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Cellular Nitrogen and Energy Metabolism in ME/CFS

This project aims to test the nitrogen hypothesis, which is that damaging, nitrogen-containing by-products of energy metabolism accumulate more readily in the cells of ME/CFS patients.

  • Daniel Missailidis, PhD
  • Robert Phair, PhD
  • Paul Gooley, PhD
  • Sarah Annesley, PhD
  • Paul Fisher, PhD
  • Christopher Armstrong, PhD
  • Lymphoblasts are a more stable and strong cell type that appear appropriate for our metabolism studies.
  • Distinct lipid and amino acid profiles can be seen between ME/CFS and controls in lysed lymphoblasts. Paper in submission.
  • Drafting hypothesis paper.
  • Metabolite monitoring expanded broadly.
  • Data collection beginning on pediatric patient samples.
  • Assessing potential to add drugs directly to the cell culture to observe impact on energy production.

ME/CFS, a condition diagnosed by symptoms like extreme tiredness after exertion (known as post-exertional malaise), ongoing fatigue, and mental cloudiness or “brain fog,” may stem from a basic problem with how energy is made and used in the body.

We hypothesize that in ME/CFS, nitrogen compounds might be mishandled in immune cells because the mitochondria (energy factories of the cell) are using amino acids (building blocks of proteins) to make energy. To explore this idea, scientists will grow immune cells from blood samples and feed them special types of sugar, fats, and amino acids that can be tracked. This will allow them to see how the metabolism of these cells in ME/CFS patients is different from people without the condition.

This study uses innovative methods to deepen our understanding of ME/CFS and possibly uncover the root causes of its symptoms.


  1. Observe how amino acids are used by cells from ME/CFS patients compared to healthy controls.
  2. Observe how sugars are used by cells from ME/CFS patients compared to healthy controls.
  3. Observe how fats are used by cells from ME/CFS patients compared to healthy controls.
  4. Observe the usage rate of sugars, fats, and amino acids in ME/CFS and controls.
  5. Test the Nitrogen Hypothesis.


Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME / CFS) Post Treatment Lyme Disease Syndrome (PTLDS), Fibromyalgia Leading Research. Delivering Hope.Open Medicine Foundation®

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