tirsdag den 30. juli 2013

Automatic Lung Parameter Estimation - useful for ME patients?

I like to keep an eye on new technology that can be useful for ME patients. And this time I found ALPE.

ALPE (Automatic Lung Parameter Estimation) is a product from Mermaid Care in Denmark. Their vision is:

“to make ALPE (Automatic Lung Parameter Estimation) the International Clinical Standard for diagnosing and characterizing the Pulmonary Gas Exchange. Our expertise in Pulmonary Gas Exchange Diagnostic is helping healthcare professionals in new ways to predict, diagnose and treat disease.”´

ALPE essential characterizes the pulmonary gas exchange and is used to minimize and document pulmonary complications during the anesthesia process. It makes an optimal preoperative pulmonary diagnostic for patients with shortness of breath.

ME patients have Diminished Cardiopulmonary Capacity During Post-Exertional Malaise (PEM).

Workwell Foundation uses cardiopulmonary exercise testing (CPET) in ME diagnostic.

Snell et al. have recently publiced this article on the subject: Discriminative Validity of Metabolic and Workload Measurements to Identify Individuals With Chronic Fatigue Syndrome

And ME patients are frequently in a state of PEM. Furthermore ME patients don’t tolerate Anesthesia very well.

Some ME patients have the co-morbidity Postural Orthostatic Tachycardia Syndrome (POTS), and this syndrome is associated with hemodynamic instability.

This makes ME patients a vulnerable group of patients during anesthesia, so maybe a close monitoring with ALPE is a good idea?

lørdag den 6. juli 2013

Project proposal: Plasma analysis of low abundance proteins in serum from ME patients after exercise

I would like to understand why ME/CFS patients get Post Exertional Malaise (PEM). We have read it again and again: PEM following physical activity are hallmark symptoms of ME/CFS and may even qualify for biomarker status. The latest fine paper on this subject is:
Discriminative Validity of Metabolic and Workload Measurements to Identify Individuals With Chronic Fatigue Syndrome

And some biochemistry do go wrong after exercise:
Differences in metabolite-detecting, adrenergic, and immune gene expression following moderate exercise in chronic fatigue syndrome, multiple sclerosis and healthy controls

If ME/CFS patients perform worse 24 hours after excercise and feel ill, there must be something in the blood/plasma to show it. There are so much advanced technology, it can't be that hard to find it!

Agilent is every nerd's dream of advanced technology. So I searched the site for a good idea, and you may be the judge of what I came up with:

My project proposal: "Plasma analysis of low abundance proteins in serum from ME/CFS patients after exercise."

We do the usual trick: We find a group af ME/CFS patients and a suitable control group. They do the exercise test, and we collect blood samples before and after exercise. We can collect blood samples 30 minutes, 8 hours, 24 hours, 48 hours after excercise.

And now for the advanced technology. We use the plasma from the blood samples, but not the "standard plasma", we make a purifed plasma. From this Agilent poster:

Multi-Dimensional Workflow Approach for Human Plasma Analysis

I have this knowledge:

Plasma is a unique sample, possessing proteins that span the entire human proteome. Analysis of plasma can provide valuable information for the discovery of new biomarkers and novel drug targets. However, the tremendous complexity of the plasma proteome presents extreme analytical challenges in proteome characterization.

High abundant proteins comprise up to 90% of the total protein mass in the plasma. Agilent has developed a method to remove the top 7 high-abundant proteins in plasma. Then you are left with a sample of low abundance proteins for further analysis.

Agilent has a lot of equipment to characterize the low abundance proteins. And they have RESEARCH GRANTS!

Now I just need some scientists and a lab to my project proposal...