Description of the state-of-the-artResearch on ME/CFS in Europe is characterised by the absence of a collaborative approach between research centres, whereas at the national level research and health services provision are usually concentrated in few centres of competence. Research efforts in the field have been restricted to some disease-specific calls from funding agencies (mainly in the UK). Consequently, they have been very fragmented, with sub-priorities (e.g. viral, immunological and environmental) determined by organisational affiliations and funding programmes. Therefore a major and concerted effort is crucial in order to align biobanks and bioinformatics platforms and to attain conformity in biomarker sets. Tissue samples are scarce. New frontiers of biomedical research are hindered by the absence of validated animal models. Imaging data consists mainly of MRI and unspecific findings (e.g., Evans index abnormalities). Only a small number of PET studies for neuro-inflammation have been completed.
Clinical practice involves unspecific
ailments, alternative pathways, and competing nosological
A large number of diverse causative factorse.g. viral infection, immune activation, exposure to toxins, chemicals, and pesticides, low intensity radiation and EM fields - have been suggested as aetiological factors (multifactorial disease). Altered gene expression profiles in ME and CFS patient populations have been reported. Pathways of disease development involve metabolic dysregulation as a chronic pathological state. Mitochondrial dysfunction also has been proposed for ME/CFS. Similarity to the pathways observed in ageing with mitochondrial (SOD, GPx) and cellular enzyme (catalase) concentration and/or decrease in activity could explain the similarity with ageing processes