism. 

Physical activity levels in ME/CFS before and after a 2-Day cardiopulmonary exercise test protocol. Candace N. Receno, PhD, Ithaca College.

This study used wearable devices to track physical activity levels for 7-10 days before and after exercise. Preliminary data suggests people with ME/CFS spend a large portion of the day in sedentary activities and less time in moderate to vigorous activities compared to healthy counterparts. However, the study revealed no change in physical activity level following CPET in ME/CFS or healthy controls.

Investigating T-cell populations for immune cell exhaustion in ME/CFS using flow cytometry, Jessica Maya, PhD candidate, Cornell University.

This study followed up on previous research showing signs of T-cell exhaustion in ME/CFS. This new study showed higher abundances and frequencies of specific transcription factors, lending more evidence T-cell exhaustion in ME/CFS.

Comprehensive gene expression profiling of the immune system in ME/CFS. Andrew Grimson, PhD, Cornell University.

This research looked at gene expression of immune cells at baseline and 24 hours after CPET. They found subtypes of monocytes, T, natural killer (NK) cells, and platelets exhibit dysregulation in ME/CFS. An analysis of cell signaling molecules implicated profound alterations in a subset of T cells, lending more support for immune mechanisms underlying PEM.